HCPCS Code Details - Q5103

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q5103
Description

Long description:
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg

Short description:
Injection, inflectra

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code D - Special coverage instructions apply
ASC payment group code Effective Apr 01, 2018 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1E - Other drugs
HCPCS Action code A - Add procedure or modifier code
Type of service 1 - Medical care
Effective date Effective Apr 01, 2018
Date added Added Apr 01, 2018
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - Q5103

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
January 1, 2019 - March 31, 2019 10 MG 57.276 - - - - - -
October 1, 2018 - December 31, 2018 10 MG 61.363 - - - - - -
July 1, 2018 - September 30, 2018 10 MG 64.978576 - - - - - -
April 1, 2018 - June 30, 2018 10 MG 69.711986 - - - - - -

See also

  • HCPCS Q5102 · Injection, infliximab, biosimilar, 10 mg

  • HCPCS Q5104 · Injection, infliximab-abda, biosimilar, (renflexis), 10 mg


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”