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Which CPT Codes are Used in COVID-19 Billing?

March 5, 2023 / Alex J. Lau / COVID, COVID Test Kits, COVID Testing Billing, COVID-19, COVID-19 Billing, COVID-19 Test Kit Reimbursement, COVID-19 Testing, COVID-19 Testing Billing
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Cpt Covid-19 Billing

Table of Contents

Toggle
  • Understanding CPT Codes
  • The CPT Codes Used in COVID-19 Billing
    • Specimen Collection
    • Laboratory Testing
    • Test Kit
  • Conclusion
  • COVID-19 CPT Code FAQs
      • Interested in Billing, Credentialing, and/or Contracting?

Covid-19 BillingThe COVID-19 pandemic has impacted the world significantly, causing widespread illness, death, and economic disruption. The virus, also known as SARS-CoV-2, primarily spreads through respiratory droplets when an infected person talks, coughs, or sneezes.

COVID-19 symptoms range from mild to severe and may include fever, cough, fatigue, body aches, loss of taste or smell, and difficulty breathing. While some people may have mild or no symptoms, others may experience severe illness and require hospitalization.

To control the spread of the virus, public health measures such as wearing masks, social distancing, and frequent hand washing have been recommended. Vaccines are also available to protect against COVID-19, and many countries have implemented vaccination campaigns to protect their populations. However, the pandemic continues to present challenges, including the emergence of new variants of the virus and vaccine hesitancy.

The ongoing efforts to control the pandemic require a coordinated global response, including continued research and development of treatments and vaccines, improved access to healthcare services, and effective communication to the public about the importance of preventive measures.

As the COVID-19 pandemic continues to impact the world, the demand for COVID-19 testing has increased significantly. The Centers for Medicare and Medicaid Services (CMS) has established Current Procedural Terminology (CPT) codes to bill for COVID-19 testing services. In this article, we will discuss which CPT codes are used in COVID-19 billing.

Understanding CPT Codes

Before discussing the specific CPT codes used for COVID-19 billing, it is essential to understand what CPT codes are. CPT codes are five-digit codes used to describe medical, surgical, and diagnostic services performed by healthcare professionals. These codes help healthcare providers and insurance companies to communicate the services provided and determine the reimbursement amount for those services.

The CPT Codes Used in COVID-19 Billing

The CMS has established several CPT codes that healthcare providers can use to bill for COVID-19 testing services. These codes describe the various aspects of the testing process, from specimen collection to laboratory testing to test kits.

Specimen Collection

The first step in COVID-19 testing is specimen collection. Healthcare providers can use the following CPT codes to bill for specimen collection:

  • 99211: This code is used for the evaluation and management of an established patient that requires a straightforward and brief service, such as a COVID-19 test.
  • 99212: This code is used for the evaluation and management of an established patient that requires a more complex and lengthy service, such as a COVID-19 test.

Laboratory Testing

After specimen collection, the next step is laboratory testing. The following CPT codes can be used for laboratory testing:

  • U0001: This code is used for COVID-19 testing services provided by the Centers for Disease Control and Prevention (CDC).
  • U0002: This code is used for COVID-19 testing services provided by laboratories certified under the Clinical Laboratory Improvement Amendments (CLIA).
  • 87635: This code is used for the laboratory testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and any pathogenic organisms that cause respiratory illness, including influenza.
  • 87426: This code is used for the laboratory testing of SARS-CoV-2 and influenza virus types A and B.

Test Kit

Healthcare providers can bill for the COVID-19 test kit separately from the specimen collection and laboratory testing. The following CPT code can be used for the COVID-19 test kit:

  • 86408: This code is used for the COVID-19 test kit.

Conclusion

COVID-19 testing is essential to control the spread of the virus, and healthcare providers need to understand the appropriate CPT codes to bill for these services. The CMS has established specific CPT codes for COVID-19 testing billing, including codes for specimen collection, laboratory testing, and the test kit itself. Healthcare providers must use these codes to bill accurately and receive appropriate reimbursement for their services.

COVID-19 CPT Code FAQs

  1. What is a CPT code?
    A CPT code is a five-digit code used to describe medical, surgical, and diagnostic services performed by healthcare professionals.
  2. Why are CPT codes important for COVID-19 testing?
    CPT codes are important for COVID-19 testing because they help healthcare providers and insurance companies communicate the services provided and determine the reimbursement amount for those services.
  3. How many CPT codes are used for COVID-19 test kit billing?
    Several CPT codes are used for COVID-19 test kit billing, including codes for specimen collection, laboratory testing, and the test kit itself.
  4. Can healthcare providers bill for COVID-19 test kit separately?
    Yes, healthcare providers can bill

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    Alex J. Lau
    Alex J. Lau

    Co-Founder and COO of Medwave, bringing more than 30 years of hands-on experience in healthcare revenue cycle management, payer contracting, and medical credentialing.

    Billing, Coronavirus, COVID CPT, COVID CPT-10, COVID-19, COVID-19 billing, COVID-19 CPT, COVID-19 testing, COVID-19 Testing Billing, CPT, CPT codes, CPT-10, Healthcare, Healthcare Billing, Medical Billing, Medical Billing Service

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