Q&A: Determining revenue code for COVID-19 monoclonal antibody infusion

Wednesday, February 10, 2021

Q: What revenue code should be attached to HCPCS codes M0239 (intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring) and M0243 (intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring)? We set it up as revenue code 260 but are getting edits to change it to 771. What are your thoughts and suggestions?

A: CMS has established the payment for these drugs under the CMS vaccine program. So, 771 is the revenue code that makes sense.

The COVID-19 monoclonal antibodies are being paid under the vaccine benefit. Please refer to this website: www.cms.gov/medicare/covid-19/monoclonal-antibody-covid-19-infusion. The program instruction states, “During the COVID-19 public health emergency, Medicare will cover and pay for these infusions (when furnished consistent with their respective EUAs) the same way it covers and pays for COVID-19 vaccines.”

Editor’s note: This question was posted in the Chargemaster and Charge Capture section of the NAHRI Forums.