HCPCS C9803 is officially defined as "Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source." HCPCS C9803 is referenced in 2 tracked payer policy changes from Blue Cross Blue Shield of Wyoming. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C9803 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
BCBSWY updated COVID-19 billing requirements to include specific specimen handling codes (G2023, G2024, C9803, 99000, 99001) for non-in-house testing to ensure proper cost share waivers. The policy also waives inpatient prior authorization for COVID-19 treatment (U07.1 diagnosis) and extends telemedicine benefits through August 31, 2020.
Updated COVID-19 testing billing guidance confirms that diagnostic COVID-19 tests are covered without cost-sharing or prior authorization requirements under federal law. Antibody testing is only covered when medically appropriate for diagnostic purposes, not for return-to-work or surveillance screening.
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