SPECIAL BULLETIN COVID-19 #151: Laboratory Codes for COVID-19 Testing

Tuesday, January 19, 2021

NC Medicaid has approved the following codes for COVID-19-related medically necessary laboratory testing and has completed adding these services in NCTracks. Please note there are other codes currently under review that will be posted at a later date.

Code

Description

Effective Date

U0001

2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel – CDC

Feb. 24, 2020

U0002

2019 Novel Coronavirus Test – Non-CDC
March 20, 2020 QW modifier added

Feb. 24, 2020

C9803

Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source

March 01, 2020

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
March 20, 2020 QW modifier added

March 13, 2020

U0003

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, making use of high throughput technologies.

March 18, 2020

U0004

2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies

March 18, 2020

86328

Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (e.g., reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID19])

April 20, 2020

86769

Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

April 20, 2020

G2023

Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source

March 01, 2020

G2024

Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a SNF or by a laboratory on behalf of a HHA, any specimen source

March 01, 2020

87426

Infectious agent antigen detection by immunoassay technique, (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19]).

Sept. 01, 2020

Providers can now be reimbursed for uninsured individuals who enroll in NC Medicaid Optional Testing (MCV). Enrollment information can be found in Medicaid Special Bulletin COVID-19 #128. NC Medicaid Be Smart Family Planning program (MAFDN) beneficiaries are eligible for the MCV testing but do not need to complete this application. 

Medical office providers can be reimbursed for COVID-19 specimen collection using CPT code 99211 (ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT, TYPICALLY 5 MINUTES) with modifier CR. CMS has approved the use of this code for new patients when used for specimen collection.

Providers should regularly check the NCDHHS COVID-19 webpage for the most up-to-date information and resources.

CONTACT

NCTracks Contact Center: (800) 688-6696