COVID-19 Antigen Testing Code 87426 Available for Immediate Use from AMA
The American Medical Association (AMA) has released a new code for antigen testing of patients suspected to have been infected with COVID-19 (AMA, 2020). The CPT code for antigen testing was approved at a special meeting of the CPT Editorial Panel and released with a June 25, 2020, effective date. The special meeting and action by AMA was designed to react rapidly to the urgent need for the code. AMA President Susan R. Bailey M.D. commented, “Moving quickly during this crisis to meet the medical coding needs of the health care industry has enhanced the reporting of innovative tools now available to advance medicine’s overarching goals of reducing the COVID-19 disease burden, improving health outcomes and reducing long-term care costs” (AMA, 2020).
The code, 87426, represents antigen tests using an immunofluorescent or immunochromatographic technique for the detection of biomolecules produced by the SAR-CoV-2 virus (COVID-19). Antigen testing is intended to be easier and quicker than other COVID-19 testing and can be conducted at the point of care. It is expected that this code will be the industry standard for reporting and tracking of antigen tests.
The long descriptor for the new antigen testing code is:
87426 – “Infectious agent antigen detection by immunoassay technique, (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19])” (AMA, 2020).
AMA released additional CPT codes for COVID-19 testing in March and April 2020. On April 10, 2020, 2 new antibody testing codes were released. See a description of these codes in our article, “AMA Releases Two New CPT Codes for COVID-19 Antibody Detection.”
A new code for laboratory testing for COVID-19 was released on March 13, 2020. Detailed information on this change is explained in our article, “Selecting the Right COVID-19 Code: Should You Use CPT or HCPCS?”
As these new antigen testing codes have developed, they have been effective immediately to allow for the tracking of testing for COVID-19. Additional information about the new antigen testing code 87426 is available in a special edition of CPT Assistant for June 2020 (AMA, 2020). Also included in the special edition is information on two new Proprietary Laboratory Analyses (PLA) codes: 0223U and 0224U. There are clinical examples and descriptions of all three codes included in the CPT Assistant.
The CPT Editorial Panel will continue to monitor updates in the clinical indications for these antigen tests as knowledge of COVID-19 evolves. Clarification will be provided if additional information becomes available.