CPT code 87636 is used to report nucleic acid assays that detect the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. CPT code 87637 is used to report nucleic acid assays that detect the presence of influenza viruses A and B.
Coding rules for CPT codes 87636 and 87637 are as follows:
- Only one unit of service should be reported per patient encounter, regardless of the number of tests performed.
- These codes may be reported once per date of service, regardless of the number of specimens collected or the number of results reported.
- If multiple tests are performed on the same specimen, only one code should be reported, based on the highest level of complexity of the tests performed.
- If a combination test is performed that detects both COVID-19 and influenza A/B, only one code should be reported, based on the highest level of complexity of the test performed.
- These codes are used for reporting laboratory testing performed in-house, as well as testing performed by a reference laboratory.
- These codes may be reported with modifiers to indicate the circumstances of the testing, such as when testing is performed on a patient who is suspected of having COVID-19 or influenza.
It is important to note that coding rules and guidelines may change over time, so it is always recommended to consult the latest guidelines and updates from authoritative sources such as the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA).