Wiki Billing for Nirsevimab (Beyfortus) RSV 200 mg dose

[amwittler]

I am looking for advice on how to bill for when a pt receives the 200 mg dose. I know that two 90381 should be reported, but what about the admin codes ( 96380 or 96381)? Do you only report one admin regardless of how many intramuscular injections?

90381 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use

96380 Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physical or other qualified health care professional.
96381 Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection

 

[rthomas@impcna.com]

I am looking for advice on how to bill for when a pt receives the 200 mg dose. I know that two 90381 should be reported, but what about the admin codes ( 96380 or 96381)? Do you only report one admin regardless of how many intramuscular injections?

90381 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use

96380 Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physical or other qualified health care professional.
96381 Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection

A lot of the payers we deal with are wanting us to use 96372 for the administration. Here is the link to the Beyfortus website https://pro.campus.sanofi/us/products/beyfortus/cost-and-coverage. It also states that payer policies may require reporting administration CPT code 96372 for therapeutic, prophylactic, or diagnostic injection until their coverage policies and payment systems are ready to accept claims using CPT 96380 and 96381.