COVID-19 Coding Updates | TotalMD
Summary
Centers for Medicare and Medicaid (CMS) said it plans to pay 95% of the average wholesale price of the treatment to providers. Providers will have to submit documentation showing that the patient is being treated for mild-to-moderate COVID-19 and are at high risk of the disease progressing to a severe status, possibly including hospitalization. Due to Phase 3 clinical trial results, Pfizer and BioNTech have released the mRNA- based COVID-19 vaccine. They were developed to enable more granular reporting and tracking of the vaccine, even if the vaccine is administered for free: • 0001A – Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose • 0002A – Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; second dose • 0011A – Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) vaccine, mRNA-LNP, spike protein, preservative free, 100/0.5mL dosage, first dose • 0012A – Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) vaccine, mRNA-LNP, spike protein, preservative free, 100/0.5mL dosage, second dose There will be continuous updates to the coding of the drugs being developed for the COVID-19 pandemic. CMS Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment [News Brief].
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