What You Should Know:
– AMA announces new CPT codes for multi-virus tests to detect COVID-19 and flu for immediate use.
The American Medical Association (AMA) today published an update to the Current Procedural Terminology (CPT®) code set that includes new code additions and editorial revisions 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 the authority to review and approve proposed additions and revisions to the CPT code set. The new additions and revisions to the CPT code set have been approved for immediate use.
“Two of the newly approved codes report nucleic acid assays that allow a single test to simultaneously detect the novel coronavirus and a combination of common viral infectious agents, including influenza A/B and respiratory syncytial virus,” said AMA President Susan R. Bailey, M.D. “Concurrent detection promises to conserve important testing resources, allowing for ongoing surveillance of influenza while testing for the novel coronavirus.”
New CPT Codes
For quick reference, the new category I CPT codes and long descriptors are:
87636: Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique
87637: Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique
CPT Editorial Panel Revisions
The CPT Editorial Panel also revised CPT codes ranging from 87301 to 87430 by removing the undefined term “multi-step method” from code descriptors. The revision clarifies the proper reporting for antigen tests that are read by a machine, as compared to those which can be visually interpreted without a machine. This revision affects the newly developed descriptor for CPT code 87426.
87426: Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])
In accordance with the above revision, the CPT Editorial Panel approved a new category I code, 87811, to report infectious agent antigen detection by immunoassay with direct visual observation.
87811: Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])
In addition to the long descriptors, short and medium descriptors for CPT codes 87636, 87637, 87426 and 87811 can be accessed on the AMA website, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SAR-CoV-2 virus and the COVID-19 disease.