Esketamine antidepressant nasal spray, billed per 1 milligram administered

This code represents the administration of esketamine, a nasal spray formulation, in 1 mg units. Esketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist used for the treatment of treatment-resistant depression (TRD) and depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior. It is typically administered in a supervised healthcare setting due to potential dissociative and sedative effects.

Use this code when billing for the drug esketamine administered via nasal spray. This applies to patients receiving esketamine for TRD or MDD with acute suicidal ideation/behavior. Documentation should clearly indicate the dosage administered, the route of administration (nasal), and the medical necessity for esketamine treatment.

• Report units based on the total milligrams administered during the encounter, with each unit representing 1 mg.
• Ensure the medical record supports the diagnosis of TRD or MDD with acute suicidal ideation/behavior.
• This code is for the drug product only; separate codes are required for the administration service and facility charges.