With the recent COVID-19 pandemic, the everyday lives of many people have changed. The legal world is no different. While people grasp with new ways of doing things, the legal world is having a whole host of new issues that come up.
One question we have been getting frequently is whether COVID-19 tests are reimbursable under PIP. Due to the pandemic many chiropractors, orthopedists, diagnostic facilities, and other physicians that treat PIP patients have still been open for business providing medical care for injured patients.
We have clients that have informed us of the extra precautions they are taking. One of those precautions is having a patient tested at the office for COVID-19 prior to receiving treatment. As this comes at a cost to the medical facility, clients have asked whether the tests are reimbursable under PIP. While some PIP insurers have been paying for the tests, others have denied them.
As this is a new issue, there is no caselaw on point. However, under PIP, treatment needs to be reasonable, related, and necessary in order to be reimbursable. While there is no certainty on how courts will ultimately rule on the issue, we believe there is quite a strong argument that the COVID-19 tests would be reimbursable under PIP.
COVID-19 has killed over 130,000 people and spreads rather easily. Medical professionals are in extremely close quarters with their patients and are unable to properly social distance themselves from their patients. Whether it is an orthopedist checking on a patient’s extremities, diagnostic facilities placing a patient in the proper position for a diagnostic test, or a chiropractor performing an adjustment on a patient, it is often very difficult to properly treat a patient without violating social distance protocols.
Doctors and other medical professionals also have a right and a duty to take proper precautions in their office to insure that COVID-19 does not spread to other patients, their employees, and themselves. They have a right to make sure that the patient they are treating does not have COVID-19 to keep themselves and their other patients safe. A very strong, compelling argument can be made that the COVID-19 test is thus reasonable, related, and necessary. Many doctors would not be safely able to perform the proper treatment on a patient that has COVID-19.
If you have any denials for COVID-19 testing, or any other CPT code denials, please contact us with any questions. Our goal is to get you paid for treating injured patients. Please call us at (877)817-4127.