Ask a Rev Cycle Expert: Remdesivir Administration Coding?
Question:
Two new IP procedure codes were created for remdesivir (Veklury®) administration, depending on how it is administered. Under what revenue code should administration of remdesivir be reported? Should the infusion of remdesivir be reported using the non-chemotherapy drug infusion codes 96365/96366?
Answer:
The Secretary of the Department of Health and Human Services declared a public health emergency that justifies the emergency use of Veklury® to treat coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection. In response, the U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for the unapproved product, Veklury®, for the treatment of COVID-19.
The Centers for Medicare & Medicaid Services (CMS) released two International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) codes, effective August 1, 2020 to report the administration of Remdesivir.
- XW033E5, Introduction of Remdesivir Anti-infective into Peripheral Vein, Percutaneous Approach, New Technology Group 5
- XW043E5, Introduction of Remdesivir Anti-infective into Central Vein, Percutaneous Approach, New Technology Group 5
CMS has not indicated a specific revenue code assignment; in the absence of specific guidance, revenue code reporting should represent the code where the costs will be reported on the facility’s cost report. The decision to charge separately for infusion of drugs, including Remdesivir, for hospital inpatients should be determined by each hospital and outlined in a policy and procedure.
Current Procedural Terminology (CPT®) codes and Healthcare Common Procedure Coding System (HCPCS) codes are not reported on inpatient claims, so use of CPT® codes 96365 and 96366 is not necessary.
Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).