icd 10 code for covid testing

by Prof. Forest Skiles V 8 min read

Diagnosis Coding. Effective April 1, 2020, a new ICD-10-CM diagnosis code chapter, Chapter 22 Codes for Special Purposes (U00-U85) and new code U07. 1 COVID-19 was made available for reporting the coronavirus diagnosis.Oct 19, 2020

What is the COVID-19 PCR diagnostic test?

PCR test: Stands for polymerase chain reaction test. This is a diagnostic test that determines if you are infected by analyzing a sample to see if it contains genetic material from the virus.Jan 21, 2022

How many COVID-19 tests can I get reimbursed for?

Health plans must cover 8 individual at-home over-the-counter COVID-19 tests per person enrolled in the plan per month. That means a family of four can get 32 tests per month for free.Jan 12, 2022

What is the difference between a PCR test and a rapid COVID-19 test?

“Unlike the PCR test, the antigen test can only determine if you have an active virus in your body. The rapid test can't detect small amounts of the virus or asymptomatic cases as accurately as the PCR test can,” Heather said. The rapid test is less accurate and there is a greater chance for a false negative.Feb 9, 2022

Can a person test negative and later test positive for COVID-19?

It is possible for this test to give a negative result that is incorrect (false negative) in some people with COVID- 19. This means that you could possibly still have COVID- 19 even though the test is negative. The amount of antigen in a sample may decrease the longer you have symptoms of infection.Apr 4, 2022

What if I buy more than one COVID-19 test at a time?

See full answerYour plan is required to provide reimbursement for 8 tests per month for each individual on the plan, regardless of whether the tests are bought all at once or at separate times throughout the month.If your plan has set up a network of convenient options such as pharmacies and retailers, in which individuals can get their tests’ cost covered up front (at the point of sale) then the plan is permitted to limit the reimbursement for tests purchased outside of their network to $12 per test (or the actual price of the test, if less than $12). If more than one test is purchased or ordered at a time, such as a package with two tests in it, then the insurer would reimburse up to $12 for each of the tests purchased at that time.Jan 12, 2022

Will I have to pay for my COVID-19 test up front?

See full answerThe Biden-Harris Administration is strongly incentivizing health plans and insurers to set up a network of convenient locations across the country such as pharmacies or retailers where people with private health coverage will be able to order online or walk in and pick up at-home over-the-counter COVID-19 tests for free, rather than going through the process of having to submit claims for reimbursement. Consumers can find out from their plan or insurer if it provides direct coverage of over-the-counter COVID-19 tests through such a program or whether they will need to submit a claim for reimbursement. If you are charged for your test after January 15, keep your receipt and submit a claim to your insurance company for reimbursement.Jan 12, 2022

Which COVID-19 tests are more accurate PCR or antigen tests?

PCR tests are more accurate than antigen tests. "PCR tests are the gold standard for detecting SARS-CoV-2," says Dr. Broadhurst. "It is the most accurate testing modality that we have.Dec 29, 2021

What is the rapid COVID-19 test?

Rapid Point-of-Care tests, test performed or interpreted by someone other than the individual being tested, can be performed in minutes and can include antigen and some NAATs. Self-tests are rapid tests that can be taken at home or anywhere, are easy to use, and produce rapid results. Laboratory tests can take days to complete and include RT-PCR and other types of NAATs.Watch Video: Viral Test for COVID-19 [00:01:08] Antibody Tests An antibody test (also known as a serology test) can detect

What kind of tests are used to see if you have COVID-19?

Diagnostic tests can show if you currently are infected with SARS-CoV-2, the virus that causes COVID-19. There are two types of COVID-19 diagnostic tests: Molecular tests, such as polymerase chain reaction (PCR) tests. Antigen tests, often referred to as rapid tests.Feb 28, 2022

What are consequences of a false negative COVID-19 test?

Risks to a patient of a false negative test result include: delayed or lack of supportive treatment, lack of monitoring of infected individuals and their household or other close contacts for symptoms resulting in increased risk of spread of COVID-19 within the community, or other unintended adverse events.Jul 21, 2021

How long does it take to show symptoms after you have been exposed to COVID-19?

Symptoms may appear 2-14 days after exposure to the virus. If you have fever, cough, or other symptoms, you might have COVID-19.

How long does it take to develop immunity after a COVID-19 infection?

Although the immune correlates of protection are not fully understood, evidence indicates that antibody development following infection likely confers some degree of immunity from subsequent infection for at least 6 months.

Insurance Coverage

  • CMS requires group and individual health plans to cover visits that result in the administration of COVID-19 testing provided on or after March 18, 2020 without prior authorization or cost-sharing, including telehealth and non-traditional care settings, such as drive-through COVID-19 screening sites.
See more on acog.org

Diagnosis Coding

  • Effective April 1, 2020, a new ICD-10-CM diagnosis code chapter, Chapter 22 Codes for Special Purposes (U00-U85) and new code U07.1 COVID-19was made available for reporting the coronavirus diagnosis.
See more on acog.org

Swab Collection

  • There is no specific code for swabbing the enduring for COVID-19. Swab collection is included in E/M service. However, if collected in the office and transported to the laboratory, CPT code 99000 can be billed: 1. 99000: Handling and/or conveyance of specimen for transfer from office to a laboratory
See more on acog.org

Laboratory

  • There are three codes for COVID-19 testing: 87635 is designed to detect the COVID-19 virus and effective March 13, 2020, and 86328 and 86769 will be used to identify the presence of antibodiesto the COVID-19 virus and are effective April 10, 2020. Please note that all aforementioned changes are not included in CPT 2020 code set. They will be included in CPT 20…
See more on acog.org

In-Person Office Visits

  • The American Medical Association has created a billing code to reimburse for the additional supplies and clinical staff time required to mitigate transmission of respiratory infectious disease while providing evaluation, treatment, or procedural services during a public health emergency in the outpatient office setting. CPT® code 99072 can be utilized by all payers, although there has …
See more on acog.org

Additional Resources

Payer Resources

  • Private payers continue to update their policies as the COVID-19 public health crisis. To check each payer’s most updated policy changes in relation to the billing and coding for telehealth and COVID-19, please visit the payer’s website.
See more on acog.org