Question 1

What is HCPCS code M0245?

Accepted Answer

HCPCS code M0245 is "Bamlan and etesev infusion". Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring

Question 2

What category is M0245 in?

Accepted Answer

M0245 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M0245?

Accepted Answer

Use M0245 when billing for bamlan and etesev infusion. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is M0245 covered by Medicare?

Accepted Answer

Coverage for M0245 (Bamlan and etesev infusion) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for M0245?

Accepted Answer

Documentation for M0245 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).