Question COVID-19 ADMINISTRATION CODE

surfergirl

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I have been researching this and I have only found the CPT Coding for the Vaccines. Does anyone have a link or and idea if there is an administration code for this? Thank you
 

SharonCollachi

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M0243, intravenous infusion, casirivimab and imdevimab includes infusion and post-administration monitoring

Correct. That means you don't charge separately for the time to monitor the patient after the infusion.
 

csperoni

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But I still can code a 96365 or 96367 with it right for an infusion
The description is "Intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring." If M0243 includes the infusion, then you cannot bill for it a second time separately.
 

CarlaA

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Can you bill a home visit code with M0243? I am guessing for the M0244 you would not bill with a 99350 with it since it states in the home. But could you the M0243 or would it be more appropriate to just file the M0244?
 

rachaelwilleford

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Can you bill a home visit code with M0243? I am guessing for the M0244 you would not bill with a 99350 with it since it states in the home. But could you the M0243 or would it be more appropriate to just file the M0244?
M0244 is for the home health administration. M0243 is for outpatient administration. Q0243 is for the drug code itself. Since this drug is being furnished by the government you don't bill for the drug code. No other infusion codes are billed. I don't bill home health, so I can't answer on the 99350.
 

CarlaA

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M0244 is for the home health administration. M0243 is for outpatient administration. Q0243 is for the drug code itself. Since this drug is being furnished by the government you don't bill for the drug code. No other infusion codes are billed. I don't bill home health, so I can't answer on the 99350.
Thank you
 

lmickell

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My provider also does a normal saline with the covid infusion via IV. Should I be billing for that separately or is it wrapped in the M0243 cost? Can I bill for all these?

  • RATE FLOW REGULATOR IV SET -
    • Use as directed. Dispense Qty: 1 Unit
  • ANGIOCATH AUTOGUARD IV CATH 20 GAUGE X 1" INFUSION SET -
    • Use as directed. Dispense Qty: 1 Unit
  • INTRAVENOUS INFUSION (PROC)
    Place of service: OFFICE
    Procedure code: 96365, 96367, 96368, 96366
  • IV INFUSION, HYDRATION, 31-60 MIN (PROC)
    Place of service: OFFICE
    Procedure code: 96360
  • IV INSERTION (PROC)
    Place of service: OFFICE
    Procedure code: 96372, 96375, 96379, 96376, 96373, 96374
  • sodium chloride 0.9 % intravenous solution -
    • Inject 250 mL by intravenous route. Quantity: 250 mL Route: Intravenous
  • REGEN-COV (EUA) 60 mg-60 mg/mL intravenous solution -
    • Inject 1200 mg by intravenous route. Quantity: 1200 mg Route: Intravenous
 

tinaleslie

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Quick question everyone. our ED providers are now providing the Mo243 infusion, they have basically taken another room and expanded it for an infusion room. My question is place of service code.
23 since the emergency Department providers are providing it? or POS 22 for out patient hospital. Thoughts anyone?
 

csperoni

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Quick question everyone. our ED providers are now providing the Mo243 infusion, they have basically taken another room and expanded it for an infusion room. My question is place of service code.
23 since the emergency Department providers are providing it? or POS 22 for out patient hospital. Thoughts anyone?
I am going to offer advice based on previous information about hospital POS, and not specifically about M0243 infusions. If there is other specific advice unique to these infusions I am unaware of, that could change the answer.
The POS is based on the status of the patient, not necessarily exactly where in your building they are.
For example, if a patient is admitted, but is physically the in ER awaiting a room, they are still considered inpatient.
So, if the patient was seen/evaluated in ER, and provider determined would get infusion, then be discharged, I would code POS 23.
If patient was seen/evaluated elsewhere (for example at urgent care), who determined patient qualifies for infusion, and sent to hospital for the infusion, I would code POS 22.
Two patients sitting in the same physical infusion room could be 2 different POS.
 
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