New Laboratory COVID-19 Antibody Testing Codes: 86328 and 86769
The American Medical Association (AMA) announced two new CPT® codes for COVID-19 specific antibody serology (blood) tests effective April 2, 2020. Our systems will be updated with CMS pricing soon after the pricing is released.
Please use the following codes when testing for COVID-19 Antibodies:
- 86328: Immunoassay for infectious agent antibody(ies), qualitative or semi-quantitative, single-step method (e.g., reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).
Code 86328 represents a simple single-step test that is often used as a point-of-care test, that could be done in a physician office setting. Per AMA’s direction, if two different antibodies are tested, then only one unit is billable
- 86769: Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease COVID-19)
Code 86769 represents a multi-step method test that is likely to be done by an independent lab or hospital. Per AMA’s direction, if two different antibodies are tested, then two units are billable.
Antibody tests must be FDA approved and the office performing the test must have a Clinical Laboratory Improvement Amendments (CLIA) waiver certification to bill for these services.
Reimbursement for COVID-specific antibody testing is not subject to member cost sharing and should be appended with modifier CS.
CPT® is a registered mark of the American Medical Association.