Time for HCPCS Code Updates

By Susan Dooley

Where does the time go? June is almost half over already, and July will be here before we know it! CMS
is celebrating the half-year mark by releasing new Healthcare Common Procedure Coding System
(HCPCS) codes that become effective for claims with dates of service on or after July 1, 2016. Well also
look at a code that became effective for dates of service in April of this year.

Check Out These New Q Codes

Q5102, Injection, Infliximab, 10 mg, biosimilar

Code Q5102 is effective for dates of service on and after Apr. 5, 2016. Infliximab-dyyb is the generic
name of the brand-name drug Inflectra, a biosimilar to Remicade (infliximab). Remicade was originally
licensed in 1998 to Janssen Biotech. Infliximab and infliximab-dyyb are FDA-approved for the treatment
of Crohns disease, ulcerative colitis, rheumatoid arthritis, and other conditions. Inflectra (infliximabdyyb) is manufactured by a Korean company for Hospira of Lake Forest, Illinois. Claims for Q5102 must
include the modifier ZB for Pfizer/hospira.
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
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Biosimilars are biological products whose approval is based on proof that they are highly similar to an
already approved biologic agent, which is called a reference product. The biosimilar must have no
clinically meaningful differences of safety and effectiveness compared to the reference product.

Q9981, Rolapitant, oral, 1 mg

Rolapitant is the generic form of the drug Varubi, an antiemetic agent useful in treating intractable
nausea and vomiting in patients undergoing chemotherapy regimens that are especially emetogenic,
or inducing of nausea and vomiting.

Q9982, Flutemetamol F18, diagnostic, per study dose, up to 5 millicuries

Flutemetamol F18 is the generic name for Vizamyl, a contrast medium used along with positronemission tomography (PET) imaging of the brain to estimate the degree of density of beta-amyloid
neuritic plaques. When large numbers of these senile plaques are present in the brain, this is a
characteristic of Alzheimer disease.

Q9983, diagnostic Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries

Florabetaben F18, sold under the brand name of Neuraceq, has similar indications to Vizamyl; this
contrast agent is used to help rule in or out the presence of Alzheimer disease by helping to estimate
the degree of density of senile plaques characteristic of Alzheimer.
According to the Medicare Learning Network, both Q9982 and Q9983 codes are payable for Medicare.

How About You?

Think these new Q codes will affect your practice? Let us know.

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Contact Us:
Name: Sam Nair
Title: Associate Director
Email: shyamn@codinginstitute.com
Direct: 704 303 8150

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com