New codes account for multi-virus tests for Covid, flu

CHICAGO — The American Medical Association announced the addition of two new Current Procedural Terminology (CPT) codes for tests that simultaneously detect Covid-19 and influenza A/B, as well as code revisions to clarify proper reporting for antigen tests.

These updates, which were approved for immediate use by the CPT Editorial Panel, are intended to assist clinicians in correctly reporting medical services connected to the ongoing Covid-19 pandemic.

“Two of the newly approved codes report nucleic acid assays that allow a single test to simultaneously detect the novel coronavirus and a combination of common viral infectious agents, including influenza A/B and respiratory syncytial virus,” said AMA President Susan R. Bailey, MD, in a statement. “Concurrent detection promises to conserve important testing resources, allowing for ongoing surveillance of influenza while testing for the novel coronavirus.”

The AMA provided these new CPT codes, as well as their descriptions, in its announcement:

  • 87636: “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [Covid-19]) and influenza virus types A and B, multiplex amplified probe technique.”
  • 87637: “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [Covid-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique.”

The CPT Editorial Panel also made changes to codes “ranging from 87301 to 87430, the AMA reported, removing the term “multi-step method” from code descriptors to distinguish between antigen tests that are read by a machine and those that can be visually interpreted.

This revision, the AMA noted, “affects the newly developed descriptor for CPT code 87426” and led to the creation of a new category I code—87811—for reporting antigen detection using an immunoassay interpreted via direct visual observation:

  • 87426: “Infectious agent antigen detection by immunoassay technique, (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [Covid-19]).”
  • 87811: “Infectious agent antigen detection by immunoassay with direct optical (i.e., visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [Covid-19]).”

Short and medium descriptors for CPT codes 87636, 87637, 87426, and 87811 are available on the AMA’s website, “along with several other recent modifications to the CPT code set that have helped streamline the public heqlth response to the SARS-CoV-2 virus and the Covid-19 disease,” the AMA wrote.

John McKenna, Associate Editor, BreakingMED™

Cat ID: 30

Topic ID: 79,30,730,933,30,926,192,927,925,934