Revised Status Indicator for HCPCS Code Q5101

Revised Status Indicator for HCPCS Code Q5101

Effective Sept. 3, 2015, the status indicator for HCPCS Level II code Q5101 Injection, Filgrastim (G-CSF), Biosimilar, 1 microgram has changed from E Not paid by Medicare when submitted on outpatient claims (any outpatient bill type) to K Paid under OPPS; separate APC payment.

This change is effective Oct. 1, 2015.

The Centers for Medicare & Medicaid Services (CMS) notified Medicare administrative contractors (MAC) in Transmittal 3352 of this change, and it is in the October update of the Integrated Outpatient Code Editor (I/OCE).

If you had claims for Q5101 with dates of service on or after Sept. 3, 2015, that were processed prior to the installation of the October 2015 Outpatient Prospective Payment System Pricer, you can request that those claims be adjusted by your MAC.

Source: MLN Matters® MM9298 Revised

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Renee Dustman

Renee Dustman

Renee Dustman is executive editor at AAPC. She has a Bachelor of Science degree in Journalism and a long history of writing just about anything for just about every kind of publication there is or ever has been. She’s also worked in production management for print media, and continues to dabble in graphic design.
Renee Dustman

About Has 425 Posts

Renee Dustman is executive editor at AAPC. She has a Bachelor of Science degree in Journalism and a long history of writing just about anything for just about every kind of publication there is or ever has been. She’s also worked in production management for print media, and continues to dabble in graphic design.

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