Effective September 8th, the American Medical Association (AMA) published two new CPT code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic.
One code, CPT 99072, can be used to report additional practice expenses incurred to perform safety protocols during a declared Public Health Emergency.
This new code is designed to capture practice expense factors such as:
- Time beyond what is included in the primary service of clinical staff. Time to conduct a pre-visit phone call to screen the patient (symptom check), provide instructions on social distancing during the visit, check patients for symptoms upon arrival, apply and remove PPE, and perform additional cleaning of the examination/procedure/imaging rooms, equipment, and supplies.
- Cleaning supplies, including additional quantities of hand sanitizer and disinfecting wipes, sprays, and cleansers.
Code 99072 does not depend on a specific patient diagnosis and may be reported with in-person patient encounters for office visits or other non-facility services where staff are following implemented guidelines to mitigate the transmission of a respiratory disease for which a PHE was declared.
Additionally, code 99072 can be reported only once per in-person patient encounter per provider identification number (PIN), regardless of the number of services rendered at that encounter.
The second code published by the AMA, CPT code 86413, was created in response to the development of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies.
This new code indicates tests that measure the quantity of SARS-CoV-2 antibodies rather than if antibodies are merely present or not.
The AMA provided recommendations on payment to CMS upon releasing the new codes. However, CMS has not released guidance on reimbursement or reporting at this time.
For more details on these codes from the AMA, CLICK HERE.
As always, ADVOCATE will continue to keep you informed on the issues impacting medical groups as they develop.
Manager, Regulatory Affairs