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Our Pediatric office is looking for the best/correct CPT code to use when performing a Rapid Covid test in our office. We've tried 87635, 87426 and now 87301. Has anyone had success with any of these codes?
I was looking into billing for it also i have read some info where they state they don't coverer the cost of the test. I was seeing the 87426 have you had any luck getting reimbursement
Per Anthem BC PPO, in Southern California, cpt 87426 generally is charged $55 but allowable is generally around $24. The variance is due to contractual agreements.
Peace
@_*
Hope that helps. Here is a sample reimbursement policy from another insurance company.
We are billing 87636-Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique
87636
pos 11(office)
no e/m
no modifier
Receiving payments from most payors. So far we have not receive payment from Oxford , EmblemHealth HIP/GHI
we are charging the 87636, and the patient is asymptomatic, but exposure to Covid-19. and yet there are denial for the L37348 associated dx code. if they are asymptomatic why would there need to be another dx code?