Revised Status Indicator for HCPCS Code Q5101

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  • September 22, 2015
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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, BS, AAPC MACRA Proficient, is managing editor - content & editorial at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 30 years' experience in journalistic reporting, print production, graphic design, and content management. Follow her on Twitter @dustman_aapc.

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