Question 1

What is HCPCS code M0248?

Accepted Answer

HCPCS code M0248 is "Sotrovimab inf, home admin". Intravenous infusion, sotrovimab, 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

Question 2

What category is M0248 in?

Accepted Answer

M0248 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M0248?

Accepted Answer

Use M0248 when billing for sotrovimab inf, home admin. 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 M0248 covered by Medicare?

Accepted Answer

Coverage for M0248 (Sotrovimab inf, home admin) 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 M0248?

Accepted Answer

Documentation for M0248 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).