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Cracking the Code

What modifiers eliminate COVID-19 deductibles?

On April 7, 2020, CMS proposed a new Families First Coronavirus Response Act. This act waives co-insurance and deductibles for additional COVID-19 related services. Under this act, CMS requires modifier CS applied to applicable institutional and non-institutional claim lines to identify that the service is subject to the cost-sharing waiver for COVID-19 testing-related services. This ensures that Medicare members are NOT charged any co-insurance or deductibles for those services as well.

Q: A 30-year-old male presents to the hospital emergency department with a fever, cough, and shortness of breath. The physician orders a CDC COVID-19 lab test, and the results are positive.
A: L89.314 (pressure ulcer of right buttock, stage 4) L89.313 (pressure ulcer of right buttock, stage 3)
Reference: Primary diagnosis: U07.1, COVID-19 CPT for COVID-19 lab test: U0001-CS
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