Question 1

What is HCPCS code M0235?

Accepted Answer

HCPCS code M0235 is "Intrav inf, mon anti, fir do". Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients 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, not otherwise classified, first dose

Question 2

What category is M0235 in?

Accepted Answer

M0235 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M0235?

Accepted Answer

Use M0235 when billing for intrav inf, mon anti, fir do. 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 M0235 covered by Medicare?

Accepted Answer

Coverage for M0235 (Intrav inf, mon anti, fir do) 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 M0235?

Accepted Answer

Documentation for M0235 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).