Billing Beat

BCBS Commercial – Covid Testing Coding

September 14, 2021

Use correct diagnosis codes for COVID-19 testing.

Reminder and clarification on which diagnosis codes to use for COVID-19 testing for commercial members:

Blue Cross Blue Shield of Michigan and Blue Care Network continue to cover COVID-19 testing that is considered medically necessary by an attending health care provider.

For commercial members, when an attending health care provider administers or refers a patient for COVID-19 testing, Blue Cross and BCN assume the health care provider has determined the test to be medically necessary, unless it’s coded with a noncovered diagnosis code (see below). Medical necessity is possible regardless of whether the patient is experiencing symptoms or has been exposed to COVID-19.

• For medically necessary testing (includes symptomatic testing and testing due to contact with and [suspected] exposure to COVID-19): Use Z20.822 as the primary diagnosis for dates of service on or after Jan. 1, 2021. (Use Z20.828 for dates of service on or before Dec. 31, 2020.)

• For pre-operative COVID-19 testing: Use Z01.810, Z01.811, Z01.812 or Z01.818

Source: https://www.bcbsm.com/content/dam/microsites/corpcomm/provider/BCNPN/Assets/archive/2021/05/BCNProviderNews_2021SepOct.pdf#page=34

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