HCPCS Code Details - Q5104

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q5104
Description

Long description:
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg

Short description:
Injection, renflexis

HCPCS Modifier1
HCPCS Pricing indicator
Multiple pricing indicator
Coverage code - n/a
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
Notes Processing Note: 0187
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 - Q5104

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
October 1, 2018 - December 31, 2018 10 MG 64.382 - - - - - -
July 1, 2018 - September 30, 2018 10 MG 69.222276 - - - - - -
April 1, 2018 - June 30, 2018 10 MG 70.378386 - - - - - -

See also

  • HCPCS Q5103 · Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg

  • HCPCS Q5105 · Injection, epoetin alfa, biosimilar, (Retacrit) (for esrd on dialysis), 100 units


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”