Billing & Coding

AMA Creates New CPT Code 87426 for COVID-19 Antigen Testing

On June 24, the American Medical Association Current Procedural Terminology (CPT) approved new CPT code 87426 to report COVID-19 antigen tests, which use immunofluorescent or immunochromatographic techniques to detect the SARS-CoV-2 virus at the point of care. As of June 26, only one such test has received Emergency Use Authorization (EUA) from the FDA, the Sofia 2 SARS Antigen FIA rapid point-of-care test from Quidel, which received EUA on May 8. On the same day it unveiled the new CPT 87426 code, the AMA also issued new Proprietary Laboratory Analyses (PLA) Codes 0223U and 0224U for SARS-CoV-2 detection.

New CPT & PLA Codes for SARS-CoV-2 Tests

The new 87426 antigen testing code is the latest in a series of CPT codes created by the AMA in response to the pandemic. Here’s the entire list of the SARS-CoV-2 related CPT and PLA codes that have been approved or revised and published for the 2021 CPT code set, listed in chronological order:

  • CPT Code 87635 (effective March 13, 2020) for infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique; Effective March 13, 2020;
  • CPT Code 86318 (effective April 10, 2020) revised for use to report immunoassay for infectious agent antibody(ies) and be a parent to 86328;
  • CPT Code 86328 (effective April 10, 2020) for single step antibody testing for severe acute respiratory syndrome coronavirus 2;
  • Child Code 86769 (effective April 10, 2020) for multiple-step antibody testing for severe acute respiratory syndrome coronavirus 2;
  • PLA Code 0202U (effective May 20, 2020) for the BioFire® Respiratory Panel 2.1 (RP2.1) test;
  • CPT Code 87426 (effective June 24, 2020) for infectious agent antigen detection by immunoassay technique of SARS-CoV and SARS-CoV-2;
  • PLA Codes 0223U and 0224U for detection of SARS-CoV-2.

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