HCPCS Code Section: HCPCS Q Codes

Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg Short Description: Inj., trazimera, 10 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: October 1, 2019 Effective …

Injection, rituximab-abbs, biosimilar, (truxima), 10 mg Short Description: Inj truxima 10 mg Coverage Code: Special coverage instructions apply Action Code: Add procedure or modifier code Date Added: July 1, …

Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg Short Description: Inj ogivri 10 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: July 1, 2019 Effective …

Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg Short Description: Inj herzuma 10 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: July 1, 2019 Effective …

Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg Short Description: Inj ontruzant 10 mg Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: July 1, 2019 Effective …

Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg Short Description: Injection, udenyca 0.5 mg Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective …

High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml Short Description: Hocm

Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg Short Description: Morphine epidural/intratheca Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Injection, perflutren lipid microspheres, per ml Short Description: Inj perflutren lip micros,ml Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: April 1, 2005 Effective …

Injection, epoetin beta, 1 microgram, (non-esrd use) Short Description: Epoetin beta non esrd Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: July …