AMA Unveils New CPT Code for Coronavirus Test

The American Medical Association (AMA) recently announced that the CPT Editorial Panel approved a new Current Procedural Terminology (CPT) code for a novel coronavirus test.

“In the face of the COVID-19 pandemic, the CPT Editorial Panel has expedited approval of a unique CPT code to report laboratory testing services that diagnose the presence of the novel coronavirus,” Patrice A. Harris, MD, MA, president of AMA, stated in the announcement.

“The new CPT code assigned to the test for the novel coronavirus provides analytical advantages for tracking, allocating and optimizing resources as testing ramps up in the United States.”

The CPT code created by the CPT Editorial Panel is a new Category I CPT code, the AMA revealed in the March 13 announcement. The code and the descriptor are as follows:

87635 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

The AMA stated that the CPT code is now effective for use as the industry standard for reporting tests for the novel coronavirus in the US healthcare system. Additionally, the code has short and medium descriptors, which can be accessed on the AMA website.

According to statistics gathered by Johns Hopkins University, there are over 205,400 confirmed cases of the novel coronavirus across the world at the time of this publication. Of those cases, over 6,500 are in the US where President Trump declared a national emergency.

Diagnostic testing for the novel coronavirus is critical to effectively managing the rapid outbreak already impacting thousands in other countries.

“Diagnostics are a critical need in the overall strategy to fight this newest global public health threat,” said Rick A. Bright, PhD, director of Biomedical Advanced Research and Development Authority (BARDA) at HHS.

“We need increased testing capacity in the US to rapidly identify, isolate, and treat those infected with COVID-19 in order to limit transmission of the virus, and we need those tests as close to the patients as possible,” Bright continued.

Industry stakeholders have criticized the administration’s efforts to increase access to diagnostic tests for the novel coronavirus, citing delays and shortages. Public health officials also raised concerns that an inability to access tests for the novel coronavirus would further delay care for those in need and impact the support given to those on the frontline of the outbreak.

The new CPT code for coronavirus tests is a key way providers will be able to approach the outbreak in a data-driven manner to achieve efficiency and optimal care delivery, the AMA stressed.

The CPT code set is used by the healthcare industry to describe the services rendered to a patient during an encounter. The code set is maintained by the AMA and is commonly used for medical billing, as well as for tracking healthcare utilization, gathering statistics about populations, and other management uses.

In addition to the CPT code set, healthcare providers also use the Healthcare Common Procedure Coding System (HCPCS), which is largely used to document patient encounters for public healthcare programs like Medicare.

CMS announced earlier this year the creation of two new HCPCS codes for testing of the novel coronavirus. The first billing code released in February (U0001) is for SARS-CoV-2 diagnostic tests performed specifically for CDC testing laboratories. The second billing code (U0002) released earlier this month will expand medical billing and coding for coronavirus lab tests, permitting laboratories to bill for non-CDC laboratory tests for SARS-CoV-2/2019-nCoV, otherwise known as the novel coronavirus or COVID-19.

“Our new code will help encourage doctors and laboratories to use these essential tests for patients who need them,” CMS Administrator Seema Verma stated following the release of the second code.

As of March 16, coronavirus testing is occurring in all 50 states plus Washington DC, Guam, and Puerto Rico, according to the Centers for Disease Control and Prevention (CDC).