Coding Updates For COVID-19

Updated March 25, 2020

The Centers for Medicare and Medicaid Services (CMS) announced implementation of new telehealth flexibility authorized by the supplemental appropriations bill that passed March 6. These changes will allow clinicians to both care for patients who may be infected with COVID-19 and to exercise caution with all patients by keeping people out of waiting rooms where they may be exposed to the virus by billing traditional E/M services.

The Centers for Disease Control and Prevention (CDC) has issued ICD-10 coding guidelines to document COVID-19 encounters. The CPT Editorial Panel created a new code to report novel coronavirus testing. The Centers for Medicare and Medicaid Services (CMS) has also issued guidance regarding coding and coverage of services (either a CPT code or HCPCS code may be necessary depending on the payer processing it), and an additional memorandum directs part C and part D flexibility through waivers of cost-sharing for COVID-19 tests and other services.

The following Medicare and CPT codes for other services may also be helpful to care for patients remotely:

  • G2012: Brief communication technology-based service, e.g., virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
  • G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment
  • 99421: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
  • 99422: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes
  • 99423: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes
  • 99451: Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient's treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time
  • 99452: Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes
  • 99457: Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes
  • 99458: Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; each additional 20 minutes (List separately in addition to code for primary procedure)
  • G2061: Qualified nonphysician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes
  • G2062: Qualified nonphysician healthcare professional online assessment service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes
  • G2063: Qualified nonphysician qualified healthcare professional assessment service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes

For specific COVID-19 related services use:

  • 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
  • 99091 – Handling and/or conveyance of specimen for transfer from the patient in other than an office to a laboratory (distance may be indicated)
  • Z03.818 – ICD-10 code for possible exposure to COVID-19
  • Z20.828 – Actual exposure to COVID-19
  • U07.1 – Diagnosed Patient – effective 4/1/2020

Additionally, you can use your Evaluation and Management codes to bill for Telemedicine Visits. See the AMA's special coding advice.

More instruction for billing CPT codes can be found in the 2020 CPT Codebook.

Visit ACC's COVID-19 Hub for additional COVID-19 guidance and information and check the updated AMA COVID-10 resource center.

Keywords: ACC Advocacy, Public Health, Coronavirus, Telemedicine, Emergency Medical Service Communication Systems, Centers for Disease Control and Prevention (U.S.), World Health Organization, Cardiology


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