AHA Coding Clinic® for HCPCS - 2020 Quarter 4; Ask the Editor
PLA code 0202U vs. CPT code 87635
Our facility utilizes the BioFire® respiratory panel 2.1, a proprietary laboratory test (PLA) represented by code 0202U that tests 22 targets including SARS-CoV-2. It is our only in-house option for COVID-19 test reporting. Is it appropriate to assign code 0202U , Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected, when the only test ordered is for COVID-19 or should CPT code 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, be assigned instead? ...
Subscribe or sign in to view the full article.
Article Overview
This article explains a coding question involving a proprietary laboratory assay used for respiratory and COVID-19 testing, and compares it with a CPT infectious agent detection code for SARS-CoV-2. It is relevant to laboratory billers, coders, compliance staff, and revenue cycle teams that handle molecular diagnostic test reporting. The discussion focuses on how the test context, test intent, and code-set selection are framed for laboratory claims and reporting.
Why This Topic Matters
Choosing the correct laboratory code affects claim accuracy, coding consistency, and reporting for COVID-19-related molecular testing. The article helps readers understand the distinction between a proprietary panel code and a targeted pathogen detection code in a lab billing context.
What You Will Learn
- How the article frames a coding comparison for respiratory molecular testing.
- The general considerations involved in selecting a laboratory test code for SARS-CoV-2 reporting.
- How proprietary laboratory test coding is discussed alongside a CPT molecular infectious disease code.
- The lab billing context in which COVID-19 test reporting questions arise.
Who Should Read This
- Medical coders
- Laboratory billing staff
- Compliance professionals
- Revenue cycle teams
- Health information management professionals
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com