AHA Coding Clinic® for HCPCS - 2017 Quarter 4; For Your Information
A new modifier for a biosimilar biological product
A new modifier effective on July 1, 2017, and can be appended to HCPCS code Q5102 , Injection, infliximab, biosimilar, 10 mg, for the biosimilar biological product utilized. Therefore, as of July 1, 2017, there are now two existing modifiers that may be appended as applicable. See table on the following page. HCPCS Modifier Long Descriptor Effective Date HCPCS Code Long Descriptor ZB Pfizer/Hospira 04/01/2016 Q5102 Injection, Infliximab, Bio similar, 10 mg ZC Merck/Samsung Bioepis 07/1/2017 Q5102 Injection, Infliximab, Biosimilar, 10 mg ...
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Article Overview
This article covers a change related to HCPCS reporting for a biosimilar biological product, including the addition of a new modifier and the existing modifier structure tied to the same billing code. It is relevant to coding professionals, billers, and reimbursement staff who track HCPCS updates and effective dates for biosimilar products.
Why This Topic Matters
Updates like this affect how biosimilar biological products are identified in claims and supporting documentation. Staying current helps coding and billing teams align reporting with the applicable HCPCS guidance and effective dates.
What You Will Learn
- The general purpose of the article’s HCPCS modifier update
- How the article frames the relationship between the biosimilar product and the associated billing code
- The effective-date context for the modifiers discussed
- Which organizations and product names are associated with the reporting update
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Compliance staff
- Healthcare administrators
Codes Discussed
Modifiers Discussed
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