What You Should Know:
– The American Medical Association adds two new CPT codes to streamline the reporting of innovative tools and services now available to help reduce the COVID-19 disease burden.
– The two new codes 99072 and 86413 have been approved for immediate use.
The American Medical Association (AMA) published
an update to the Current Procedural Terminology (CPT®) code set that
includes two code additions for reporting medical services sparked by the
public health response to the COVID-19 pandemic.
The update to the CPT code set was approved by the CPT Editorial Panel, the independent body convened by the AMA with authority to expedite the review of proposed modifications and additions to the CPT code set. The two additions to the CPT code set have been approved for immediate use.
CPT Code 99072 Overview
The first addition, CPT code 99072, was approved in response to sweeping measures adopted by medical practices and healthcare organizations to stem the spread of the novel coronavirus (SARS-CoV-2), while safely providing patients with access to high-quality care during in-person interactions with health care professionals. The additional supplies and clinical staff time to perform safety protocols described by code 99072 allow for the provision of evaluation, treatment or procedural services during a public health emergency in a setting where extra precautions are taken to ensure the safety of patients as well as health care professionals.
AMA/Specialty Society RVS Update Committee (RUC) worked with 50 national
medical specialty societies and other organizations over the summer to collect
data on the costs of maintaining safe medical offices during the public health
emergency and submitted recommendations today to the Centers for Medicare and
Medicaid Services to inform payment of code 99072.
CPT Code 86413 Overview
The second addition, CPT code 86413, was approved in response to the development of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies, as opposed to a qualitative assessment (positive/negative) of SAR-CoV-2 antibodies provided by laboratory tests reported by other CPT codes. By measuring antibodies to SARS-CoV-2, the tests reported by 86413 can investigate a person’s adaptive immune response to the virus and help access the effectiveness of treatments used against the infection.
The two new Category I CPT codes and long descriptors are:
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
86413: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative
Why It Matters
“The CPT code set continues to quickly adapt during the COVID-19 pandemic to streamline the reporting of innovative tools and services now available to help reduce the COVID-19 disease burden, improve health outcomes and reduce long-term care costs,” said AMA President Susan R. Bailey, M.D. “This update is the latest in a series of modifications to the CPT code
sset to meet the needs of the health care industry as medical advancements expand the fight against COVID-19.”