## **What is the HCPCS code Q5118 for?**
The HCPCS code Q5118 is meant to designate the provision of a biosimilar bevacizumab-bvzr injection, specifically every 10 mg dose of it.
This injection is more commonly known as a Zirabev injection. The purpose of this injection is to administer a biosimilar medication that inhibits the growth of blood vessels supplying nutrients to tumors (malignant neoplasms) in the bloodstream. Doing so will slow (and hopefully stop) the progression of cancer and boost the survival rate of the patient.
Here are some cancers that this injection treats: (metastatic) renal cell carcinoma, (metastatic) colorectal cancer, (metastatic) cervical cancer, (recurrent) glioblastoma, kidney cancer, and non-small cell lung cancer.
While primarily used for cancers, Zirabev can also be used to treat age-related macular degeneration and macular edema. Also, please note that Zirabev is not indicated for adjuvant treatment of colon cancer.
This injection is also administered intravenously.
## **Documentation requirements for Q5118**
As with any HCPCS code, ensure that you prepare documentation that satisfies your insurer's coding guidelines, requirements, related policy articles, and local coverage determinations. Here are examples of what you need:
- The full name of the patient
- The full names and credentials of the professionals handling the patient
- The name, address, and type of facility where the injection was administered
- The physician's order for the injection
- The relevant information and clinical indications from your patient's medical record and current condition to justify medical necessity
- Drug information (e.g., name, dosage and strength administered, route of administration, lot number, manufacturer, National Drug Code, etc.)
- Start/stop times of the infusion
- Imaging tests showing size and locations of tumors
- Blood tests that provide information about the patient's kidney function
## **Billing requirements for Q5118**
Besides the documentation requirements above, please make sure to take note of or have the following:
- Per 10 mg = 1 unit
- Please use the appropriate ICD code based on the patient's condition (e.g., C72.9 - Malignant neoplasm of central nervous system, unspecified; C64.9 - Malignant neoplasm of unspecified kidney, except renal pelvis, C34.00-C34.92 - Malignant neoplasm of unspecified main bronchus; D49.2 - Neoplasm of unspecified behavior of bone, soft tissue, and skin; D42.0 - Neoplasm of uncertain behavior of cerebral meninges)
- Modifier JA for intravenous administration
- Use either of two modifiers: JW if there's unused medication in a vial (wastage), or JZ if there's no unused medication.
- Use the appropriate CPT code (e.g., 96413, 96415, or 96417)
## **Other similar codes**
- **Q5107** - Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg
- **Q5102** - Injection, infliximab, biosimilar, 10 mg
- **Q5116** - Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg
- **Q5121** - Injection, infliximab-axxq, biosimilar, (avsola), 10 mg
- **Q5113** - Injection, trastuzumab-pkrb, biosimilar, (Herzuma), 10 mg
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