There are two new HCPCS Level II codes, effective March 22, 2024. The codes apply to the supply and administration of Pemgarda™. The U.S. Food and Drug Administration (FDA) issued an emergency use authorization for this unapproved product for the pre-exposure prophylaxis of COVID-19 in certain patients. Review the code descriptors carefully for age, weight, and health requirements.
The product code is Q0224 Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to COVID-19 vaccination, 4500 mg.
The administration code is M0224 Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, includes infusion and post administration monitoring.
These updates are now available on Codify by AAPC.
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