Table of content for "Injection,pegfilgrastim-bmez" (HCPCS C9058)
General information on the “C9058” code
HCPCS Code: C9058
Long Description: Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg
Short Description: Injection,pegfilgrastim-bmez
Original information is taken from C9058 page
Pricing indicators
Pricing Indicator Code 1: 53 – Statute
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Statute Number: 1833(t)
Cross Reference Code 1: Q5120 ;
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 9 – Other medical items or services
Type Of Service 2: F – Ambulatory surgical center (facility usage for surgical services)
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20191115
Code Effective Date: 20200701
Termination Date: 20200630
Action Code: N – No maintenance for this code