Ob-Gyn Coding Alert

Find out what to report for pregnant patients who present with the coronavirus.

The 2019 novel coronavirus (COVID-19) has been declared a pandemic national emergency in the United States — which means your ob-gyn practice may be adjusting to new coding scenarios. Here’s the latest coding guidance you should be adopting as soon as possible.

Rationale: Healthcare systems must begin using these codes to report all COVID-19 testing and confirmed diagnoses. This critical data could potentially help the lives of millions.

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 Ob-Gyn 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.

Learn This Category I Pathology and Laboratory Code

In the midst of cold and flu season, labs are responding to the need for testing and monitoring COVID-19 cases by sharing knowledge with clinicians, using infection control measures, and implementing appropriate testing.

“Our goal is early detection of new cases and to prevent further spread of the coronavirus,” said Robert R. Redfield, MD, director of the Center for Disease Control and Prevention (CDC) in a press release.

The CPT^® Editorial Panel approved a new Category I Pathology and Laboratory code for novel coronavirus testing: 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). The code became effective March 13, 2020.

Heads up: This is an early release, so you will need to manually upload this code descriptor into your electronic health record and billing systems.

More info: A special edition CPT^® Assistant is publicly available, which provides guidance for using this new code. You can also visit the AMA website for more information. https://www.ama-assn.org/system/files/2020-03/cpt-assistant-guide-coronavirus.pdf.

You Also Have Two New HCPCS Level II Codes

The Centers for Medicare and Medicaid Services (CMS) created two codes as well, says Suzan Hauptman, MPM, CPC, CEMC, CEDC, director compliance audit at Cancer Treatment Centers of America. They are U0001 (Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel) and U0002 (2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc).

For Medicare beneficiaries being tested for the coronavirus (COVID-19), CDC laboratories may use temporary HCPCS code U0001 “to bill for tests and track new cases of … SARS-CoV-2,” while non-CDC laboratory tests can use U0002 “to bill for SARS-CoV-2/2019-nCoV (COVID-19).”

Keep Up to Date With Latest G Specimen Codes

If your practice contains a lab, you may use the following new G codes:

• 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)

Don’t Overlook ICD-10-CM Options

You should also check out the new ICD-10-CM codes to reflect the coronavirus.

1) For confirmed cases of COVID-19:

The Centers for Disease Control (“CDC”) has released a new ICD-10-CM code, U07.1 (2019-nCoV acute respiratory disease). The new code, originally announced earlier this year, was initially to be effective Oct. 1, 2020. However, CDC announced during the Coordination and Maintenance Committee meeting on March 18, 2020 “that due to the ‘urgent need to capture the reporting of [COVID-19] in our nation’s claims and surveillance data,’ the agency has changed the effective date of new diagnosis code U07.1, COVID-19, from Oct. 1, to April 1, 2020.”

In the interim, the CDC instructs you not to use B34.2 (Coronavirus infection, unspecified) for confirmed cases of COVID-19, “because the cases have universally been respiratory in nature, so the site would not be ‘unspecified,” and as of April 1, 2020, the new code is more specific to the COVID-19 confirmed illness.

2) For cases when COVID-19 is confirmed as the cause of, or associated with, diseases classified elsewhere:

Example 1: A patient diagnosed with acute bronchitis due to a confirmed case of COVID-19. You’ll report codes U07.1 and J20.8 (Acute bronchitis due to other specified organisms). For patients with a gynecologic malignancy being actively treated for the disease and considered at the time of the visit, but not the primary reason for the visit, the cancer diagnosis ICD-10-CM code would be reported in the 3rd position (such as, C56.2, Malignant neoplasm of left ovary). If the malignancy is present in this scenario and the physician does not treat or assess the patient’s cancer, you would use the status code.

Example 2: You’ll use U07.1 and an additional code if the virus is responsible for such diseases as pneumonia, classified as J12.89 (Other viral pneumonia), or sepsis, classified as A41.89 (Other specified sepsis). For gynecologic oncology patients, the same additional codes described in Example 1 would be applicable in this situation as well.