Medical coding is a standardized method to assign alphanumeric codes for medical diagnostics, surgical and external procedures to generate billing for an episode of care. Medical coding professionals translate the medical records and providers’ notes to create a claim to send to insurance carriers as a part of the medical billing process.
Under the changed circumstances due to the current Coronavirus outbreak, new COVID-19 specific codes have become necessary. AMA President Patrice A. Harris, M.D. noted that “equipping a health care workforce to accurately code medical procedures streamlines communication across the health system, reducing administrative and rework costs at a time when resources are stretched by the COVID-19 pandemic.”
New codes for the testing of the Coronavirus also allows for the reporting and analysis of data to help providers and payers overcome the challenges associated with COVID-19. Officials will be able to use this data to assist in the nation’s response to a public health pandemic.
Following the World Health Organization’s declaration of the Novel Coronavirus as a pandemic, the CDC announced the addition of the new ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) emergency code, U07.1: 2019-nCoV acute respiratory disease, for the diagnosis of COVID-19. The CDC explained a new diagnosis code will be implemented on October 1, 2020, with the next update.
The AMA announced new CPT ® (Current Procedural Terminology) codes to streamline the testing of the novel coronavirus. CPT code 87635, used for infectious agent detection by nucleic acid, was announced and became effective March 13, 2020. This code should be used when a healthcare provider determines if a patient has the symptoms compatible with the Coronavirus and collects a respiratory swab to send to the lab.
The CPT codes 86318, 86328, and 86769 were announced and became effective April 10, 2020. These codes are used for antibody tests using a single-step method, nucleic acid tests, and antibody tests using a multiple-step method, respectively.
The AMA listed various scenarios for professionals to compare and determine which CPT code fits the situation best.
The Centers for Medicare and Medicaid Services (CMS) ensured that their facilities were prepared to deal with the Coronavirus outbreak by creating an HCPCS (Healthcare Common Procedure Coding System) code allowing labs to bill for COVID-19 testing. The code U0001, created in February, is specifically for CDC testing laboratories while the code U0002 is for laboratories outside of the CDC to bill for the testing of COVID-19.
These codes became effective April 1, 2020, for service dates following February 4, 2020. The hope of CMS is that these codes will aid in the tracking of the Novel Coronavirus.