EmblemHealth (NY)- updated medical billing and coding for COVID-19 specimen collection

Effective 07/01/2020-

Medicare and Commercial:

Effective for DOS 03/01/2020 and thereafter

 These codes should only be used when the provider or facility is NOT running the test.

+Providers should bill 99211-CS for collecting specimen in the office setting.

+Independent clinical diagnostic laboratories should bill G2023  or G2024 (for patients that are homebound, in skilled nursing facility)

+Outpatient Hospitals should use C9803 to code for symptoms assessment and specimen collection.

Medicaid:

Effective for DOS 05/01/2020 and thereafter (consistent with NY Medicaid billing guidance)

+Practicioners and Clinics should bill G2023  or G2024  -this code should be bill ONLY when NO OTHER service was given to the patient on that particular DOS AND the provider is NOT billing for Laboratory COVID-19.

+ Independent Laboratories (POS 81) are NOT reimbursed separately for specimen collection

Code Definitions:

G2023  – Specimen collecton for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) by a laboratory on behalf of a home health agency, any specimen source

G2024 – Specimen collecton for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) from an individual in a skilled nursing facility by a laboratory, any specimen source

C9803  – Hospital outpatent clinic visit specimen collecton for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), any specimen source

99211-CS – Use for specimen collecton in the physician ofce for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), any specimen source