Coronavirus 2019 (COVID-19)

Coronavirus 2019 (COVID-19)

April 2, 2020

BlueCross BlueShield of South Carolina and its subsidiary BlueChoice® HealthPlan will cover testing to diagnose COVID-19 for their members when medically necessary and prescribed by health providers. Any subsequent necessary care will be done in close coordination with federal, state and public health authorities. This currently applies to our fully insured groups, but our administrative services only (ASO) groups are being encouraged to comply. We will be sure to keep you updated on the status of their decisions.

When consistent with the Centers for Disease Control and Prevention* (CDC) guidelines, and where it is not covered as part of the Public Health Service response, the following members’ responsibilities will be covered to diagnose COVID-19:

  • Copays

  • Coinsurance

  • Deductibles

Additionally, prior authorizations for diagnostic tests and covered services that are medically necessary and consistent with CDC guidelines for members diagnosed with COVID-19 will be waived, but notification is required.

If the member is admitted to the hospital, please follow the normal procedures to obtain a prior authorization by using one the following methods:

  • My Insurance Manager® — Fast Track Option (Coronavirus — COVID-19) — Only use this when the member has tested positive for COVID-19 and the admission is related to complications associated with COVID-19.

  • Fax — Use the number located on the back of the member’s ID card.

  • Phone — Use the number located on the back of the member’s ID card.

There are three codes associated with COVID-19:

  • U0001 - 2019-nCoV Real-Time RT-PCR Diagnostic Panel, CDC.
    Note: Use this code if your lab uses CDC test kits.

    U0002 - 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC.
    Note: Use this code if your lab does not use CDC test kits and your test is not described by code 87635 listed below.

    87635 - (Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])

As for the diagnosis codes, you would continue submitting claims with the appropriate diagnosis code(s) based on the symptoms provided (i.e., shortness of breath, acute bronchitis, respiratory infection, etc.).

A new ICD-10 emergency code (U07.1, 2019-nCoV acute respiratory disease) has been established by the World Health Organization* (WHO). The new code will be available 04/01/2020.

For any additional questions, please contact Provider Education using the Provider Education Contact Form located on www.BlueChoiceSC.com.

 

* The U.S. Centers for Disease Control and Prevention and the World Health Organization are independent organizations that provide health information you may find useful.

 

See the FAQs for COVID-19 here.