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Coronavirus Code

CMS Has Released a Medical Billing Code for Coronavirus COVID-19

The novel coronavirus that spread to the human population in December 2019 was referred to as 2019-nCoV and now has been officially named COVID-19 by the World Health organization (WHO). The Centers for Medicare & Medicaid Services (CMS) is taking an active role in making sure U.S. healthcare facilities are prepared and has released a test panel for diagnosis of the disease and a medical billing code for the lab test so that providers can be specific in their claims for reimbursement from insurers and government payers.

CMS COVID-19 Test and Coding

The lab test that is run to identify COVID-19 specifically is the “Centers for Disease Control and Prevention (CDC) 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel.”

The Healthcare Common Procedure Coding System (HCPCS) code for the test panel is U0001. The code is applicable for services provided as of February 4, 2020, but the Medicare claims processing system will not be set up to approve these claims until April 1, 2020.

Only CLIA Certified Labs Are Qualified to Perform COVID-19 Testing

The COVID-19 test panel has been issued an Emergency Use Authorization (EUA) by the United States Food and Drug Administration (FDA). In order for a laboratory to be able to perform the assay, it must be CDC qualified and certified to perform high complexity tests under the Clinical Laboratory Improvement Amendments of 1988 (CLIA).

CMS Has Reached Out to Healthcare Facilities

CMS has already begun taking steps to see that healthcare facilities and labs are ready to respond should COVID-19 spread to the US. The primary tactic that has been instructed is to ensure compliance with existing procedures for prevention and control of infection and preventing the spread of infection. Providers are also asked to stay abreast of the latest information about the novel coronavirus, and CDC is publishing frequent updates with the statistics and details of the spread of the disease.

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