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CMS, Healthcare Common Procedure Coding System (HCPCS)

HCPCS is a standardized coding system that Medicare and other health insurers use to submit claims for services provided to patients.

Testing for SARS-CoV-2/2019-nCoV (COVID-19)

HCPCS U0001Tests at CDC testing laboratoriesHCPCS - U0001 - Billing coded for SARS-CoV-2/2019-nCoV (COVID-19)tests, specifically for CDC laboratories - Feb 13 2020
https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test
HCPCS U0002Tests at non-CDC laboratoriesHCPCS - U0002 - Billing coded for SARS-CoV-2/2019-nCoV (COVID-19) tests, specifically for Non-CDC laboratories - Mar 5 2020
https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

Coverage and Payment Related to COVID-19 Medicare

https://www.cms.gov/files/document/03052020-medicare-covid-19-fact-sheet.pdf

https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf

  • Medicare claims processing will accept claims with U0001 and U0002 starting on Apr 1 2020, for dates of service on or after Feb 4 2020.
  • If the claim is submitted to a payer that requires CPT codes, then code 87635 should be reported. Conversely, if the payer requires use of the
    HCPCS Level II code, the HCPCS Level II code should be reported.
  • CPT and HCPCS codes should not both be reported on the same claim.
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