Medical Coding & Billing Tips for COVID-19

Medical Coding & Billing Tips for COVID-19

With the number of COVID-19 (2019-Novel Coronavirus) cases expected to rise in North America, the Centers for Medicare & Medicaid Services (CMS) has provided information on how to medically code and bill all encounters related to COVID-19 for Medicare beneficiaries (CMS, 2020).

Do you want to learn how to apply the new 2022 ICD-10 COVID-19 codes? Sign up for our COVID-19 ICD-10 Coding Learning Path and find out how to code Coronavirus infections, symptoms, screening, post-COVID-19 condition, treatments and vaccines. The webinar provides an update to the FY2022 Official Coding Guidelines for COVID-19.

Here are the latest medical coding tips and billing updates:

• The Healthcare Common Procedure Coding System (HCPCS) code U0001 will cover the tests and track emerging cases (CMS, 2020). Providers can start using this code on April 1 for services dated February 4 and later.
• The second HCPCS code U0002 includes non-CDC lab tests for SARS-CoV-2/2019-nCoV (COVID-19) (CMS, 2020). Providers can start using this code on April 1 for services dated February 4 and later.
• The payment amount for U0001 and U0002 claims will be determined by Medicare Administrative Contractors (MAC). By their local jurisdictions until a national rate is established by Medicare (CMS, 2020). Providers can consult their local MAC for payment estimates before submitting a billing claim.
• If a Medicare beneficiary is placed in quarantine as a medical necessity – but does not require acute inpatient care. Medicare will cover any cost outliers and the provider’s diagnosis-related group rate while the patient remains in the quarantine (The National Law Review, 2020).
• Providers with private and semiprivate rooms are not permitted to charge a differential for a private room that is deemed a medical necessity (CMS, 2020).
• There will be no additional deductible if a patient elects to remain in the hospital under quarantine. Even if he or she would have otherwise been discharged (CMS, 2020).

Codes & Guidelines

• The American Medical Association (AMA) has released a new CPT code to streamline COVID-19 tests from providers (AMA, 2020). CPT code 87635 has short, medium, and long descriptors that can be found on the AMA website.
• Additional coding guidelines for COVID-19 have been established by the CDC (2020). The effective date of ICD-10-CM code U07.1 for COVID-19-related diagnoses is being fast-tracked to April 1. CDC UPDATE 3/18/2020: “New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), April 1, 2020.” For a more in-depth review of the new ICD-10 code for COVID-19, as well as historical background on the virus, read our latest article, “Coding for Coronavirus Outbreak: Interim Guidance from the CDC.”

Need Training?

Do you want to learn how to apply the new 2022 ICD-10 COVID-19 codes? Sign up for our COVID-19 ICD-10 Coding Learning Path. Find out how to code Coronavirus infections, symptoms, screening, post-COVID-19 condition, treatments and vaccines. The webinar provides an update to the FY2022 Official Coding Guidelines.