Neurosurgery Coding Alert

CPT^® adds new code 87635 for novel coronavirus testing.

The novel coronavirus (COVID-19) has been dominating the news lately. This pandemic national emergency has truly changed every aspect of our lives, especially our healthcare system. To keep your claims clean, your neurosurgery practice must stay up to date on the new COVID-19 codes and guidelines.

Read on to learn more.

Disclaimer: Information related to COVID-19 is changing rapidly. This information was accurate at the time of writing. Be sure to stay tuned to future issues of Neurosurgery Coding Alert for more information. You can also refer to payer websites, CMS (cms.gov), CDC (cdc.gov), and AAPC’s blog (www.aapc.com/blog) for the most up-to-date information.

Discover New CPT^® Code 87635

The CPT^® Editorial Panel has approved 87635 (Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19], amplified probe technique) as a new code for novel coronavirus testing. This code became effective on March 13, 2020.

Don’t miss: Since 87635 is an early release code, you will need to manually upload its code descriptor into your electronic health record system (EHR).

Code 87635 is not in the CPT^® 2020 manual; it will be added to the 2021 code set in the microbiology subsection of the pathology and laboratory section. Code 87635 will be a child code under parent code 87471 (Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique) in the 2021 CPT^® code set.

“Use of code 87635 will help to efficiently report and track testing services related to SARS-CoV-2 and will streamline the reporting and reimbursement for this test in the United States,” according to a special edition of CPT^® Assistant, Vol. 30.

Check Out 2 New HCPCS Level II Codes

The Centers for Medicare & Medicaid Services (CMS) has released the following two new HCPCS Level II G-codes for COVID-19. The effective date for these codes is March 1, 2020:

• G2023 (Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source)
• G2024 (Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source)

Then, for Medicare patients, CMS has also established the following new codes for coronavirus testing: Code U0001 (Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel) should be used specifically for CDC testing laboratories to test patients for SARS-CoV-2 and to track new cases of the virus, according to CPT^® Assistant, Vol. 30. And code U0002 (2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc) is intended for laboratories to report non-CDC laboratory tests for SARS-CoV-2/2019-nCoV (COVID-19).

Meet New ICD-10 Code for Confirmed COVID-19 Cases

In an emergency meeting back in January, the World Health Organization (WHO) created a code for the coronavirus. Then during the Coordination and Maintenance Committee meeting on March 18, 2020, the CDC announced that the effective date for the new code U07.1 (COVID-19) was pushed up from the original date of Oct. 1, 2020 to April 1, 2020.

So, starting on April 1, 2020, you should report U07.1 for confirmed cases of COVID-19.

The CDC changed the effective date under the National Emergencies Act Section 201 and 301. “This off-cycle update is unprecedented and is an exception to the code set updating process established under HIPAA,” according to the CDC announcement.

Coding guidance: Per the CDC ICD-10-CM April 1, 2020 Addenda, you should report an additional code along with U07.1 to identify pneumonia or other manifestations.

Relate The COVID-19 Outbreak to Your Neurosurgery Practice

On the American Association of Neurological Surgeons website (URL: https://www.aans.org/COVID-19-Update/COVID-19-Information-Hub), you’ll find some neurosurgery-related issues addressed concerning COVID-19.