Apurva Posted Fri 24th of April, 2020 08:59:45 AM
1. Who can bill for G2023 and G2024?
2. A lab performs COVID-19 test and Can the Lab bill G2023 for all the tests
3. When can a lab bill for G2024 ?
4. MS will allow a specimen collection fee for sputum collection performed by trained laboratory personnel. What does a trained personal mean
SuperCoder Answered Mon 27th of April, 2020 07:10:30 AM
Thank you for your Question!
HCPCS Codes G2023 and G2024 can be billed by Independent laboratories or Clinical diagnostic laboratories.
- G2023 is reportable when a trained laboratory technician in an independent laboratory collects a specimen from a patient while
- G2024 is reportable when an independent laboratory sends a trained laboratory technician to collect a specimen from a patient in a skilled nursing facility (SNF) or for a home health agency (HHA). labs report this code G2023 when a trained laboratory technician collects a nasopharyngeal, oropharyngeal, sputum, or another type of specimen for the purpose of performing a laboratory test for the SARS–CoV–2 virus.
Note: COVID-19 tests that allow patients to collect the specimen themselves are not eligible for this specimen collection fee. You can report G2023 and G2024 for claims with a date of service on or after March 1, 2020. These codes are only billable by clinical diagnostic laboratories, according to a special March 31, 2020 edition of MLN Connects®.
The only variation between the G2023 and G2024 code descriptors is this wording in G2024: “from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency.”
The nominal specimen collection fee for COVID-19 testing for homebound and non-hospital inpatients “generally will be $23.46,” according to the interim final rule. For individuals in a SNF or for individuals whose samples will be collected by a laboratory on behalf of an HHA, the fee will be $25.46. These fees are higher than the typical specimen collection fees of $3 to $5, reflecting the higher costs required to minimize exposure risks. It also states that this fee will not be paid to anyone who has not extracted the specimen”
Trained Personnel means competent personnel that have been trained through instruction to carry out the assigned task effectively. The technician has been trained to collect and handle the specimen to minimize exposure and risk of contracting the disease for themselves and others and to maximize accurate test results.
Laboratory personnel also will need to be trained on how to minimize risks for spreading the virus to themselves and/or others in the chain of handling the specimen before it arrives at the laboratory for analysis
The interim final rule states the HCPCS code, G2024, is necessary because the Social Security Act and CMS regulations “require a higher fee for collecting a specimen from an individual in a SNF [skilled nursing facility] or by a laboratory on behalf of an HHA [home health agency].”
In accordance with this provision, Medicare established a travel allowance for a laboratory technician to draw a specimen from homebound patients and non-hospital inpatients. Under current guidance, the travel allowance is intended to cover the estimated travel costs of collecting a specimen from a Medicare beneficiary and to reflect the technician’s salary and travel costs. It is paid only when the nominal specimen collection is also payable and is not available if the technician is merely performing a messenger service to pick a specimen drawn by a physician or nursing home personnel.
Hope that Helps!