COVID-19 CPT, HCPCS and ICD-10 Reporting
The Centers for Medicare and Medicaid Services (CMS) has issued the second quarter update to the Clinical Laboratory Fee Schedule effective April 1, 2020. The update includes the following two HCPCS codes related to COVID-19, which are effective for services on or after February 4, 2020:
- U0001 - CDC 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel
- U0002 -2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC
The Division of Workers’ Compensation Administrative Director has issued an Order dated March 24, 2020, updating the workers’ compensation Pathology and Clinical Laboratory Fee Schedule. The Order adopts the HCPCS Codes U0001 and U0002 and sets maximum fees based upon 120% of the California Medicare fees set by the Medicare Administrative Contractor.
The Administrative Director’s Order does not adopt the American Medical Association CPT code 87635 into the fee schedule at this time, as there is no Medicare fee established for this code. The American Medical Association (AMA) added the Category I Pathology and Laboratory CPT code 87635 in reference to COVID-19 testing, effective March 13, 2020. The CPT code 87635 will pass the WCIS validation edit, since it is a valid CPT code and may be in use by providers of the COVID-19 test.
The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS), the federal agency responsible for use of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Clinical Modification (ICD‐10‐CM) in the United States, in collaboration with other agencies has created one new ICD‐10‐CM code
U07.1- 2019-nCoV acute respiratory disease.
For medical bill data reporting, the WCIS has included these codes in its incoming data validation tables and will accept medical bills with these codes.
If you have questions about how to report COVID-19, please contact WCIS at WCIS@DIR.CA.GOV or your designated trading partner contact.
WCIS trading partner contacts:
Trading partner letters A, C, G, I-L, S-V, Z
Trading partner letters B, D-F, H, M-R, W-Y
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