Medical coding has no end point. It involves numerous codes with multiple categories. It is the same with Covid-19 coding too! Codes for Covid-19 have several categories where each represents a unique procedure or diagnosis involved. Not all codes can be memorized, especially the codes that are new and updated. This coding guide provides information on most of the categories and codes for the procedures.
Here it goes:
Covid-19 codes for Covid-19 Vaccines:
- CPT codes for vaccines are developed as required for reporting immunizations for the novel coronavirus (SARS-CoV-2).
- The American Medical Association (AMA) has introduced a tool to help select the appropriate CPT code for the type and dose of vaccine that is being administered.
- The codes for vaccines are given below:
- 91300 –Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use (Report 91300 with administration codes 0001A, 0002A)
- 0001A –Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID19]) vaccine, mRNALNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose.
- 0002A –Second dose
- 91301 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use (Report 91301 with administration codes 0011A, 0012A)
- 0011A – Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID19]) vaccine, mRNALNP, spike protein, preservative free, 100 mcg/0.5mL dosage; first dose
- 0012A – Second dose
- 91302 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5×1010 viral particles/0.5mL dosage, for intramuscular use (Report 91302 with administration codes 0021A, 0022A)
- 0021A – Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5×1010 viral particles/0.5mL dosage; first dose
- 0022A – Second dose
- 91303 –Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5×1010 viral particles/0.5mL dosage, for intramuscular use (report with administration code 0031A)
- 0031A – Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5×1010 viral particles/0.5mL dosage, single dose.
Covid-19 coding for immunology:
- 86413 -Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative
- 86318 –Immunoassay for infectious agent antibody(ies), qualitative or semi-qualitative, single step method (eg, reagent strip)
- 86328 – Immunoassay for infectious agent antibody(ies), qualitative or semi-quantitative, single step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])
- 86408 –Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]); screen
- 86409 – titer
- 86635 –Antibody; coccidioides
- 86769 –Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])
Codes for Microbiology:
- 87301 –Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semi-quantitative; adenovirus enteric types 40/41
- 87426 – Severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19]) (Coronavirus disease [COVID-19])
- 87428 – Severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19]) and influenza virus types A and B.
- 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
- 87636 –Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID19]) and influenza virus types A and B, multiplex amplified probe technique
- 87637 –Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique
- 87811 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])
Read more: FAQs on Healthcare Billing Services for Covid-19 Vaccination
Special services, procedures and reports for Covid-19 coding:
- 99072was introduced in response to the significant additional practice expenses related to activities required to safely provide in-person medical services to patients during a public health emergency. These activities and supplies are over and above those usually included in a medical visit or service.
- 99072 – Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease.
- CMS won’t include the CPT code 99072as a separately payable service in the Medicare Physician Fee Schedule, but rather as a bundled service. According to CMS, payment for the services and supplies described in 99072 are inherent in payment for other services. Private payer policies regarding 99072 may differ from CMS.
Proprietary Laboratory Analyses:
- 0202U –Infectious disease (bacterial or viral respiratory tract infection), pathogen specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected.
- 0240U –Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 3 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B), upper respiratory specimen, each pathogen reported as detected or not detected.
- 0241U –Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 4 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B, respiratory syncytial virus [RSV]), upper respiratory specimen, each pathogen reported as detected or not detected.
- 0223U – Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected.
- 0224U –Antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), includes titer(s), when performed
- 0225U –Infectious disease (bacterial or viral respiratory tract infection) pathogen-specific DNA and RNA, 21 targets, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe technique, including multiplex reverse transcription for RNA targets, each analyte reported as detected or not detected
- 0226U –Surrogate viral neutralization test (sVNT), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), ELISA, plasma, serum.
HCPCS codes descriptions:
- U0001 –CDC 2019 novel coronavirus (2019-ncov) real-time RT-PCR diagnostic panel HCPCS code
- U0001 – Should be used specifically for Centers for Disease Control and Protection (CDC) testing laboratories to test patients for SARS-CoV-2 (CDC 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel)
- U0002 – 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-CDC
- U0002 – Allows laboratories to bill for non-CDC laboratory tests for SARS-CoV-2/2019-nCoV (COVID-19)
- HCPCS code U0002 may be used to report new types of COVID-19 tests in the future, if they are not already specified by either U0001 or 87635.
- CMS will monitor the development of tests and assign codes when appropriate.
- U0003 –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, making use of high throughput technologies as described by CMS-2020-01-R.
- U0004 –2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R.
- C9803 –Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [Covid-19])
ICD-10 CM codes for Covid-19 coding:
- Z11.52 – Encounter for screening for COVID-19
- Z20.822 – Contact with and (suspected) exposure to COVID-19.
Verify each code thoroughly while using it for Covid-19 coding. Slight difference or mismatch of codes can cause huge trouble and also result in denials. It’s very crucial to code with complete concentration based on the procedure and diagnosis.
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