AMA releases new CPT code for COVID-19 testing

March 16, 2020
Medicare Web

The American Medical Association (AMA) announced Friday that its CPT® Editorial Panel expedited approval of a unique CPT code to report laboratory testing services for COVID-19. The new code supports the urgent public health need for streamlined reporting of testing for the novel coronavirus.

Effective March 13, hospitals, health systems, and laboratories may use new CPT code 87635 (infectious agent detection by nucleic acid [DNA or RNA]; severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [COVID-19), amplified probe technique) to report testing for COVID-19. Healthcare professionals may contact third-party payers to determine their guidelines regarding applicability for retroactive billing and reimbursement.

Physicians and health systems must manually upload this code descriptor into their electronic health record systems. The new code will be published in the Pathology and Laboratory section of the 2021 CPT code set, anticipated for release later this year.

The AMA published a special edition CPT Assistant fact sheet with coding guidance for reporting CPT code 87635, as well as HCPCS Level II codes that may be used in conjunction with or in place of 87635 to describe testing for COVID-19.

The fact sheet includes:

  • Clinical examples
  • Description of the procedure
  • FAQs