HCPCS Code Section: HCPCS Q Codes

Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose Short Description: Tisagenlecleucel car-pos t Coverage Code: Carrier judgment Action Code: …

Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose Short Description: Axicabtagene ciloleucel car+ Coverage Code: …

Cast supplies, long arm cast, adult (11 years +), plaster Short Description: Cast sup long arm adult plst Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion Short Description: Tisagenlecleucel car-pos t Coverage Code: Carrier judgment Action Code: No …

Cast supplies, shoulder cast, adult (11 years +), fiberglass Short Description: Cast sup shoulder cast fbrgl Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: …

Influenza virus vaccine, not otherwise specified Short Description: Influenza virus vaccine, nos Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Cast supplies, long arm splint, pediatric (0-10 years), plaster Short Description: Cast sup lng arm splnt ped p Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Cast supplies, long arm splint, adult (11 years +), fiberglass Short Description: Cast sup lng arm splint fbrg Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Cast supplies, long arm splint, adult (11 years +), plaster Short Description: Cast sup lng arm splint plst Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass Short Description: Cast sup gauntlet ped fbrgls Coverage Code: Carrier judgment Action Code: No maintenance for …