March 19, 2020
We're here to help support you and to keep our communities safe during the coronavirus (COVID-19) outbreak. This FAQ can help answer your questions and is updated regularly to provide you with the most accurate information.
Which codes do I use for COVID-19?
The Centers for Disease Control and Prevention (CDC) released ICD-10-CM Interim Coding Guidance for COVID-19. Using the correct codes for COVID-19 helps claims process correctly and waives cost sharing as appropriate for our members.
Currently there are two HCPCS codes available for lab tests.
CPT code:
The American Medical Association added a new CPT code for reporting COVID-19 tests:
87635 - Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease, COVID-19), amplified probe technique.
ICD-10 code:
The World Health Organization established a new ICD-10 emergency code for reporting the virus, U07.1, 2019-nCoV acute respiratory disease. This code is effective with the next update on October 1, 2020. Premera is accepting this code and encourages you to use it.
To identify patients who test positive for COVID-19, current CDC guidance instructs to code first for the presenting illness, followed by B97.29 - Other coronavirus, as the cause of diseases classified elsewhere.
Can I offer telehealth services to my patients?
Yes. Virtual care is covered under your current Premera contract if the care provided is appropriate within the scope of the provider’s licensure.
Refer to your Premera contract for allowable information for virtual care codes. For specific coding information for Premera patients, see our telehealth payment policy.
If you have questions, call your Premera provider network team.