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).

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. 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).

To accommodate this revision, new code 87811 was developed 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).

Read the AMA Press Release for more information (2020).

Additional New CPT Codes Released for COVID-19

Review these additional CPT codes that were released to report COVID-19 tests:

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

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

covid-19 respiratory hot topics webinarDo you want to learn the ICD-10-CM coding guidelines for COVID-19 code U07.1? Sign up for our Respiratory Diagnoses Hot Topics Webinar and find out how to code Coronavirus infections, symptoms, screening, and patient encounters. The webinar on hot coding topics provides an overview of the Official Coding Guidelines for COVID-19. See more here.

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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