CDC has developed a laboratory blood test to assist with efforts to determine how much of the U.S. population has been infected with SARS-CoV-2, the virus that causes COVID-19. CDC is also using its serologic test (antibody) to evaluate the performance of commercial antibody tests.
CPTs for the same 86328 and 86769. Reimbursement rate is still not released.
The American Medical Association (AMA) recently released expedited CPT updates that include two new codes, effective April 10, for COVID-19 antibody tests:
86328 — Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (e.g., reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).
86769 — Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).
Code 86328 should be used for antibody tests with a single-step method immunoassay — typically a strip with all the necessary components for the assay, appropriate for a point-of-care testing platform. Report 86328 once per reagent strip. If more than one reagent strip is used, modifier 59 (distinct procedural service) should be appended to the code for the second reagent strip assay to identify two distinct analyses were performed.
Code 86769 should be used for antibody tests with multi-step methods. When two distinct analyses are performed (e.g, IgG and IgM), 86769 is reported on two claim lines with modifier 59 (distinct procedural service) appended to 86769 on the second claim line.
