AMA Announces New CPT Codes for Coronavirus Testing

CPT Code for Coronavirus Testing

Four new CPT codes for coronavirus testing, including through antibody tests, will enable providers to report more laboratory testing of the novel coronavirus on medical claims.

The American Medical Association (AMA) recently expanded its Current Procedural Terminology (CPT) code set to include four new CPT codes for coronavirus testing, according to a special coding guidance document.

The new CPT codes are 86408 for SARS-CoV-2 neutralizing antibody screen; code 86409 for SARS-CoV-2 neutralizing antibody titer; and codes 0225U and 0226U for proprietary laboratory analyses to detect SARS-CoV-2.

The new CPT codes became effective immediately.

The new codes add to the AMA’s growing list of coronavirus-related CPT codes that have been approved and published for the 2021 code set, including:

  • Code 87635 to report infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique
  • Code 86318 to report immunoassay for infectious agent antibody(ies) and to be a parent to 86328; addition of code 86328 to report single step antibody testing for severe acute respiratory syndrome coronavirus 2; addition of child code 86769 to report multiple-step antibody testing for severe acute respiratory syndrome coronavirus 2; and revision of the Immunology guidelines
  • PLA code 0202U to report the BioFire® Respiratory Panel 2.1 (RP2.1) test
  • Code 87426 to report infectious agent antigen detection by immunoassay technique of SARS-CoV and SARS-CoV-2

But no CPT codes existed prior to the update for reporting tests that measure a patient’s coronavirus neutralizing antibodies or related to the use of a cellular reporting system to measure live virus infection of cells in culture, the AMA stated in the special coding guidance document earlier this week.

“A cellular response to infection is measured through the use of a cellular reporter system as a measure of infection. These tests determine if antibodies present in a patient specimen can directly block infection of cells expressing the viral entry receptor on their surface,” the organization wrote in the document.

Coronavirus antibody testing is now broadly available as communities reopen and start to resume normal activities. The tests can determine if a person has had a past coronavirus infection even if they have never shown symptoms by verifying whether their body has created antibodies to help fight the infection.

Testing positive for coronavirus antibodies may indicate that a person is protected from re-infection, but clinical evidence has yet to verify if humans can develop immunity to the novel virus through the immune system’s own antibodies.

The tests, however, play an important role in understanding the transmission of the novel coronavirus in the general population and for identifying high-risk groups, the CDC said in its own guidance for providers on coronavirus antibody testing.

Coronavirus antibody tests can also help identify people who may qualify to donate blood that can be used to manufacture a convalescent plasma as a potential treatment for seriously ill coronavirus patients, according to the federal agency.

The FDA has approved emergency use authorizations for over 30 coronavirus antibody tests at the time of this story’s publication.

The AMA has established CPT codes for these antibody tests. Code 86328 is used for reporting the use of coronavirus antibody tests that employ a single-step method immunoassay, while code 86769 captures the use of antibody tests with multi-step methods.

But the existing CPT codes for coronavirus antibody testing do not capture the use of tests that determine whether antibodies present in a patient can directly block infection of cells, the AMA clarified in the new guidance document.

“Code 86328 describes only the presence of antibodies. In contrast, codes 86408 and 86409 are used to report tests that determine if the antibodies present can block the COVID-19 virus infection,” the organization explained.

The FDA has yet to authorize the use of neutralization tests for the novel coronavirus, according to the CDC.

Additionally, the kinetics of antibody response, longevity of antibodies, the ability of antibodies to protect from re-infection, the protective titer of neutralizing antibodies, and the correlation of binding antibody titers to neutralization ability impose limitations on all coronavirus antibody testing, the agency added.

For More Information: https://revcycleintelligence.com/news/ama-announces-new-cpt-codes-for-coronavirus-testing

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