CPT codes 87636 & 87637(tests for COVID-19 & flu) Coding rules

Introduction of Multi-virus test COVID CPT code 87636 and 87637

The American Medical Association (AMA)  introduced the two codes for COVID-19 Test  as below:

“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. “Concurrent detection promises to conserve important testing resources, allowing for ongoing surveillance of influenza while testing for the novel coronavirus.”

Read also: 2023 new CPT  coding changes for coders

List of new ICD 10 codes for 2023 chapterwise

Description of CPT code 87636 and 87637

This is a test for the detection of SARS-CoV-2 and any pan-coronavirus types or subtypes. Specimens have been collected using one or more methods (bronchoalveolar lavage, lower respiratory tract or nasal/nasopharyngeal aspirate/wash, nasopharyngeal/oropharyngeal swab, or sputum induction), placed into appropriate containers, and transported to the laboratory. The test uses specific primers and amplified probe assay to detect DNA or RNA sequences specific for the SARS-CoV-2 virus. Infectious agent specificity may also include terminology such as severe acute respiratory syndrome coronavirus 2, coronavirus disease, or COVID-19. CPT code 87635 is reported for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), amplified probe technique; CPT code 87636 is reported for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique. CPT code 87637 is reported for 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.

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

 

Read also: New CPT code changes for 2023

Below is the list of Related CPT codes

87301 Infectious agent antigen detection by immunoassay technique, (eg,enzyme immunoassay [EIA], enzymelinked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; adenovirus enteric types 40/41
87305 Aspergillus
87320 Chlamydia trachomatis
87324 Clostridium difficile toxin(s)
87327 Cryptococcus neoformans (For Cryptococcus latex agglutination, use 86403)
87328 cryptosporidium
87329 giardia
87332 cytomegalovirus
87335 Escherichia coli 0157 (For giardia antigen, use 87329)
87336 Entamoeba histolytica dispar group
87337 Entamoeba histolytica group
87338 Helicobacter pylori, stool
87339 Helicobacter pylori (For H. pylori, stool, use 87338. For H. pylori, breath and blood by mass spectrometry, see 83013, 83014. For H. pylori, liquid scintillation counter, see 78267, 78268)
87340 hepatitis B surface antigen (HBsAg)
87341 hepatitis B surface antigen (HBsAg) neutralization
87350 hepatitis Be antigen (HBeAg)

87380 hepatitis, delta agent

87385 Histoplasma capsulatum

87389 HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result
87390 HIV-1

87391 HIV-2

87400 Influenza, A or B, each

87420 respiratory syncytial virus

87425 rotavirus

87426 severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])
87427 Shiga-like toxin

87430 Streptococcus, group A

87449 not otherwise specified, each organism
(87450 has been deleted. Forinfectious agent antigen detection by immunoassay technique, see 87301-87451. For infectious agent antigen detection by immunoassay technique with direct optical [ie, visual]
observation, see 87802-87899)
87451 polyvalent for multiple organisms, each polyvalent antiserum

87802 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B

87803 Clostridium difficile toxin A
#87806 HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies
87804 Influenza
87806 Code is out of numerical sequence.
87807 respiratory syncytial virus
#I87811 severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (Coronavirus disease [COVID-19])
87808 Trichomonas vaginalis
87809 adenovirus
87810 Chlamydia trachomatis
87850 Neisseria gonorrhoeae
87880 Streptococcus, group A
87899 not otherwise specified

References: 

https://www.ama-assn.org/press-center/press-releases/

One Thought to “CPT codes 87636 & 87637(tests for COVID-19 & flu) Coding rules”

  1. AMA New CPT codes (87636 & 87637) multi-virus tests for COVID-19 & flu – medicalbilling

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