New CPT Codes Released & Revised to Document COVID-19 & Respiratory Syncytial Virus Detection Test

New CPT Codes Released & Revised to Document COVID-19 & Respiratory Syncytial Virus Detection Test

In continuing response to the COVID-19 pandemic, AMA has released two new CPT codes that allow for nucleic acid infectious agent detection for Coronavirus, influenza types A and B, and respiratory syncytial virus (RSV) via a single test (AMA, 2020).

Furthermore, the effective date of these new viral tests codes is October 7, 2020:

87636 – “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique” (AMA, 2020).

87637 – “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique” (AMA, 2020).

Revisions to CPT codes in the 87301-87430 series were also included to remove the term “multi-step method” from the codes. Additionally, this clarifies that these antigen tests are read by machine vs. interpreted visually. This revision was also made to code 87426.

87426 – “Infectious agent antigen detection by immunoassay technique, (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19])” (AMA, 2020).

Furthermore, to accommodate this revision, the AMA developed new code 87811 for antigen test detection with direct visual observation.

87811 – “Infectious agent antigen detection by immunoassay with direct optical (i.e., visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])” (AMA, 2020).

Additionally, you can read the AMA Press Release for more information (2020).

Additional New CPT Codes Released for COVID-19

In addition, review these additional CPT codes that were released to report COVID-19 tests:

ICD-10-CM/PCS Codes Released for COVID-19

Also, review these other ICD-10-CM/PCS codes to document COVID-19 symptoms, infections, tests, and more:

covid-19 and telehealth course

In addition, do you need to learn how to code the COVID-19 vaccines or telehealth services? You can also enroll in the latest CPT Hot Topics learning series from YES HIM Education. Additionally, this series dives into the HCPCS/CPT codes and guidelines for COVID-19 monoclonal antibodies, COVID-19 vaccines, and telehealth. We also discuss payment policies for all three topics.

Ann Zeisset, RHIT, CCS, CCS-P, co-authored this article with Teri Jorwic, MPH, RHIA, CCS, CCS-P, FAHIMA.

Teri Jorwic

Contract Educator, MPH, RHIA, CCS, CCS-P, FAHIMA
respiratory syncytial virus

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