Should CPT code 87635 , a HCPCS Level II code, or both be reported if the test for COVID-19 is performed? ...
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Article Overview
This premium article covers general reporting guidance for COVID-19 test claims when different payers require different code sets. It is aimed at coders, billing staff, and compliance teams who need to understand which governing source to follow and why payer-specific instructions matter. The article also points readers to CMS guidance for additional context on HCPCS Level II reporting.
Why This Topic Matters
COVID-19 testing claims may be processed under different payer rules, so understanding which code set a payer expects can affect claim accuracy and acceptance. This article helps readers identify the type of guidance they need without substituting for the payer’s own instructions.
What You Will Learn
- How payer-specific reporting requirements affect COVID-19 test claim coding
- When to look to CPT guidance versus HCPCS Level II guidance
- Why local payer instructions and CMS resources may be relevant
- How the article frames the relationship between multiple code sets for the same test scenario
Who Should Read This
- Medical coders
- Billing specialists
- Compliance staff
- Practice managers
- Revenue cycle professionals
Codes Discussed
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