icd 10 code for pre procedure covid testing

by Ms. Salma Olson 5 min read

What is a PCR test in the context of COVID-19 testing?

A 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

What is the procedure for a COVID-19 test?

For a COVID-19 diagnostic test, you provide a sample of mucus from your nose or throat, or a sample of saliva. The sample needed for diagnostic testing may be collected at your doctor's office, a health care facility or a drive-up testing center.Feb 23, 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

How accurate are COVID-19 PCR tests?

PCR tests are very accurate when properly performed by a health care professional, but the rapid test can miss some cases.Feb 23, 2022

What types of COVID-19 tests are available in the US?

Diagnostic tests can show if you have an active COVID-19 infection. Antibody or serology tests look for antibodies in a blood sample to determine if an individual has had a past infection with the virus that causes COVID-19 but cannot be used to diagnose current COVID-19 infection.Mar 31, 2022

What can I expect from a COVID-19 diagnostic test?

For a COVID-19 diagnostic test, a health care professional takes a sample of mucus from your nose or throat, or a sample of saliva. The sample needed for diagnostic testing may be collected at your doctor's office, a health care facility or a drive-up testing center.Feb 23, 2022

How should you take a COVID-19 rapid test?

Please don't go sticking that #COVID19 testing swab down your throat. Use swabs as instructed: via the nose. FACT: When it comes to at-home rapid antigen #COVID19 tests, those swabs are for your nose and not your throat.Jan 11, 2022

How long does it take to get results for a COVID-19 antigen test?

This COVID-19 test detects certain proteins in the virus. Using a long nasal swab to get a fluid sample, some antigen tests can produce results in minutes. Others may be sent to a lab for analysis.Feb 23, 2022

Insurance Coverage

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.
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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
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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 includ...
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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 …
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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.
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