CMS has released several fact sheets in recent weeks on billing and coding to provide guidance to healthcare organizations testing and treating patients for COVID-19, the disease caused by the novel coronavirus.
Seven things to know:
- CMS developed Healthcare Common Procedure Coding System code U0001 to allow laboratories and healthcare providers to bill for using the CDC’s RT-PCR Diagnostic Test Panel. Healthcare organizations should use HCPCS code U0002 to bill for validated, in-house developed COVID-19 diagnostic tests, according to CMS.
- Beginning April 1, laboratories and healthcare providers can bill Medicare and other health insurers using codes U0001 and U0002 for services provided on or after Feb. 4.
- Local Medicare Administrative Contractors will develop the payment amount for claims received for codes U0001 and U0002 in their respective jurisdictions. CMS said laboratories may seek guidance from their MAC on payment before billing for the tests.
- When Medicare beneficiaries with COVID-19 no longer require acute inpatient care but remain quarantined in a hospital room to avoid infecting others, Medicare will pay the diagnosis-related group rate and any cost outliers until the patient is discharged, according to The National Law Review.
- Patients will not have to pay an additional deductible for quarantine in a hospital if they would have otherwise been discharged, according to CMS.
- CMS said hospitals offering both private and semiprivate rooms may not charge patients a differential for a private room where isolation is medically necessary.
- The American Medical Association announced March 10 that it is expediting the creation of a Current Procedural Terminology code for reporting tests for COVID-19.