Table of content for "Inj retacrit esrd on dialysi" (HCPCS Q5105)
General information on the “Q5105” code
HCPCS Code: Q5105
Long Description: Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units
Short Description: Inj retacrit esrd on dialysi
Original information is taken from Q5105 page
Pricing indicators
Pricing Indicator Code 1: 57 – Other carrier priced
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: D – Special coverage instructions apply
ASC Payment Group: YY
ASC Payment Group Effective Date: 20180701
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 1 – Medical care
Type Of Service 2: L – ESRD supplies (eff 04/95) (renal supplier in the home before 04/95)
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20180701
Code Effective Date: 20200101
Action Code: N – No maintenance for this code