News: COVID-19 Regeneron antibody codes released

CDI Strategies - Volume 14, Issue 56

CMS has released new Healthcare Common Procedural Coding system (HCPCS) codes for a COVID-19 antibody drug that has recently been approved by the Food and Drug Administration (FDA).

The codes are to be used for Regeneron’s investigational antibody therapy cocktail. The new codes are:

  • Q0243
    • Long descriptor: Injection, casirivimab and imdevimab, 2400 milligrams
    • Short descriptor: casirivimab and imdevimab
  • M0243
    • Long descriptor: intravenous infusion, casirvimab and imdevimab includes infusion and post administration monitoring
    • Short descriptor: casirivi and imdevi infusion

The FDA granted the therapy emergency use authorization for the treatment of mild-to-moderate COVID-19 patients who are at risk of progressing to severe COVID-19 or hospitalization.

According to CMS, Medicare will cover costs for infusions for this and a previously approved antibody therapy during the public health emergency as long as the infusions are administered according to their emergency use authorizations.

CMS provided additional information on Medicare payment allowances for the injections, noting that while it went into effect on November 21, it will be adjusted regionally.

Editor’s note: The new HCPCS codes can be found here. ACDIS coverage of CPT codes for COVID-19 antibody testing can be found here.

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