AMA Announces New CPT Codes for Coronavirus Testing

CPT Code for Coronavirus Testing

The American Medical Association (AMA) has recently expanded its Current Procedural Terminology (CPT) code set to include four additional codes for coronavirus testing. These new codes facilitate providers in reporting a wider range of laboratory tests for the novel coronavirus on medical claims.

The newly introduced CPT codes are as follows:

•86408: SARS-CoV-2 neutralizing antibody screen
•86409: SARS-CoV-2 neutralizing antibody titer
•0225U and 0226U: Proprietary laboratory analyses for detecting SARS-CoV-2

These codes are now in immediate effect. They join the growing list of coronavirus-related CPT codes approved and published for the 2021 code set, which encompass various aspects of infectious agent detection, immunoassay, and antigen detection.

Notably, prior to this update, there were no existing CPT codes for tests measuring a patient’s coronavirus neutralizing antibodies or those related to using a cellular reporting system to gauge live virus infection in cell cultures, as clarified in the special coding guidance document released by the AMA.

Coronavirus antibody testing is now widely accessible as communities reopen and return to normal activities. These tests ascertain if an individual has previously had a coronavirus infection, even if they never displayed symptoms, by confirming the presence of antibodies that aid in combating the infection. While a positive result may suggest protection from re-infection, it’s crucial to note that clinical evidence hasn’t conclusively established whether humans can develop immunity to the novel virus through their own antibodies.

Nonetheless, these tests play a vital role in comprehending the transmission of the novel coronavirus in the general populace and identifying high-risk groups, as outlined in the CDC’s guidance for providers on coronavirus antibody testing.

Moreover, coronavirus antibody tests assist in identifying potential blood donors whose plasma could be used in manufacturing convalescent plasma for treating seriously ill coronavirus patients, according to the federal agency.

As of the time of this publication, the FDA has granted emergency use authorizations for over 30 coronavirus antibody tests. The AMA has assigned specific CPT codes for these tests, differentiating between single-step and multi-step methods of immunoassay. It’s important to note that the existing CPT codes for coronavirus antibody testing do not encompass tests that determine whether the antibodies in a patient can directly impede viral infection of cells, as clarified in the new guidance document.

In particular, CPT Code 86328 indicates only the presence of antibodies. In contrast, codes 86408 and 86409 are designated for tests that ascertain if the antibodies present can obstruct COVID-19 virus infection, the organization elucidated.

The FDA has not yet authorized the use of neutralization tests for the novel coronavirus, according to the CDC. Additionally, limitations persist in areas such as the kinetics of antibody response, antibody longevity, their protective capacity against re-infection, the necessary titer of neutralizing antibodies, and the correlation between binding antibody titers and neutralization capabilities in all coronavirus antibody testing, as emphasized by the agency.