Updated CPT Codes for COVID-19

At times when COVID hit the world, it became clear that medical billing service methods, tests, medicines, and vaccines will be evolving and changing from time to time. This is why medical codes needed revision so that the practitioners will get paid according to the services they provide.

CPT code additions that began going into effect in March 2020 will cover testing for SARS-CoV-2. Every service now requires unique codes to process claims like for testing for the virus, treatment of infected patients, follow-ups, extensive care requirements all require unique codes.


CPT Code 99072 for Additional Cost of Materials and Time

Medical care facilities were vulnerable to the virus, uninfected people were most likely to get infected from coronavirus but the problem stands that unlike educational institutes, theaters, and restaurants medical facilities cannot just shut down.

To counter and protect people associated with medical facilities, extensive precaution was set into place in order to keep the virus away from the medical staff while giving care and treatment to the patients that were infected. These precautions included a great use of sanitation products and a lot of time to ensure the safety protocols were followed. The new codes are meant to give more payout to the providers as they are using a lot of material to protect themselves which costs them a lot.

There are limits that these codes specific which includes in the following description “Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease.” The description states clearly that these codes are meant to be used when a public emergency is inbound.


CPT Code 86413 for Antibody Quantitative Testing

This one code is assigned to differentiate billing for quantitative antibody detection from the existing codes and this covers only qualitative assessment that only opts out a negative or positive result for COVID-19 antibodies.


The description of this code is “Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative” the quantitative aspect of the test allows practitioners to look insight into the immune response to the virus and aids in assessing how the treatment is effective.


Codes Were Approved to be Used Immediately

Initially, when codes were introduced for COVID-19, the codes were labeled and specified with a future “effective date”. This created a lot of confusion between providers, patients, and insurers because the claims for the services were submitted after the codes were issued but the claims before the effective date that were submitted were declined. To encounter this issue these codes were labeled as “effective immediately” so that the problem doesn’t occur again.

Our company Themedicalbilling.net keeps our systems updated with every coding system to ensure that every claim is submitted according to it to avoid claim denials. Give us a call today if you have any queries or want us to handle your finance. Our certified staff will provide seamless coding and billing service so that you get maximum revenue while focusing more on patient care.


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