Coding spotlight: Tips and best practices for compliance

Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. The guidance below can make it easier for you to refer your patients to high-quality, lower-cost COVID-19 testing sites, find Anthem Blue Cross (Anthem) contracted laboratories and identify the proper CPT codes to use. Contact your Anthem representative for additional information or visit https://providers.anthem.com/ca.

 

Refer patients to www.anthem.com/ca/medi-cal to find convenient testing locations

If an Anthem member requests a COVID-19 test, you may refer them to Anthem to find a testing location near them. Our test-site finder gives members important information about each site, including days and hours of operation, and if they offer:

• Appointment or walk-in
• Drive through service
• Rapid test results
• Antibody testing
• Testing for children

 

Consider Antigen testing as an option when rapid results are needed

Antigen tests can be a quicker way to detect COVID-19 than nucleic acid amplification test (NAAT), (for example, PCR). Antigen tests offer a reasonable and lower cost alternative when screening asymptomatic or low-risk patients and may be most useful for individuals within the first five to seven days of symptoms when virus replication is at its highest.

 

Send swab tests to Anthem-contracted laboratories

When providing COVID-19 molecular testing services to our members, consider utilizing the following additional in-network, high-quality labs to assist in helping to ensure that our members are receiving high-value health care.

 

In-network lab	Telephone	Website
Fulgent Therapeutics	1-626-350-0537	https://www.fulgentgenetics.com/covid19
Lab 24, LLC	1-877-319-7222	https://lab24.us