Reimbursement
Reimbursement for antibody testing
Updated April 10, 2020
AMA COVID-19 Coding and Guidance can be found here.
New Current Procedural Terminology (CPT®) codes have been created that streamline the novel coronavirus testing currently available on the United States market.
A revision to code 86318 and addition of two codes are effective April 10, 2020 for use as the industry standard for reporting of novel coronavirus antibody tests across the nation’s health care system.
The previously established code 87635 was effective March 13, 2020 for novel coronavirus tests through infectious agent detection by nucleic acid.
Please note that, per the standard early release delivery process for CPT codes, you will need to manually upload these code descriptors into your EHR system. These CPT codes will arrive as part of the complete CPT code set in the data file for 2021 later this year.
RESULTS
INTERPRETATION OF RESULTS
All test controls should be examined prior to interpretation of patient results. If the controls are not valid, the patient results cannot be interpreted.
INTERPRETATION OF RESULTS (Please refer to the illustration).
IgG POSITIVE: *The colored line in the control line region (C) appears and a colored line appears in test line region IgG indicates that COVID-19-IgG antibody was detected in the sample.
IgM POSITIVE: *The colored line in the control line region (C) appears and a colored line appears in test line region IgM indicates that COVID-19-IgM antibody was detected in the sample, and is indicative of primary COVID-19 infection.
IgG AND IgM POSITIVE: *The colored line in the control line region (C) appears and two-colored lines should appear in test line regions IgG and IgM. The color intensities of the lines do not have to match. The result is positive for IgG & IgM antibodies.
NEGATIVE: The colored line in the control line region (C) appears. No line appears in test line regions IgG or IgM.
INVALID: There is no line appear in the control line region (C).