Healthcare providers are working tirelessly to care for patients during the COVID-19 crisis. Many are isolated from their families so they can take care of our families. Supporting them are countless non-clinical professionals working to keep their organizations operating and create plans for how to successfully transition out of this crisis when the time comes. A big part of that is properly coding COVID-19 claims.
Depending on what types of claims you are submitting, you will need a combination of HCPCS, CPT, ICD, and DRG codes. Several new codes are being implemented to ensure that healthcare providers can properly bill and receive reimbursement for the patient care they are providing during this critical time.
Two new HCPCS codes were introduced to bill for patient testing for Coronavirus:
A new CPT code was introduced by American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Panel on March 13, 2020 that laboratories can use to bill Medicare when applicable:
A new diagnosis code for COVID-19 is being implemented April 1, 2020 by Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS):
DRG coding is a little trickier; the codes that will most likely be applicable for COVID-19 diagnoses are:
There are additional DRG codes for infants and HIV patients.
Practices will likely have to manually load these new codes into their Practice Management/EMR systems for use on claims. Accuracy and specificity are important when coding COVID-19 claims so healthcare professionals can not only get paid properly but can learn from the data. The new codes will allow for more specific coding and later reporting on how COVID-19 has impacted the country. As always, check your references and stay current on coding requirements, and THANK YOU for taking care of the people who are taking care of our people!
Editor’s note: This article has been corrected to reflect the fact that U07.1 is the only new diagnosis code being implemented by the CDC at the time of this writing.