2025 HCPCS code M0241
(Unknown) Effective Date: N/A Revision Date: N/A Intravenous infusion or subcutaneous injection - Miscellaneous Medical Services Feed
Intravenous infusion or subcutaneous injection of casirivimab and imdevimab, including infusion or injection 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 (subsequent repeat doses).
Medical necessity is established by the patient's risk factors for developing severe COVID-19, potential exposure to the virus, and clinical guidelines for post-exposure prophylaxis.
The provider is responsible for discussing the need for the infusion or injection, preparing the medication according to instructions, administering the medication via IV or subcutaneous injection, and monitoring the patient during and after the procedure.
In simple words: This code covers repeat doses of COVID-19 antibody treatment given by IV or injection at a patient's home. The healthcare provider prepares and gives the medication, then monitors the patient afterward.
Casirivimab and imdevimab are administered via intravenous infusion or subcutaneous injection, followed by post-administration monitoring.The service is performed in the patient's home or residence, including temporary lodging or a home designated as provider-based during the COVID-19 PHE. This code specifically covers subsequent repeat doses after the initial dose. The provider prepares the solution according to instructions, including temperature adjustment, vial inspection, and dilution for infusion or preparation for subcutaneous injection. For infusions, the provider sets up equipment, inserts the catheter, connects the infusion bag, and administers the medication at the prescribed drip rate.Subcutaneous injections are administered in the fatty layer below the skin. This is often used as post-exposure prophylaxis (PEP) for individuals at risk of severe COVID-19.Repeat dosing may involve an initial dose of 1200 mg followed by 600 mg every four weeks during ongoing exposure. This code is for subsequent repeat doses. The patient is monitored clinically during and after administration, typically for an hour.
Example 1: A patient with a high risk of developing severe COVID-19 receives a repeat dose of casirivimab and imdevimab at home via IV infusion due to ongoing exposure., An immunocompromised individual receives a repeat subcutaneous injection of casirivimab and imdevimab at their residence as post-exposure prophylaxis., A patient residing in a temporary lodging receives a repeat dose of casirivimab and imdevimab via IV infusion at their temporary location, which is considered their home during the COVID-19 PHE.
Documentation should include the patient's diagnosis, risk factors for severe COVID-19, previous doses of casirivimab and imdevimab, method of administration (IV or subcutaneous), dosage, post-administration monitoring details, and the location of service (patient's home or residence).
- Specialties:Infectious Disease, Internal Medicine, Family Medicine, Home Health
- Place of Service:Home, Assisted Living Facility, Temporary Lodging, Group Home, Homeless Shelter