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May 16, 2023

Education Article: COVID Serology Testing

Now that the Public Health Emergency has ended CGS Administrators will be transitioning to case-to-case consideration for COVID serology testing.

COVID serology test’s ability to guide patient care have been challenged by timely access and reporting of results, variability in patients’ immune response and vaccination’s impact on test results. While the tests can determine if antibodies to coronavirus are present the tests cannot distinguish between different strains and may possibly be confounded by exposure to other coronaviruses.

Billing Instructions:

Claims billed for 86769, 86328, 87635 are subject to case-to-case review.

You may receive an Additional Documentation Request (ADR) for medical records for this review.

Please ensure the documentation within the medical record indicates the patient medical history pertinent to this test and why the test was medically necessary for the patient.

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