Industry Insight

AMA Announces New CPT Codes for Multivirus Tests to Detect COVID-19 and Flu

The American Medical Association (AMA) recently published an update to the CPT code set that includes new code additions and editorial revisions for reporting medical services sparked by the public health response to the COVID-19 pandemic.

The update to the CPT code set was approved by the CPT Editorial Panel, the independent body convened by the AMA with authority to review and approve proposed additions and revisions to the CPT code set. The new additions and revisions to the CPT code set have been approved for immediate use.

“Two of the newly approved codes report nucleic acid assays that allow a single test to simultaneously detect the novel coronavirus and a combination of common viral infectious agents, including influenza A/B and respiratory syncytial virus,” says AMA President Susan R. Bailey, MD. “Concurrent detection promises to conserve important testing resources, allowing for ongoing surveillance of influenza while testing for the novel coronavirus.”

For quick reference, the new category I CPT codes and long descriptors are the following:

87636: Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique.

87637: Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique.

The CPT Editorial Panel also revised CPT codes ranging from 87301 to 87430 by removing the undefined term “multi step method” from code descriptors. The revision clarifies the proper reporting for antigen tests that are read by a machine, as compared with those that can be visually interpreted without a machine. This revision affects the newly developed descriptor for CPT code 87426.

87426: Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]).

In accordance with the above revision, the CPT Editorial Panel approved a new category I code, 87811, to report infectious agent antigen detection by immunoassay with direct visual observation.

87811: Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).

In addition to the long descriptors, short and medium descriptors for CPT codes 87636, 87637, 87426, and 87811 can be accessed on the AMA website, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SAR-CoV-2 virus and the COVID-19 disease.

Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel that collects broad input from the health care community and beyond to ensure CPT content reflects the coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology, so it can fulfill its vital role as the trusted language of medicine today and the code to its future.

— Source: American Medical Association

ELLKAY Names New Chief Information Officer

ELLKAY, a health care connectivity company, announced Marc Probst as its new CIO. Probst recently retired as CIO of Intermountain Healthcare, a not-for-profit health system based in Salt Lake City. In early 2020, the College of Healthcare Information Management Executives (CHIME) and HIMSS jointly recognized him as CIO of the Year. As the new CIO of ELLKAY, Probst will be a driving force in continuing ELLKAY’s position as interoperability experts. His focus will be on growth, partnerships and strategic initiatives, thought leadership, and guiding innovation and ELLKAY’s product roadmap.

Probst says, “I am proud and excited to join this experienced company who has demonstrated their dedication to providing innovative and interoperable solutions to hospitals and health systems, ambulatory practices, vendors, labs, and payer partners. ELLKAY’s agility and commitment to delivering market-leading solutions is second to none and I am honored to be a part of it.”

Probst joins ELLKAY at a time in which the company is experiencing significant growth across multiple HIT segments. The company recently announced 30% year-over-year growth, with one-half of that growth occurring during Q2 2020, and also appointed two new chief innovation and strategy officers.

ELLKAY’s CEO Kamal Patel says, “Marc brings valuable industry experience and expands our strategic relationships in the industry. His passion for innovation and strategic eye will be instrumental in ELLKAY’s mission to enable full interoperability in the health care industry.”

With more than three decades of HIT industry experience, Probst comes to ELLKAY as a recognized leader in HIT. At Intermountain, Probst led a team of more than 1,000 technology professionals through innovative initiatives including the development of new digital health solutions, opening of a virtual hospital, and the adoption of several telehealth specialty programs. He has also served on the CHIME Innovation Advisory Board and CHIME Board of Trustees, and was Chair of the CHIME Foundation Board and Chair of CHIME’s Public Policy Steering Committee. As a member of the CHIME Policy Steering Committee, Probst offered testimony on Capitol Hill and was appointed to serve on the Federal Health IT Policy Committee, where he had offered testimony to Congress and helped develop HIT policies for the federal government.

— Source: ELLKAY

Health Catalyst Acquires Revenue Workflow Optimization Startup

Health Catalyst, a provider of data and analytics technology and services to health care organizations, entered into a definitive agreement to acquire Vitalware, a provider of revenue cycle management solutions for hospitals and health systems of all sizes.

Vitalware, founded in 2011, has received an undisclosed amount of venture capital funding (in 2015) from Eight Roads Ventures and F-Prime Capital.

According to the company, its suite of revenue cycle solutions and services used by nearly 1,000 health care organizations addresses all aspects of mid–revenue cycle management, including documentation, coding, charge capture, auditing, and lost revenue recovery.

The amount of the acquisition was not disclosed. Health Catalyst expects to fund the acquisition using a mix of stock and cash.

Health Catalyst CEO Dan Burton says, “In addition to adding a best in KLAS technology solution from Vitalware, this acquisition is another powerful example of Health Catalyst’s ability to integrate and scale software on top of our DOS platform. Ultimately, DOS, our cloud-based data platform, will further enhance the analytics insights made available by Vitalware’s technology by integrating charge and revenue data with claims, cost, and quality data.”

More recently, Health Catalyst acquired healthfinch, a health care workflow automation company, for $40 million.

“Vitalware, since inception, has been about delivering solutions that provide critical insights and better financial outcomes to health systems,” says Kerry Martin, Vitalware CEO and cofounder. “We have a great team committed to our clients and their success, and adding the expertise and solutions from the Health Catalyst team will allow Vitalware to deliver even more innovative solutions. Our No. 1 priority continues to be to create positive outcomes for our clients, and we’re confident the combination of our resources with Health Catalyst will only accelerate that effort.”

— Source: Mercom Capital Group