BC Advantage - 2020 Issue 3
CMS Develops Additional Code for Coronavirus Lab Tests
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Article Overview
This article explains CMS actions related to COVID-19 testing, including the addition of a new HCPCS billing code and accompanying coverage guidance from CMS. It also summarizes related fact sheets for Medicare, Medicaid, CHIP, and individual/small group market coverage, making it relevant for laboratories, billing staff, compliance teams, and healthcare organizations tracking federal response updates.
Why This Topic Matters
It helps readers understand the federal coding and coverage updates tied to COVID-19 diagnostic testing and broader CMS public health guidance.
Article Sections
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CMS action on COVID-19 lab testing
Overview of CMS’s response measures related to coronavirus testing and laboratory billing. Introduces the new coding and coverage context addressed in the article.
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HCPCS coding update and billing timing
Discusses the newly developed HCPCS billing code and related operational details for claims processing. Also notes the roles of Medicare contractors and the timing for claims acceptance.
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CMS fact sheets and coverage highlights
Summarizes the fact sheets CMS released on coverage topics across Medicare, Medicaid, CHIP, and private insurance markets. Covers the broad categories of services and benefits discussed in the article.
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Summary of CMS public health action on COVID-19 to date
Lists prior CMS public health actions and related announcements concerning COVID-19. Provides a chronological recap of agency communications and resources.
What You Will Learn
- How CMS updated its HCPCS coding approach for coronavirus laboratory testing
- What general coverage topics CMS addressed in its COVID-19 fact sheets
- Which CMS program areas and stakeholders are affected by the guidance
- How CMS framed its broader public health response activities related to COVID-19
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Clinical laboratories
- Healthcare compliance teams
- Hospital and facility administrators
- Payer and health plan staff
Codes Discussed
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