Billing and Coding

*New* Fact Sheet Medicare PFS
Proposed rule for 2021_08.03.20
*New* COVID-19 End Date and Billing Guidance
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Quick Links:

Virtual Evisits - Telehealth Guide 

MGMA COVID-19 Cheat Sheet

Shifting your medical coding staff to remote work during the COVID-19 pandemic from MGMA

Coding guidance for new ICD-10-CM and lab testing codes for COVID-19

ICD-10-CM Official Coding and Reporting Guidelines April 1, 2020 through September 30, 2020

CMS has issued another round of sweeping rule changes and regulatory waivers, giving physicians, hospitals and other healthcare organizations greater flexibility in responding to the COVID-19 pandemic.

 

From the AMA NEW CPT® CODE ANNOUNCED TO REPORT NOVEL CORONAVIRUS TEST
The American Medical Association (AMA) announced that the CPT® Editorial Panel approved a new addition to the Current Procedural Terminology (CPT®) code set that will help streamline data-driven resource planning and allocation in the battle against the novel coronavirus (SARS-CoV-2) as the number of confirmed COVID-19 cases continues to rise.

For quick reference, the new Category I CPT code and descriptor are:
l 87635 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.

The code is effective immediately for use as the industry standard for reporting of tests for the novel coronavirus across the nation’s health care system. In addition to the long descriptor, CPT code 87635 has short and medium descriptors that can be accessed on the AMA website.

Please note that, per the standard early release delivery process for CPT codes, you will need to manually upload this code descriptor into your EHR system. This CPT code will arrive as part of the complete CPT code set in the data file for 2021 later this year. To read the full press release click here.
 

AMA RELEASES SPECIAL CODING ADVICE RELATED TO COVID-19

New guidance from the AMA provides special coding advice during the COVID-19 public health emergency. One resource outlines coding scenarios designed to help health care professionals apply best coding practices. The scenarios include telehealth services for all patients.

Examples specifically related to COVID-19 testing include coding for when a patient:

  • comes to the office for an E/M office visit and is tested for COVID-19
  • receives a telehealth visit regarding COVID-19
  • is directed to come to a physician’s office or physician’s group practice site for testing
  • receives a virtual check-in/online visit regarding COVID-19 (not related to an E/M visit)
  • is directed to come to a physician's office for testing

There is also a quick-reference flowchart that outlines Current Procedural Terminology (CPT®) reporting for COVID-19 testing. A new web page on the AMA site also outlines CMS payment policies and regulatory flexibilities related to COVID-19. Check the AMA COVID-19 resource center to stay up to date and for additional resources.

From the American Medical Association 
The American Medical Association (AMA) announced that the CPT Editorial Panel approved a new addition to the Current Procedural Terminology (CPT®) code set that will help streamline data-driven resource planning and allocation in the battle against the novel coronavirus (SARS-CoV-2) as the number of confirmed COVID-19 cases continues to rise.


For quick reference, the new Category I CPT code and descriptor are:

87635

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

The code is effective immediately for use as the industry standard for reporting of tests for the novel coronavirus across the nation’s health care system. In addition to the long descriptor, CPT code 87635 has short and medium descriptors that can be accessed on the AMA website