Bamlanivimab Emergency Use Authorization Has Been Revoked. What Does That Mean For You?
- Lindsay Everson
- May 6, 2021
- 2 min read
On April 16, 2021, the FDA revoked the emergency use of Monoconal Antibody Bamlanivimab when administered alone. This infusion had been approved in November 2020 and has been used throughout the last 6 months as a treatment for patients with confirmed mild to moderate cases of COVID-19. The infusion helped prevent the infection from becoming severe. Although this particular EUA is being revoked, there are still alternative therapies available and approved: casirivimab and imdevimab can be administered together and bamlanivimab and etesevimab can be administered together. The coding for each pair is below:
Casirivimab & Imdevimab:
CPT codes M0243 for the administration and Q0243 for the injection, 2400 mg. The Medicare allowable is showing as $450 for M0243 and $0.10 for Q0243 effective 5/6/21. You should diagnosis codes Z23 and U07.1.
M0244 has just been released and can be used if applicable. Here is the description: Intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made provider-based to the hospital during the covid-19 public health emergency. This is effective 5/6/21 and is showing an allowable amount of $750.
Bamlanivimab and Etesevimab:
CPT codes M0245 for the administration and Q0245 for the injection, 2100 mg. The Medicare allowables are the same as above. Use diagnosis codes Z23 and U07.1.
M0246 has just been released, effective 5/6/21. Here is the description: Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made provider-based to the hospital during the covid-19 public health emergency. The allowable for this $750.
The Medicare billing information can be found here: COVID-19 Vaccines and Monoclonal Antibodies | CMS and the FDA revocation can be found here: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-revokes-emergency-use-authorization-monoclonal-antibody-bamlanivimab
If you have any questions regarding billing for monoclonal antibody infusion, our contact information is below.
Premier Medical Billing LLC
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