HCPCS Code Q5101: Injection, Filgrastim-sndz, Biosimilar, (Zarxio), 1 Microgram

Learn about the HCPCS code Q5101 for "Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram" through this short guide.

Use Code

## **What is the HCPCS code Q5101 for?** The HCPCS code Q5101 is meant to designate the provision of a biosimilar filgrastim-sndz injection (sometimes called a Zarxio injection), specifically per 1 microgram dosage. This kind of injection can be a subcutaneous injection or used for intravenous infusion. Please note that it isn't a diagnostic injection because it's not meant for diagnosis. The purpose of this injection is to serve as support for the patient's immune system. It does this by increasing the body's ability to produce white blood cells, which reduces their risk of infection. This is often used on patients who have weakened immune systems due to chemotherapy, those who have had surgery for bone marrow transplant, and those with (severe chronic) neutropenia.

## **Documentation requirements for Q5101** Before deciding to file a claim for HCPCS code Q5101, please make sure you have sufficient documentation that satisfies your insurer's coding guidelines and requirements, related policy articles, and local coverage determinations. Here are examples of what you need: - The full name of the patient - The full name and credentials of the healthcare professionals handling the patient - The name, address, and type of facility where the injection was administered - Physician's order for the drug - The relevant information and clinical indications related to the patient's medical history and record (e.g., chemotherapy-induced neutropenia prevention, bone marrow transplant) - Drug information (e.g., total dosage and strength administered, drug name, brand name, lot number, manufacturer, route of administration, National Drug Code, etc.) - Date and time of administration, including stop and start times (especially if provided intravenously)

## **Billing requirements for Q5101** Besides the documentation requirements above, please make sure you take note of or have the following: - 1 microgram = 1 unit of service (e.g., 300 micrograms = 300 units) - The applicable ICD code(s) based on your patient's condition(s) - This should also accompany either one of these two CPT codes: 96365 if you administered the injection via IV, or 96372 if you administered it subcutaneously - Use either of two modifiers: JW if there's unused medication in a vial (wastage), or JZ if there's no unused medication.

## **Other similar codes** - **Q5110** - Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram - **Q5125** - Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram - **Q5148** - Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram - **Q5108** - Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg - **Q5111** - Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg