In response to the continued
widespread outbreak of COVID-19, the AMA has revised one CPT code and
released two additional CPT codes to report and identify the presence
of COVID-19 antibodies
The new codes are effective April 10, 2020.
|86318 (REVISED)||Immunoassay for infectious agent antibody(ies), qualitative or semiqualitative, single step method (eg, reagent strip);|
|86328 (NEW)||Immunoassay for infectious agent antibody(ies), qualitative or semiqualitative, single step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])|
|86769 (NEW)||Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])|
CPT code 86328 was created to report qualitative or semi-qualitative testing
using a single-step method immunoassay.
CPT code 86769 was created to report an antibody test for COVID-19 using a multiple-step method.
The special CPT Assistant also provides clinical examples and FAQs. It can be accessed here: https://www.ama-assn.org/system/files/2020-04/cpt-assistant-guide-coronavirus-april-2020.pdf
In addition to these developments, the Coronavirus Aid, Relief and Economic Security Act (CARES Act) temporarily suspended the 2% sequestration (payment adjustment) applied to all Medicare Fee for Service Claims. The suspension is effective for claims with dates of service from May 1 through December 31, 2020.
We recommend referring to the CMS and other regulatory sites frequently as changes and updates are occurring rapidly. CMS has a dedicated page on their website for all emergency updates here: https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page
HBE is available to assist with remote outsource coding, training of your providers and staff, revenue cycle oversight as well as policy revisions, auditing and other compliance needs you may have. We will continue to monitor these important developments.
DISCLAIMER: This newsletter contains only summary information and highlights; it should be read in conjunction with the full article or document provided as a link. Any advice or recommendations given are general and specific questions should be directed to professional counsel.