What’s the news: The AMA has published an update to the Current Procedural Terminology (CPT®) code set that enables reporting the multiplex assays that have been developed to simultaneously test for SARS-CoV-2 and other respiratory illnesses that can feature similar clinical presentations.

E/M coding update checklist

Get step-by-step advice on navigating the office visit documentation coding changes and meet the January 2021 deadline for CMS’ E/M coding update with confidence.

The update to the CPT code set was approved by the CPT Editorial Panel, the independent body convened by the AMA with authority to review and approve proposed additions and revisions to the CPT code set. The new additions and revisions to the CPT code set have been approved for immediate use.

For quick reference, the new category I CPT codes and long descriptors are:

  • 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.

Why it’s important: With flu season underway, many patients will develop symptoms that can be consistent across influenza, respiratory syncytial virus (RSV) and SARS-CoV-2, the novel coronaviruses that causes COVID-19.

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Having “a single test to simultaneously detect the novel coronavirus and a combination of common viral infectious agents” is an important step forward, said AMA President Susan R. Bailey, MD. “Concurrent detection promises to conserve important testing resources, allowing for ongoing surveillance of influenza while testing for the novel coronavirus.”

The CPT Editorial Panel also revised CPT codes ranging from 87301 to 87430 by removing the undefined term “multiple-step method” from code descriptors. The revision clarifies the proper reporting for antigen tests that are read by a machine, as compared to those which can be visually interpreted without a machine.

Learn more: The AMA website lists COVID-19 CPT coding and guidance. That includes short and medium descriptors for CPT codes 87636, 87637, 87426 and 87811, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SARS-CoV-2 virus and the COVID-19 disease.

Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel that collects broad input from the health care community and beyond to ensure CPT content reflects the coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology, so it can fulfill its vital role as the trusted language of medicine today and the code to its future.

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The CPT Network is your resource for CPT coding answers. AMA members and CPT Network subscribers have access to the tools to quickly research a database of commonly asked questions and clinical examples, or vignettes. If the answer to a specific question cannot be found in the database, authorized users may submit an electronic inquiry directly to the AMA’s staff of CPT coding experts, who are committed to providing users with timely and accurate responses to their coding inquiries.

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