Additional COVID‑19 testing codes now payable in office

Current Procedural Terminology codes *87811 and *87428 are now payable when provided in the physician’s office for Medicare Plus Blue℠, Blue Care Network and BCN Advantage℠ members. They’ve been added to Medicare Plus Blue’s Physician Office Laboratory List and BCN’s in-office lab list, available on Provider Secure Services.

We’re making these codes payable retroactive to Jan. 1, 2021, to make it easier for our physicians to treat members. These codes are already payable in office for Blue Cross Blue Shield of Michigan commercial members.

Code descriptions

• *87428: Infectious agent antigen detection by immunoassay technique (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19]) and influenza virus types A and B
• *87811: Infectious agent antigen detection by immunoassay with direct optical (visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])

If you received a previous rejection for performing these tests in a physician’s office setting for Medicare Plus Blue, BCN or BCN Advantage members, you don’t need to do anything. We’ll reprocess the claims.

For more information, see the COVID-19 patient testing recommendations for physicians document on our public website at bcbsm.com/coronavirus or within Provider Secured Services by clicking on Coronavirus (COVID-19).