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BETA v.3.0

2025 HCPCS code Q0243

Injection, casirivimab and imdevimab, 2400 mg.

Report one unit of Q0243 for each 2400 mg injection. Modifier JW may be applicable if only part of a vial is administered.

Medical necessity for this code is established by the FDA's Emergency Use Authorization (EUA) for casirivimab and imdevimab for the treatment of mild to moderate COVID-19 in specific patient populations.

Providers are responsible for ordering, administering, and monitoring patient response to the injection of casirivimab and imdevimab.

IMPORTANT:For intravenous infusion and post-administration monitoring of casirivimab and imdevimab, use M0243. For a 1200 mg dose, use Q0244. M0244 is used for intravenous infusion or subcutaneous injection including post-administration monitoring at home or residence.

In simple words: This code covers the supply of two antibodies (casirivimab and imdevimab) given together as a 2400 mg injection to treat COVID-19.

Injection, casirivimab and imdevimab, 2400 mg. This HCPCS code represents the supply of casirivimab and imdevimab, monoclonal antibodies typically administered by intravenous infusion or subcutaneous injection to treat COVID-19. One unit of this code represents 2400 mg of the medication.

Example 1: A patient diagnosed with mild to moderate COVID-19 receives a 2400 mg injection of casirivimab and imdevimab at an infusion center., A nursing home resident with confirmed COVID-19 is administered casirivimab and imdevimab., A high-risk individual with a positive COVID-19 test receives the antibody treatment as an outpatient.

Documentation should include the diagnosis of COVID-19, dosage administered, route of administration, patient response to treatment, and any adverse reactions.

** This code is specific to the supply of the drug and does not include administration. It is important to consult payer guidelines for billing practices, as coverage and reimbursement policies may vary. As of December 10, 2024, this information may not be entirely up-to-date due to potential changes in coding and billing guidelines.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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