HCPCS Code Details - Q5113

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q5113
Description

Long description:
Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg

Short description:
Inj herzuma 10 mg

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
ASC payment group code Effective Oct 01, 2023 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1E - Other drugs
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Oct 01, 2023
Date added Added Jul 01, 2019
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 - Q5113

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
Jul 1, 2024 - Sep 30, 2024 10 MG 62.632 - - - - - -
April 1, 2024 - June 30, 2024 10 MG 55.797 - - - - - -
January 1, 2024 - March 31, 2024 10 MG 40.307 - - - - - -
October 1, 2023 - December 31, 2023 10 MG 20.183 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 10 MG 29.87 20% - - - - -

See also

  • HCPCS Q5112 · Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg

  • HCPCS Q5114 · Injection, trastuzumab-dkst, biosimilar, (ogivri), 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”