Maximizing efficient, high quality COVID-19 screenings

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 Empire BlueCross BlueShield (“Empire”) contracted laboratories and identify the proper CPT codes to use.

 

Contact your Empire representative if you need additional information or visit empireblue.com/coronavirus/providers.

COVID-19 testing coding guidelines

• For a new or established patient, CPT code 99211 would be appropriate if patient is being seen for no other services besides a specimen collection.
• For a patient assessment in addition to a specimen collection it is appropriate to bill the applicable E&M service, CPT codes 99202-99215. Specimen collection is a component of the E&M service and not separately reimbursable. Effective 04/01/2021, CPT codes G2023 and G2024 are appropriate when billed by clinical laboratories only and are not appropriate for provider practices.

Refer patients to empireblue.com/coronavirus to find convenient testing locations

If an Empire member requests a COVID-19 test, you may refer them to empireblue.com or the Sydney Health mobile app to find testing locations near them. Our test-site finder gives members important information about each site, including days and hours of operation, and if they offer:

• Appointments or walk-ins.
• Drive-through service.
• Rapid test results.  
• Antibody testing.
• Testing for children.

Send swab tests to Empire-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
Eurofins NTD	(888) 683-5227	https://www.ntd-eurofins.com/
Eurofins Viracor	(800) 305-5198	https://www.viracor-eurofins.com/test-menu/8300-coronavirus-covid-19-sars-cov-2-rt-pcr/
Eurofins Boston Heart	(877) 425-1252	https://bostonheartdiagnostics.com/
Fulgent	(626) 350-0537	https://www.fulgentgenetics.com/covid19
Invitae	(650) 466-7242	https://www.invitae.com/en/partners/
Gravity		https://gravitydiagnostics.com/covid-19-coronavirus-testing-partners/
Mako Medical Laboraties	(919) 351-6256	https://makomedical.com/
LAB24	(800) 641-0133	https://www.lab24inc.com/corona-virus-home-test-kit
MD Tox Lab	(866) 363-0203	https://www.ihdlab.com

Consider antigen testing when rapid test results are needed

Antigen tests can be a quicker way to detect COVID-19 than nucleic acid amplification tests (NAAT), e.g. 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.

 

Antigen tests can be used to detect current infection, are relatively easy to use, and most can provide point-of-care testing results. The Centers for Disease Control and Prevention (CDC) notes that proper interpretation of antigen test results (and confirmatory testing with NAAT when indicated) is important for accurate clinical management of patients with suspected COVID-19; more information can be found here.

 

The CDC notes that when molecular tests are unavailable or rapid turnaround time is needed, antigen tests can generally be used for diagnosis of COVID-19.

 

Antigen tests are typically less sensitive, and clinicians should interpret negative results carefully.  When symptoms are present or a high clinical suspicion exists, negative antigen tests should be confirmed with a molecular test.

 

When antigen tests are used in symptomatic patients, positive antigen tests can be interpreted as indicative of SARS-CoV-2 infection and do not usually require follow-up testing.

 
Consider using COVID-19 and flu combination testing when appropriate

According to the CDC, clinicians should consider testing for other causes of respiratory illness, including infections such as influenza, when clinically appropriate.

 

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