CMS Announces New Procedure Codes for Tracking COVID-19 Treatments

King & Spalding

Last week, CMS announced that hospitals can now track the use of remdesivir and convalescent plasma for treating COVID-19 patients. In a press release issued on July 30, 2020, CMS emphasized the importance of tracking these treatments in real time. To address this need, CMS is implementing new procedure codes that will allow Medicare and other insurers to identify the use of these treatments for hospital inpatients with COVID-19. The codes went into effect and were implemented into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) on August 1, 2020. ICD-10-PCS is the Health Insurance Portability and Accountability Act (HIPAA)-designated code set for reporting hospital inpatient procedures.

In May, the FDA issued an emergency use authorization for remdesivir, which allowed doctors to use the drug to treat patients hospitalized with serious cases of COVID-19. This limited approval allowed doctors to use the antiviral, intravenously administered drug to treat COVID-19 in patients with low blood oxygen levels or patients needing oxygen therapy or a mechanical ventilator. With the recently implemented procedure codes, Medicare and other payors will now be able to track the use of this treatment on patients with serious cases of COVID-19 for the purpose of collecting critically important data on the effectiveness of this treatment.

The press release from CMS is available here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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