Medicare will permit the use of HCPCS codes U0002-QW and 87635-QW for claims submitted by facilities with a valid, current CLIA certificate of waiver with dates of service on or after March 20, 2020.  Make sure your billing staffs are aware of these changes.

Currently, there is no Food and Drug Administration (FDA)-approved or cleared test to diagnose or detect COVID-19.  The FDA has issued several Emergency Use Authorizations (EUAs) for the use of a new diagnostic tests to detect the SARS-CoV-2 virus.

Policy for Diagnostic Tests for Coronavirus Disease-2019, and generally refers to settings that are equipped with the instrumentation and appropriately trained personnel necessary to perform the test and may include settings such as hospitals, physician offices, urgent care, outreach clinics, and temporary patient care settings.

Those tests listed on the FDA’s EUAs for COVID-19 website: https://www.fda.gov/medicaldevices/emergency-situations-medical-devices/emergency-use-authorizations under the Test Kit Manufacturers and Commercial Laboratories Table that include the terms “patient care settings outside of the clinical laboratory environment,” “near-patient testing,” or “point of care” in the EUA can be used by facilities having a current CLIA certificate of waiver.

Link to the complete article about HCPCS Codes U0002 and 87635: https://www.cms.gov/files/document/mm11765.pdf

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Lanny Menendez
Professional Reimbursement Managers
Professional Reimbursement Managers
www.prmbilling.com