When it comes to the ongoing COVID-19 pandemic, this is something that is no doubt putting a major strain on the healthcare system in the United States; however, being able to capture data and document cases in an accurate manner as it relates to the virus is something that will be able to help ease this strain as well.

Coding and billing as it relates to COVID-19 will enable providers to track the spread of the virus, as well as get paid for both testing and treating those patients who are showing symptoms. Additionally, more effective processes will also help providers to overcome all of the challenges related to the virus both now and in the foreseeable future.

Unfortunately, a general lack of resources and know-how is keeping multiple providers from being able to recognize the benefits of effective billing and coding when it comes to the virus.

At the present time, business as usual is something that isn’t taking place, regardless of where you look. Many different healthcare organizations have been forced to take the step of either canceling or postponing normal services in order to help with preventing the spread of COVID-19 while, at the same time, many others are treating and documenting patients with a more novel condition. Additionally, rising unemployment rates across the country are resulting in a new mix of patients, which is creating a new batch of challenges in terms of coding and documentation.

Many providers use different medical code sets in order to both document and bill for patient encounters. Some of the primary sets that are used by providers have recently composed new codes in order to help with capturing COVID-19 testing and care. Here are some of the most common that are now being utilized.

One of the common codes being used now is ICD-10-CM, which stands for International Classification of Diseases, Tenth Revision, Clinical Modification. This is an emergency code created by the World Health Organization earlier this year, and the official code used to document the diagnosis of COVID-19 is U07.1, 2019-nCoV acute respiratory disease. This is a code that was originally due to be implemented on October 1; however, due to the rapid spread of COVID-19, the implementation date was moved to April 1. The Centers for Disease Control state that providers should only use this code in order to document a confirmed COVID-19 diagnosis as documented by the provider, per documentation of a positive test result, or a presumptive positive test result. Additionally, this will also apply to asymptomatic patients who test positive for COVID-19.

Another common code being used now is CPT, which stands for Current Procedural Training. The addition of CPT code 87635 for novel coronavirus testing through infectious agent detection by nucleic acid, as well as codes 86328 and 86769 for COVID-19 antibody tests, as well as 86318, which is the revision for SARS-CoV-2 nucleic acid tests, also fall under this category as well. Additionally, code 86328 was also created for antibody tests that use a single step method immunoassay. This typically includes a strip with all of the most critical components for the assay itself and is more appropriate for a point-of-care platform.

HCPCS is another common code being used now, which stands for Healthcare Common Procedure Coding System. Two codes are being included as part of this – U0001 and U0002, both of which are designed for COVID-19 tests. The first code is used for documenting and billing tests performed at CDC testing laboratories, and the second code is used to help with supporting the CDC’s efforts with enabling clinical laboratories outside of the CDC itself to both create and bill for their own COVID-19 tests.

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