Bamlivinab-Hierarchy?

Rev code 771---unclear on the rules to follow. Should we follow the infusion hierarchy and use the M0239 as the "initial" infusion and then sequential?

We are adding the appropriate M0239 charge ourselves and instructing ED to charge the other infusions independent of the monoclonal antibody. There is no specifics to include this in the infusion hierarchy and when we have, this has denied for no initial in the original hierarchy. 

Comments

  • I would think that being a vaccine benefit with a vaccine revenue code, you'd bill them completely separately.

  • It is my understanding that we just bill the M0239 and that includes the infusion as well as the post infusion care. We are still waiting on our first one to pay, so I am anxious to see how that will turn out. Did you also use the vaccination dx? It's difficult to get my coding team to understand to use the vaccination dx since it is an infusion and not a vaccination, which I get, but that is the guidance we have been given.

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