Billing Tests for Zika Virus

The Centers for Medicare & Medicaid Services (CMS) recently issued MLN Matters SE1615 (PDF, 49 KB) reminding providers that Medicare covers Zika virus testing under Medicare Part B as long as the clinical diagnostic laboratory test is reasonable and necessary for the diagnosis or treatment of a person's illness or injury.

Presently there are no specific HCPCS codes for testing of the Zika virus. To bill for Zika virus testing, submit the claims with CPT 87999. Please keep in mind that medical documentation must support the services billed. Clinical laboratories may be asked by Medicare administrative contractors to provide resources and cost information to establish appropriate payment amounts for the tests.

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