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 and Blue Shield (Anthem) contracted laboratories and identify the proper CPT codes to use.

 

Contact your Anthem representative if you need additional information or visit anthem.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 April 1, 2021, CPT codes G2023 and G2024 are appropriate when billed by clinical laboratories only and are not appropriate for provider practices.

 

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

 

If an Anthem member requests a COVID-19 test, you may refer them to anthem.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 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

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 Therapeutics

(626) 350-0537

https://www.fulgentgenetics.com/covid19

Invitae Corporation

(650) 466-7242

https://www.invitae.com/en/partners/

Gravity Diagnostics

(855) 841-7111

https://gravitydiagnostics.com/covid-19-coronavirus-testing-partners/

Mako Medical Laboratories

(919) 351-6256

https://makomedical.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 Center for Disease Control and Prevention (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 Center of Disease Control and Prevention (CDC), clinicians should consider testing for other causes of respiratory illness, including infections such as influenza, when clinically appropriate.

 

1099-0421-PN-CNT



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COVID-19 Information - Ohio
April 2021 Anthem Provider News - Ohio