Coding Guidelines for Coronavirus for Medicare Beneficiaries


In the 2nd seven-day stretch of Walk 2020, Congress passed the Coronavirus Preparedness and Response Supplemental Appropriations Act. The legislation will permit physicians and other health care professionals to charge Medicare expense for-administration for understanding care conveyed by telehealth during the current coronavirus public health emergency. What's going on in the private health insurance sector stays muddled and may change from payer to payer. CMS likewise gave a fact sheet on 'Information Identified with COVID–19 Individual and Little Gathering Business sector Insurance Coverage.' 

  1. CMS has made two-Healthcare Common Procedure Coding System (HCPCS) codes to report testing for coronavirus. Labs that test patients for the new coronavirus utilizing the Centers for Disease Control and Prevention (CDC) 2019 Novel Coronavirus Real-Time RT-PCR Diagnostic Test Panel may charge for that test utilizing the new HCPCS code (U0001). This code is utilized explicitly for CDC testing laboratories to test patients for SARS-CoV-2. 
  2. The second HCPCS charging code (U0002) permits laboratories to charge for non-CDC laboratory tests for SARS-CoV-2/2019-nCoV (COVID-19). On Feb. 29, 2020, the Food and Drug Administration (FDA) gave another, smoothed-out approach for certain laboratories to build up their own approved COVID-19 tests. 
  3. This second HCPCS code might be utilized for tests created by these extra laboratories when submitting cases to Medicare or health insurers. Diagnosis coding for coronavirus is likewise accessible. 
  4. For a diagnosis of COVID-19, report the code for the patient condition that is identified with the COVID-19 (e.g., J12.89, "Other viral pneumonia") and B97.29, "Other coronavirus as the reason for diseases grouped somewhere else." 
  5. For suspected COVID-19, not affirmed or ruled out at the experience, report codes for the introducing signs and symptoms. Try not to report a code for coronavirus when this diagnosis isn't expressed in the clinical record. 
  6. For known openness to COVID-19 (without a diagnosis of COVID-19), report Z20.828, "Contact with and (suspected) openness to other viral, communicable diseases." 
  7. For suspected openness to COVID-19 that is ruled out after assessment, report Z03.818, "Experience for perception for suspected openness to other biological agents ruled out." 

For more information, if it's not too much trouble, see CMS's habitually posed inquiries for health care providers regarding Medicare payment for laboratory tests and different administrations identified with the 2019 novel coronavirus. CMS has likewise given related fact sheets pertaining to Medicare and Medicaid and the Kids's Health Insurance Program. Coverage, payment, and different parts of getting paid for administrations identified with the coronavirus are consistently developing. Stay tuned to the MBC web journals for further updates.

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