Oncology & Hematology Coding Alert

Question: Our in-house lab often gets orders for both SARS-CoV-2 testing and testing for Influenza A and B plus RSV for patients with non-specific respiratory symptoms. We perform all the tests using amplified probe technique. How should we code this?

Minnesota Subscriber

Answer: Because you use amplified probe technique, you can bill the SARS-CoV-2 test using 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) in most cases. Some payers or types of tests, such as high-throughput testing, may require a different code.

You can separately bill the testing for other respiratory viruses you mention: Influenza A and B and respiratory syncytial virus (RSV). Other than the fact that you’re using nucleic acid amplified probe technique, you don’t give details that might indicate billing separately for these tests. Assuming that you’re running a multiplex panel for these viruses, you should report the test as 87631 (Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets).