COVID-19 codes - coronavirus diagnosis, testing and billing codes
Current ICD-10-CM, CPT® and HCPCS codes for Coronavirus [COVID-19] diagnosis and procedure/billing codes
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Coronavirus test CPT® code (effective 2/2/2020)
86328 Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])
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 (full)
86769 Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])
see also AMA Guidelines
Coronavirus test HCPCS codes (effective 2/4/2020)
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source
G2024 Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a SNF or by a laboratory on behalf of a HHA, any specimen source
Note: For additional information about coding these collection services, CLICK HERE.
U0001 CDC 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC
U0003 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, making use of high throughput technologies as described by CMS-2020-01-R.
U0004 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R.
Coronavirus ICD-10-CM codes (effective 4/1/2020)
U07.1 COVID-19, virus identified
- New Code Usage: Only use the new U07.1 code for confirmed cases — including patients that are not experiencing any symptoms. “If the provider documents "suspected," "possible," "probable," or “inconclusive” COVID19, do not assign code U07.1. Assign a code(s) explaining the reason for encounter (such as fever) or Z20.828, Contact with and (suspected) exposure to other viral communicable diseases.”
- Sequencing: Code U07.1 is a principal diagnosis and should be reported first on the claim unless this is an obstetric patient, in which case use a code from subcategory O98.5- “Other viral diseases complicating pregnancy, childbirth and the puerperium” first and then the U07.1 code. Any other manifestations/symptoms are reported after the principal diagnosis. They also noted that if the infection progresses to sepsis, “see Section I.C.1.d. Sepsis, Severe Sepsis, and Septic Shock.”
- Exposure: “For cases where there is a concern about a possible exposure to COVID-19, but this is ruled out after evaluation”, use code Z03.818 “Encounter for observation for suspected exposure to other biological agents ruled out.” For actual exposure to someone “who is confirmed or suspected to have COVID-19, and the exposed individual either tests negative or the test results are unknown”, use code Z20.828 “Contact with and (suspected) exposure to other viral communicable diseases.”
- Screening: For no known exposure and no symptoms, use code Z11.59 “Encounter for screening for other viral diseases”. For exposure or suspected exposure, see above.
Please see the link to the new guidelines in the References below for more complete information.
source ICD-10-CM Official Coding and Reporting Guidelines April 1, 2020 through September 30, 2020
Coding for COVID-19/Coronavirus
- CPT Coding Guidance on New Lab Codes for COVID-19 - April 13th, 2020
- ICD-10-CM Official Coding and Reporting Guidelines Updated for COVID-19 - April 8th, 2020
- Understand the New Codes for Testing & Reporting the COVID-19 Coronavirus (SARS-CoV-2) - March 21st, 2020
- Additional Coronavirus Testing Code Announced - March 17th, 2020
- CPT Coding Guidance on New Code for COVID-19 - March 16th, 2020
- Coronavirus - What in the World is it and How is it Coded? 2020-02-20 - March 2nd, 2020
CMS COVID-19/Coronavirus articles & information
CMS has recently released some important information on their last MLN, the highlights are below.
COVID-19: Dear Clinician Letter
CMS posted a letter to clinicians that outlines a summary of actions CMS has taken to ensure clinicians have maximum flexibility to reduce unnecessary barriers to providing patient care during the unprecedented outbreak of COVID-19. The summary includes information about telehealth and virtual visits, accelerated and advanced payments, and recent waiver information.
COVID-19: Non-Emergent, Elective Medical Services and Treatment Recommendations
Read more here
Supplier Education on Use of Upgrades for Multi-Function Ventilators
A new MLN Matters Special Edition Article SE20012 on Supplier Education on Use of Upgrades for Multi-Function Ventilators (PDF) is available.
Quality Payment Program:
Quality Payment Program COVID-19 Response Fact Sheet
Clinical Trial Participation for MIPS Credit
Participation Status Tool
MIPS extreme and uncontrollable circumstances application
Pneumococcal Pneumonia Vaccination: Eligibility Transactions Includes DOS Starting April 13
See the MLN Matters Article (PDF) for more information.
Accelerated/Advance Payment Program
CMS Approved Approximately $34 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers in One Week!
The fact sheet on the accelerated/advance payment process and how to submit a request can be found here: Fact Sheet (PDF). Providers can also contact their Medicare Administrative Contractor for any questions.
If you have any questions on the above information you can contact firstname.lastname@example.org or 866-288-8292 (Customers who are hearing impaired can dial 711 to be connected to a TRS communications assistant)
CMS Billing & coding guidance:
- Frequently Asked Questions to Assist Medicare Providers (PDF) UPDATED (4/11/20)
- CMS Dear Clinician Letter (PDF) (4/6/20)
- Fact sheet: Expansion of the Accelerated and Advance Payments Program for Providers and Suppliers During COVID-19 Emergency (PDF) (3/30/20)
- Fact sheet: Medicare Coverage and Payment Related to COVID-19 (PDF) UPDATED (3/23/20)
- Fact sheet: Medicare Telemedicine Healthcare Provider Fact Sheet (3/17/20)
- Medicare Telehealth Frequently Asked Questions (3/17/20)
- MLN Matters article: Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (PDF) (3/17/20)
- Frequently Asked Questions about Medicare Fee-for-Service Emergency-Related Policies and Procedures Without an 1135 Waiver (PDF) (3/16/20)
- Frequently Asked Questions about Medicare Fee-for-Service Emergency-Related Policies and Procedures With an 1135 Waiver (PDF) (3/16/20)
- Fact sheet: Medicare Administrative Contractor (MAC) COVID-19 Test Pricing (PDF) (3/13/20)
- Fact sheet: Medicaid and CHIP Coverage and Payment Related to COVID-19 (PDF) (3/5/20)
- COVID-19: New ICD-10-CM Code and Interim Coding Guidance (2/20/20)
- ICD-10 MS-DRGs Version 37.1 R1 Effective April 1, 2020 (4/1/20)
AMA's CPT® Assistant provides guidance for new COVID-19 codes
CPT Assistant is providing fact sheets for coding guidance for all new SARS-CoV-2 (COVID-19)-related testing codes.
The fact sheets include:
- Codes, descriptors and purpose
- Clinical examples
- Description of the procedures
Download the March 13, 2020 CPT Assistant guide (PDF)
Download the April 10, 2020 CPT Assistant guide (PDF)
Coding advice and testing guides
- Quick reference flow chart for CPT reporting for COVID-19 testing (PDF)
- Coding scenarios and how to apply best coding practices (PDF)
AMA COVID-19 Information
CPT © Copyright 2020 American Medical Association. All rights reserved. AMA and CPT are registered trademarks of the American Medical Association.
Telehealth changes/updates due in part to COVID-19/Coronavirus
- Find-A-Code article: More Telehealth Changes Announced by CMS - April 2nd, 2020
- Providing Telehealth Services During COVID-19 Crisis - March 30th, 2020
- Interprofessional Consult Services - March 27th, 2020
- Latest Covid-19 Information For Billing Non-Face-To-Face Services - March 26th, 2020
- COVID-19: Cybercrime, Telehealth, and Coding - March 25th, 2020
- Implementing Telehealth Visits - March 23rd, 2020