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Medicare, Medicaid System Assigns Unique COVID-19 Lab Billing Code

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The Centers for Medicare & Medicaid Services (CMS) took further action to ensure America’s healthcare facilities and clinical laboratories are prepared to respond to the threat of the 2019-Novel Coronavirus (COVID-19). Specifically, CMS developed a new Healthcare Common Procedure Coding System (HCPCS) code for providers and laboratories to test patients for SARS-CoV-2. This code will allow those labs conducting the tests to bill for the specific test instead of using an unspecified code, which means better tracking of the public health response for this particular strain of the coronavirus to help protect people from the spread of this infectious disease.

Healthcare providers who need to test patients for Coronavirus using the Centers for Disease Control and Prevention (CDC) 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel may bill for that test using the newly created HCPCS code (U0001). The Medicare claims processing system will be able to accept this code on April 1, 2020 for dates of service on or after February 4, 2020. HCPCS is a standardized coding system that Medicare and other health insurers use to submit claims for services provided to patients.

On February 6, 2020, CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19. CMS also issued on the same day information for CLIA-certified laboratories about how they can test for SARS-CoV-2.

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