M0249 HCPCS - INTRAVENOUS INFUSION, TOCILIZUMAB, FOR HOSPITALIZED ADULTS AND PEDIATRIC PATIENTS (2 YEARS OF AGE AND OLDER) WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE OR INVASIVE MECHANICAL VENTILATION, OR EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) ONLY, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING, FIRST DOSE

Code Information

HCPCS Code: M0249
Sequence Number: 0010
Short Description: Adm tocilizu covid-19 1st
Long Description: Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose
Date Added: 6/24/2021
Action Code: N - No maintenance for this code
Action Effective Date: 6/24/2021
Classification: Medical Services
Coding System: HCPCS

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

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

Field Name	Field Value
Healthcare Common Procedure Coding System Code	M0249
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	Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose
HCPCS Short Description	Adm tocilizu covid-19 1st
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	6/24/2021
HCPCS Action Effective Date	6/24/2021
HCPCS Action Code	N - No maintenance for this code