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Coding Tip of the Month – September 2020

NEW CPT codes for COVID-19 Pandemic

Published September 8th by the AMA

Two new CPT codes as published by the AMA for novel coronavirus (COVID-19) related services.

The first is CPT code 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 Pubic Health Emergency as defined by law, due to respiratory-transmitted infectious disease.

This code was created in response to the exorbitant additional expenses medical practices are grappling with during the PHE.

** It is important to remember this new code may only be reported once per in-person patient encounter per day, per provider identification number, regardless of the number of services rendered at that encounter. In the instance in which the noted clinical staff activities are performed by a physician or other qualified health care professional (e.g., in practices environments without clinical staff or shortage of available staff), the activity requirements of this code would be considered as having been met; however, the time spent should not be counted in any other time-based visit or service reported during the same encounter. 1

The second new CPT code is 86413 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative.

CPT code, 86413, was created by the AMA, to differentiate laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies, as opposed to other tests that provide qualitative assessments (positive/negative) assessments of SAR-CoV-2 antibodies.

Both of these codes will remain in effect until the end of the COVID-19 PHE.

1 For detailed information on reporting codes 99072 and 86413, please refer to  the AMA CPT Assistant Special Edition Update, September 8,2020 .