M0221 HCPCS - INJECTION, TIXAGEVIMAB AND CILGAVIMAB, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND PEDIATRIC INDIVIDUALS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40KG) WITH NO KNOWN SARS-COV-2 EXPOSURE, WHO EITHER HAVE MODERATE TO SEVERELY COMPROMISED IMMUNE SYSTEMS OR FOR WHOM VACCINATION WITH ANY AVAILABLE COVID-19 VACCINE IS NOT RECOMMENDED DUE TO A HISTORY OF SEVERE ADVERSE REACTION TO A COVID-19 VACCINE(S) AND/OR COVID-19 VACCINE COMPONENT(S), INCLUDES INJECTION 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

Code Information

HCPCS Code: M0221
Sequence Number: 0010
Short Description: Tixagev and cilgav inj hm
Long Description: Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection 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
Date Added: 12/8/2021
Action Code: N - No maintenance for this code
Action Effective Date: 12/8/2021
Classification: Medical Services
Coding System: HCPCS

Code Type

Berenson-Eggers Type Of Service Code: O1G - Immunizations/Vaccinations
Type Of Service Code:
- V - Pneumococcal/flu vaccine (eff 01/96), Pneumococcal/flu/hepatitis B vaccine (eff 04/95-12/95), Pneumococcal only before 04/95

Billing Information

Pricing Indicator Code:
- 54 - Vaccinations
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

HCPCS Record

Field Name	Field Value
Healthcare Common Procedure Coding System Code	M0221
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection 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
HCPCS Short Description	Tixagev and cilgav inj hm
HCPCS Pricing Indicator Code 1	54 - Vaccinations
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Code	C - Carrier judgment
HCPCS Berenson-Eggers Type Of Service Code	O1G - Immunizations/Vaccinations
HCPCS Type Of Service Code 1	V - Pneumococcal/flu vaccine (eff 01/96), Pneumococcal/flu/hepatitis B vaccine (eff 04/95-12/95), Pneumococcal only before 04/95
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	12/8/2021
HCPCS Action Effective Date	12/8/2021
HCPCS Action Code	N - No maintenance for this code

Code Information

Code Type

Billing Information

HCPCS Record

Download Record