Significant COVID-19 Code Changes as of October 6

October 8th, 2020 - Wyn Staheli, Director of Research
Categories:   Covid-19   CPT® Coding   Modifiers  
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On October 6, 2020, the AMA announced some significant modifications to the CPT code set as part of ongoing efforts to meet the challenges of COVID-19. Find-A-Code has updated their website with these changes, but it should be noted that at the time of publication of this article, some of the descriptions (e.g., medium length) had not yet been posted by the AMA. They will be added when they are available.

Codes 87301-87899 have all been revised. Microbiology testing codes 87301-87449 have been revised as follows (green is new, strikeout is removed):

Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method;

Codes 87802-87889 have been revised as follows:

Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; 

Code 87450 was deleted and codes 87635, 87636, 87637 have been added. However, the most significant changes are in the guidelines for “Infectious agent antigen detection by immunofluorescent technique” codes. The following paragraphs show these changes (green is new, strikeout is removed):

These codes are intended for primary source only. For similar studies on culture material, refer to codes 87140-87158. Infectious agents by antigen detection, immunofluorescence microscopy, or nucleic acid probe techniques should be reported as precisely as possible. The molecular pathology procedures codes (81161, 81200-81408) are not to be used in combination with or instead of the procedures represented by 87471-87801. The most specific code possible should be reported. If there is no specific agent code, the general methodology code (eg, 87299, 87449, 87450, 87797, 87798, 87799, 87899) should be used. For identification of antibodies to many of the listed infectious agents, see 86602- 86804. When separate results are reported for different species or strain of organisms, each result should be coded separately. Use modifier 59 when separate results are reported for different species or strains that are described by the same code.

When identifying infectious agents on primary source specimens (eg, tissue, smear) microscopically by direct/indirect immunofluorescent assay [IFA] techniques, see 87260-87300. When identifying infectious agents on primary source specimens or derivatives via non-microscopic immunochemical techniques with fluorescence detection (ie, fluorescence immunoassay [FIA]), see 87301-87451, 87802-87899. When identifying infectious agents on primary source specimens using antigen detection by immunoassay with direct optical (ie, visual) observation, see 87802-87899.

According to the October CPT Assistant, there has been some confusion about different testing methods (i.e.,  immunofluorescent technique, direct optical observation, and single-step versus multiple-step techniques). Please be sure to review the CPT Assistant to gain a better understanding of these differences.

Please be sure to update your records with this information. We have updated our free COVID-19 card.

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