AHA Coding Clinic® for HCPCS - 2020 Issue 4; For Your Information
New HCPCS Level II codes for monoclonal antibody therapies for COVID-19
The U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the investigational monoclonal antibody therapy, bamlanivimab, on November 9, 2020. On November 21, 2020, an EUA was issued for casirivimab and imdevimab (also known as REGN-COV2 or REGEN-COV2). Casirivimab and imdevimab are to be administered together. These monoclonal antibody therapies are for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients with positive COVID-19 test results who are at high risk for progressing to severe COVID-19 and/or hospitalization. The Centers for Medicare and Medicaid Services (CMS) has identified specific HCPCS Level II code(s) listed...
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Article Overview
This article explains recent CMS coding updates related to monoclonal antibody therapies authorized for COVID-19 during the public health emergency. It is aimed at coders, billing staff, and compliance professionals who need to track new HCPCS Level II reporting for these therapies and the related Medicare administration codes, along with the timing of the changes and the FDA EUA context.
Why This Topic Matters
Accurate awareness of these HCPCS Level II updates helps organizations keep billing and reporting aligned with current CMS guidance for COVID-19 monoclonal antibody treatment services.
What You Will Learn
- Which COVID-19 monoclonal antibody therapies are covered in the update
- How CMS organized the associated HCPCS Level II reporting
- Which effective dates apply to the listed code updates
- The general Medicare coding context for these therapies
Who Should Read This
- Medical coders
- Billing specialists
- Compliance professionals
- Revenue cycle staff
- Healthcare administrators
Codes Discussed
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