AMA updates billing codes for COVID-19

Sept. 11, 2020

The American Medical Association (AMA) published an update to the Current Procedural Terminology (CPT) code set that includes two codes related to COVID-19, including one for antibody testing, according to an AMA press release.

The AMA said the updated codes have been approved by the CPT Editorial Panel, the independent body convened by the AMA with authority to expedite the review of proposed modifications and additions to the CPT code set. The two additions to the CPT code set have been approved for immediate use.

CPT code 86413 allows for reimbursement of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies, as opposed to a qualitative assessment (positive/negative) of SAR-CoV-2 antibodies provided by laboratory tests, which are reported by other CPT codes. By measuring antibodies to SARS-CoV-2, the tests reported by 86413 can investigate a person’s adaptive immune response to the virus and help access the effectiveness of treatments used against the infection, the AMA said.

Earlier this year, the AMA also added CPT code 87635 for “infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique.”

Meanwhile the second new code, CPT code 99072, is for evaluation, treatment or procedural services. It allows providers to be reimbursed for the costs associated with the additional supplies, materials, and clinical staff time necessary to ensure the safety of patients and staff during an office visit or other non-facility service during the public health emergency.

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