Significant COVID-19 Code Changes as of October 6

October 8th, 2020 - Wyn Staheli, Director of Research

Categories: Covid-19 CPT^® Coding Modifiers

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.

###

Questions, comments?

If you have questions or comments about this article please contact us. Comments that provide additional related information may be added here by our Editors.

Latest articles: (any category)

Artificial Intelligence in Healthcare - A Medical Coder's Perspective
December 26th, 2023 - Aimee Wilcox

We constantly hear how AI is creeping into every aspect of healthcare but what does that mean for medical coders and how can we better understand the language used in the codeset? Will AI take my place or will I learn with it and become an integral part of the process that uses AI to enhance my abilities?

Specialization: Your Advantage as a Medical Coding Contractor
December 22nd, 2023 - Find-A-Code

Medical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.

ICD-10-CM Coding of Chronic Obstructive Pulmonary Disease (COPD)
December 19th, 2023 - Aimee Wilcox

Chronic respiratory disease is on the top 10 chronic disease list published by the National Institutes of Health (NIH). Although it is a chronic condition, it may be stable for some time and then suddenly become exacerbated and even impacted by another acute respiratory illness, such as bronchitis, RSV, or COVID-19. Understanding the nuances associated with the condition and how to properly assign ICD-10-CM codes is beneficial.

Changes to COVID-19 Vaccines Strike Again
December 12th, 2023 - Aimee Wilcox

According to the FDA, CDC, and other alphabet soup entities, the old COVID-19 vaccines are no longer able to treat the variants experienced today so new vaccines have been given the emergency use authorization to take the place of the old vaccines. No sooner was the updated 2024 CPT codebook published when 50 of the codes in it were deleted, some of which were being newly added for 2024.

Updated ICD-10-CM Codes for Appendicitis
November 14th, 2023 - Aimee Wilcox

With approximately 250,000 cases of acute appendicitis diagnosed annually in the United States, coding updates were made to ensure high-specificity coding could be achieved when reporting these diagnoses. While appendicitis almost equally affects both men and women, the type of appendicitis varies, as dose the risk of infection, sepsis, and perforation.

COVID Vaccine Coding Changes as of November 1, 2023
October 26th, 2023 - Wyn Staheli

COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.

Medicare Guidance Changes for E/M Services
October 11th, 2023 - Wyn Staheli

2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....