HCPCS Q5116: Injection, trastuzumab-qyyp, biosimilar, 10 mg

A biosimilar is a biological product that is highly similar to an already FDA-approved biological product (an originator or reference product), with no clinically meaningful differences in terms of safety, purity, and potency. Q5116 (Trazimera) is a biosimilar to Herceptin (trastuzumab).

Since the billing unit is 10 mg, you divide the total dose in milligrams (mg) by 10 to get the number of units to report. A dose of 420 mg is 42 units.

Yes. Q5116 only covers the cost of the drug itself. You must bill a separate CPT code (like 96413 or 96417) for the professional service of administering the intravenous infusion.