New CPT CODES as COVID-19 Headways Extend
Early in the spread of the pandemic, it became clear that medical approaches, as well as tests for the virus and eventually medicines and vaccines, would be developing and changing, which meant medical billing codes would have to be modified to allow practitioners to get paid appropriately.
CPT code additions to cover testing for the SARS-CoV-2 coronavirus began going into effect in March of 2020. Testing for the virus, treatment of infected patients, virtual exams and follow-ups, and increased care requirements have all required new medical billing codes. These are two of the more recent ones.
CPT Code 99072 description for Extra Time and Materials for Additional Safety Protocols
It became clear early on that medical care facilities could easily become a prime location for uninfected patients to come into contact with the coronavirus; but unlike restaurants and theaters, medical facilities can’t just be shut down.
Extensive precautions were put in place to keep from infecting patients and to keep infected patients from spreading the virus to health care staff. This required the use of additional supplies for sanitation and a lot of time to make sure all the safety protocols were followed. This new medical billing code allows providers to be compensated for the extra work and materials.
Limitations on the use of the code are specified in the 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 wording makes it clear that the code only applies during a legal public health emergency.
While it does not limit the use of the medical billing code to the SARS-CoV-2 virus or COVID-19, it does include the limitation that the state of emergency is due to infectious disease that is respiratory-transmitted. The code is broad in that it covers supplies and staff time, including evaluation, treatment, and procedures where additional precautions are in place to protect health care professionals and patients, but it can only be used under this particular circumstance.
CPT Code 86413 for Antibody Quantitative Testing
This code differentiates billing for quantitative antibody detection from the existing codes which cover qualitative assessment that only gives a positive or negative result for the presence of SARS-CoV-2 antibodies.
The code description is: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative. The quantitative aspect of the test gives insight into the immune response to the virus and also helps in assessing how effective treatments are.
Codes Approved for Immediate Use
When new medical billing codes were initially introduced for dealing with COVID-19, a future “effective date” was specified. This resulted in confusion between patients, providers, and insurers as to what was covered because claims for services that were given after the code was issued, but before the effective date of the new code were denied. Both these new codes were issued as “effective immediately,” so that problem will not recur.
Medcare MSO focuses our business entirely on medical revenue cycle management (RCM). Our extensive staff of medical billers includes specialists in many different areas of medicine, including COVID-19. Give us a call today at 800-640-6409 to find out just how affordable our services are, and how much we can help you streamline your revenue process.