| Q0035 |
Cardiokymography |
| Q0081 |
Infusion therapy, using other than chemotherapeutic drugs, per visit |
| Q0083 |
Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit |
| Q0084 |
Chemotherapy administration by infusion technique only, per visit |
| Q0085 |
Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
| Q0092 |
Set-up portable x-ray equipment |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
| Q0112 |
All potassium hydroxide (koh) preparations |
| Q0113 |
Pinworm examinations |
| Q0114 |
Fern test |
| Q0115 |
Post-coital direct, qualitative examinations of vaginal or cervical mucous |
| Q0138 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) |
| Q0139 |
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis) |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
| Q0161 |
Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
| Q0164 |
Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0166 |
Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen |
| Q0167 |
Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0169 |
Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0173 |
Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0174 |
Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0175 |
Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0177 |
Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0180 |
Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen |
| Q0181 |
Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
| Q0239 |
Injection, bamlanivimab-xxxx, 700 mg |
| Q0243 |
Injection, casirivimab and imdevimab, 2400 mg |
| Q0477 |
Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0478 |
Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type |
| Q0479 |
Power module for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0480 |
Driver for use with pneumatic ventricular assist device, replacement only |
| Q0481 |
Microprocessor control unit for use with electric ventricular assist device, replacement only |
| Q0482 |
Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only |
| Q0483 |
Monitor/display module for use with electric ventricular assist device, replacement only |
| Q0484 |
Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0485 |
Monitor control cable for use with electric ventricular assist device, replacement only |
| Q0486 |
Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only |
| Q0487 |
Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only |
| Q0488 |
Power pack base for use with electric ventricular assist device, replacement only |
| Q0489 |
Power pack base for use with electric/pneumatic ventricular assist device, replacement only |
| Q0490 |
Emergency power source for use with electric ventricular assist device, replacement only |
| Q0491 |
Emergency power source for use with electric/pneumatic ventricular assist device, replacement only |
| Q0492 |
Emergency power supply cable for use with electric ventricular assist device, replacement only |
| Q0493 |
Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only |
| Q0494 |
Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0495 |
Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0496 |
Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0497 |
Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0498 |
Holster for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0499 |
Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only |
| Q0500 |
Filters for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0501 |
Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0502 |
Mobility cart for pneumatic ventricular assist device, replacement only |
| Q0503 |
Battery for pneumatic ventricular assist device, replacement only, each |
| Q0504 |
Power adapter for pneumatic ventricular assist device, replacement only, vehicle type |
| Q0506 |
Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only |
| Q0507 |
Miscellaneous supply or accessory for use with an external ventricular assist device |
| Q0508 |
Miscellaneous supply or accessory for use with an implanted ventricular assist device |
| Q0509 |
Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a |
| Q0510 |
Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
| Q0514 |
Pharmacy dispensing fee for inhalation drug(s); per 90 days |
| Q0515 |
Injection, sermorelin acetate, 1 microgram |
| Q1004 |
New technology intraocular lens category 4 as defined in federal register notice |
| Q1005 |
New technology intraocular lens category 5 as defined in federal register notice |
| Q2004 |
Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml |
| Q2009 |
Injection, fosphenytoin, 50 mg phenytoin equivalent |
| Q2017 |
Injection, teniposide, 50 mg |
| Q2026 |
Injection, radiesse, 0.1 ml |
| Q2028 |
Injection, sculptra, 0.5 mg |
| Q2034 |
Influenza virus vaccine, split virus, for intramuscular use (agriflu) |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
| Q2037 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
| Q2040 |
Tisagenlecleucel, up to 250 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion |
| Q2041 |
Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| Q2042 |
Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| Q2043 |
Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion |
| Q2049 |
Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg |
| Q2050 |
Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg |
| Q2052 |
Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration |
| Q3001 |
Radioelements for brachytherapy, any type, each |
| Q3014 |
Telehealth originating site facility fee |
| Q3027 |
Injection, interferon beta-1a, 1 mcg for intramuscular use |
| Q3028 |
Injection, interferon beta-1a, 1 mcg for subcutaneous use |
| Q3031 |
Collagen skin test |
| Q4001 |
Casting supplies, body cast adult, with or without head, plaster |
| Q4002 |
Cast supplies, body cast adult, with or without head, fiberglass |
| Q4003 |
Cast supplies, shoulder cast, adult (11 years +), plaster |
| Q4004 |
Cast supplies, shoulder cast, adult (11 years +), fiberglass |
| Q4005 |
Cast supplies, long arm cast, adult (11 years +), plaster |
| Q4006 |
Cast supplies, long arm cast, adult (11 years +), fiberglass |
| Q4007 |
Cast supplies, long arm cast, pediatric (0-10 years), plaster |
| Q4008 |
Cast supplies, long arm cast, pediatric (0-10 years), fiberglass |
| Q4009 |
Cast supplies, short arm cast, adult (11 years +), plaster |
| Q4010 |
Cast supplies, short arm cast, adult (11 years +), fiberglass |
| Q4011 |
Cast supplies, short arm cast, pediatric (0-10 years), plaster |
| Q4012 |
Cast supplies, short arm cast, pediatric (0-10 years), fiberglass |
| Q4013 |
Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster |
| Q4014 |
Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass |
| Q4015 |
Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster |
| Q4016 |
Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass |
| Q4017 |
Cast supplies, long arm splint, adult (11 years +), plaster |
| Q4018 |
Cast supplies, long arm splint, adult (11 years +), fiberglass |
| Q4019 |
Cast supplies, long arm splint, pediatric (0-10 years), plaster |
| Q4020 |
Cast supplies, long arm splint, pediatric (0-10 years), fiberglass |
| Q4021 |
Cast supplies, short arm splint, adult (11 years +), plaster |
| Q4022 |
Cast supplies, short arm splint, adult (11 years +), fiberglass |
| Q4023 |
Cast supplies, short arm splint, pediatric (0-10 years), plaster |
| Q4024 |
Cast supplies, short arm splint, pediatric (0-10 years), fiberglass |
| Q4025 |
Cast supplies, hip spica (one or both legs), adult (11 years +), plaster |
| Q4026 |
Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass |
| Q4027 |
Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster |
| Q4028 |
Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass |
| Q4029 |
Cast supplies, long leg cast, adult (11 years +), plaster |
| Q4030 |
Cast supplies, long leg cast, adult (11 years +), fiberglass |
| Q4031 |
Cast supplies, long leg cast, pediatric (0-10 years), plaster |
| Q4032 |
Cast supplies, long leg cast, pediatric (0-10 years), fiberglass |
| Q4033 |
Cast supplies, long leg cylinder cast, adult (11 years +), plaster |
| Q4034 |
Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass |
| Q4035 |
Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster |
| Q4036 |
Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass |
| Q4037 |
Cast supplies, short leg cast, adult (11 years +), plaster |
| Q4038 |
Cast supplies, short leg cast, adult (11 years +), fiberglass |
| Q4039 |
Cast supplies, short leg cast, pediatric (0-10 years), plaster |
| Q4040 |
Cast supplies, short leg cast, pediatric (0-10 years), fiberglass |
| Q4041 |
Cast supplies, long leg splint, adult (11 years +), plaster |
| Q4042 |
Cast supplies, long leg splint, adult (11 years +), fiberglass |
| Q4043 |
Cast supplies, long leg splint, pediatric (0-10 years), plaster |
| Q4044 |
Cast supplies, long leg splint, pediatric (0-10 years), fiberglass |
| Q4045 |
Cast supplies, short leg splint, adult (11 years +), plaster |
| Q4046 |
Cast supplies, short leg splint, adult (11 years +), fiberglass |
| Q4047 |
Cast supplies, short leg splint, pediatric (0-10 years), plaster |
| Q4048 |
Cast supplies, short leg splint, pediatric (0-10 years), fiberglass |
| Q4049 |
Finger splint, static |
| Q4050 |
Cast supplies, for unlisted types and materials of casts |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
| Q4074 |
Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms |
| Q4081 |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
| Q4082 |
Drug or biological, not otherwise classified, part b drug competitive acquisition program (cap) |
| Q4100 |
Skin substitute, not otherwise specified |
| Q4101 |
Apligraf, per square centimeter |
| Q4102 |
Oasis wound matrix, per square centimeter |
| Q4103 |
Oasis burn matrix, per square centimeter |
| Q4104 |
Integra bilayer matrix wound dressing (bmwd), per square centimeter |
| Q4105 |
Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter |
| Q4106 |
Dermagraft, per square centimeter |
| Q4107 |
Graftjacket, per square centimeter |
| Q4108 |
Integra matrix, per square centimeter |
| Q4110 |
Primatrix, per square centimeter |
| Q4111 |
Gammagraft, per square centimeter |
| Q4112 |
Cymetra, injectable, 1 cc |
| Q4113 |
Graftjacket xpress, injectable, 1 cc |
| Q4114 |
Integra flowable wound matrix, injectable, 1 cc |
| Q4115 |
Alloskin, per square centimeter |
| Q4116 |
Alloderm, per square centimeter |
| Q4117 |
Hyalomatrix, per square centimeter |
| Q4118 |
Matristem micromatrix, 1 mg |
| Q4119 |
Matristem wound matrix, per square centimeter |
| Q4120 |
Matristem burn matrix, per square centimeter |
| Q4121 |
Theraskin, per square centimeter |
| Q4122 |
Dermacell, dermacell awm or dermacell awm porous, per square centimeter |
| Q4123 |
Alloskin rt, per square centimeter |
| Q4124 |
Oasis ultra tri-layer wound matrix, per square centimeter |
| Q4125 |
Arthroflex, per square centimeter |
| Q4126 |
Memoderm, dermaspan, tranzgraft or integuply, per square centimeter |
| Q4127 |
Talymed, per square centimeter |
| Q4128 |
Flex hd, allopatch hd, or matrix hd, per square centimeter |
| Q4129 |
Unite biomatrix, per square centimeter |
| Q4130 |
Strattice tm, per square centimeter |
| Q4131 |
Epifix or epicord, per square centimeter |
| Q4132 |
Grafix core and grafixpl core, per square centimeter |
| Q4133 |
Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter |
| Q4134 |
Hmatrix, per square centimeter |
| Q4135 |
Mediskin, per square centimeter |
| Q4136 |
Ez-derm, per square centimeter |
| Q4137 |
Amnioexcel, amnioexcel plus or biodexcel, per square centimeter |
| Q4138 |
Biodfence dryflex, per square centimeter |
| Q4139 |
Amniomatrix or biodmatrix, injectable, 1 cc |
| Q4140 |
Biodfence, per square centimeter |
| Q4141 |
Alloskin ac, per square centimeter |
| Q4142 |
Xcm biologic tissue matrix, per square centimeter |
| Q4143 |
Repriza, per square centimeter |
| Q4145 |
Epifix, injectable, 1 mg |
| Q4146 |
Tensix, per square centimeter |
| Q4147 |
Architect, architect px, or architect fx, extracellular matrix, per square centimeter |
| Q4148 |
Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter |
| Q4149 |
Excellagen, 0.1 cc |
| Q4150 |
Allowrap ds or dry, per square centimeter |
| Q4151 |
Amnioband or guardian, per square centimeter |
| Q4152 |
Dermapure, per square centimeter |
| Q4153 |
Dermavest and plurivest, per square centimeter |
| Q4154 |
Biovance, per square centimeter |
| Q4155 |
Neoxflo or clarixflo, 1 mg |
| Q4156 |
Neox 100 or clarix 100, per square centimeter |
| Q4157 |
Revitalon, per square centimeter |
| Q4158 |
Kerecis omega3, per square centimeter |
| Q4159 |
Affinity, per square centimeter |
| Q4160 |
Nushield, per square centimeter |
| Q4161 |
Bio-connekt wound matrix, per square centimeter |
| Q4162 |
Woundex flow, bioskin flow, 0.5 cc |
| Q4163 |
Woundex, bioskin, per square centimeter |
| Q4164 |
Helicoll, per square centimeter |
| Q4165 |
Keramatrix or kerasorb, per square centimeter |
| Q4166 |
Cytal, per square centimeter |
| Q4167 |
Truskin, per square centimeter |
| Q4168 |
Amnioband, 1 mg |
| Q4169 |
Artacent wound, per square centimeter |
| Q4170 |
Cygnus, per square centimeter |
| Q4171 |
Interfyl, 1 mg |
| Q4172 |
Puraply or puraply am, per square centimeter |
| Q4173 |
Palingen or palingen xplus, per square centimeter |
| Q4174 |
Palingen or promatrx, 0.36 mg per 0.25 cc |
| Q4175 |
Miroderm, per square centimeter |
| Q4176 |
Neopatch or therion, per square centimeter |
| Q4177 |
Floweramnioflo, 0.1 cc |
| Q4178 |
Floweramniopatch, per square centimeter |
| Q4179 |
Flowerderm, per square centimeter |
| Q4180 |
Revita, per square centimeter |
| Q4181 |
Amnio wound, per square centimeter |
| Q4182 |
Transcyte, per square centimeter |
| Q4183 |
Surgigraft, per square centimeter |
| Q4184 |
Cellesta or cellesta duo, per square centimeter |
| Q4185 |
Cellesta flowable amnion (25 mg per cc); per 0.5 cc |
| Q4186 |
Epifix, per square centimeter |
| Q4187 |
Epicord, per square centimeter |
| Q4188 |
Amnioarmor, per square centimeter |
| Q4189 |
Artacent ac, 1 mg |
| Q4190 |
Artacent ac, per square centimeter |
| Q4191 |
Restorigin, per square centimeter |
| Q4192 |
Restorigin, 1 cc |
| Q4193 |
Coll-e-derm, per square centimeter |
| Q4194 |
Novachor, per square centimeter |
| Q4195 |
Puraply, per square centimeter |
| Q4196 |
Puraply am, per square centimeter |
| Q4197 |
Puraply xt, per square centimeter |
| Q4198 |
Genesis amniotic membrane, per square centimeter |
| Q4200 |
Skin te, per square centimeter |
| Q4201 |
Matrion, per square centimeter |
| Q4202 |
Keroxx (2.5g/cc), 1cc |
| Q4203 |
Derma-gide, per square centimeter |
| Q4204 |
Xwrap, per square centimeter |
| Q4205 |
Membrane graft or membrane wrap, per square centimeter |
| Q4206 |
Fluid flow or fluid gf, 1 cc |
| Q4208 |
Novafix, per square cenitmeter |
| Q4209 |
Surgraft, per square centimeter |
| Q4210 |
Axolotl graft or axolotl dualgraft, per square centimeter |
| Q4211 |
Amnion bio or axobiomembrane, per square centimeter |
| Q4212 |
Allogen, per cc |
| Q4213 |
Ascent, 0.5 mg |
| Q4214 |
Cellesta cord, per square centimeter |
| Q4215 |
Axolotl ambient or axolotl cryo, 0.1 mg |
| Q4216 |
Artacent cord, per square centimeter |
| Q4217 |
Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter |
| Q4218 |
Surgicord, per square centimeter |
| Q4219 |
Surgigraft-dual, per square centimeter |
| Q4220 |
Bellacell hd or surederm, per square centimeter |
| Q4221 |
Amniowrap2, per square centimeter |
| Q4222 |
Progenamatrix, per square centimeter |
| Q4226 |
Myown skin, includes harvesting and preparation procedures, per square centimeter |
| Q4227 |
Amniocore, per square centimeter |
| Q4228 |
Bionextpatch, per square centimeter |
| Q4229 |
Cogenex amniotic membrane, per square centimeter |
| Q4230 |
Cogenex flowable amnion, per 0.5 cc |
| Q4231 |
Corplex p, per cc |
| Q4232 |
Corplex, per square centimeter |
| Q4233 |
Surfactor or nudyn, per 0.5 cc |
| Q4234 |
Xcellerate, per square centimeter |
| Q4235 |
Amniorepair or altiply, per square centimeter |
| Q4236 |
Carepatch, per square centimeter |
| Q4237 |
Cryo-cord, per square centimeter |
| Q4238 |
Derm-maxx, per square centimeter |
| Q4239 |
Amnio-maxx or amnio-maxx lite, per square centimeter |
| Q4240 |
Corecyte, for topical use only, per 0.5 cc |
| Q4241 |
Polycyte, for topical use only, per 0.5 cc |
| Q4242 |
Amniocyte plus, per 0.5 cc |
| Q4244 |
Procenta, per 200 mg |
| Q4245 |
Amniotext, per cc |
| Q4246 |
Coretext or protext, per cc |
| Q4247 |
Amniotext patch, per square centimeter |
| Q4248 |
Dermacyte amniotic membrane allograft, per square centimeter |
| Q4249 |
Amniply, for topical use only, per square centimeter |
| Q4250 |
Amnioamp-mp, per square centimeter |
| Q4254 |
Novafix dl, per square centimeter |
| Q4255 |
Reguard, for topical use only, per square centimeter |
| Q5001 |
Hospice or home health care provided in patient's home/residence |
| Q5002 |
Hospice or home health care provided in assisted living facility |
| Q5003 |
Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf) |
| Q5004 |
Hospice care provided in skilled nursing facility (snf) |
| Q5005 |
Hospice care provided in inpatient hospital |
| Q5006 |
Hospice care provided in inpatient hospice facility |
| Q5007 |
Hospice care provided in long term care facility |
| Q5008 |
Hospice care provided in inpatient psychiatric facility |
| Q5009 |
Hospice or home health care provided in place not otherwise specified (nos) |
| Q5010 |
Hospice home care provided in a hospice facility |
| Q5101 |
Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram |
| Q5102 |
Injection, infliximab, biosimilar, 10 mg |
| Q5103 |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
| Q5104 |
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg |
| Q5105 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
| Q5106 |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units |
| Q5107 |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
| Q5108 |
Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg |
| Q5109 |
Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg |
| Q5110 |
Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram |
| Q5111 |
Injection, pegfilgrastim-cbqv, biosimilar, (udenyca), 0.5 mg |
| Q5112 |
Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg |
| Q5113 |
Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg |
| Q5114 |
Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg |
| Q5115 |
Injection, rituximab-abbs, biosimilar, (truxima), 10 mg |
| Q5116 |
Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg |
| Q5117 |
Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg |
| Q5118 |
Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg |
| Q5119 |
Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg |
| Q5120 |
Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg |
| Q5121 |
Injection, infliximab-axxq, biosimilar, (avsola), 10 mg |
| Q5122 |
Injection, pegfilgrastim-apgf, biosimilar, (nyvepria), 0.5 mg |
| Q9001 |
Assessment by department of veterans affairs chaplain services |
| Q9002 |
Counseling, individual, by department of veterans affairs chaplain services |
| Q9003 |
Counseling, group, by department of veterans affairs chaplain services |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
| Q9951 |
Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml |
| Q9953 |
Injection, iron-based magnetic resonance contrast agent, per ml |
| Q9954 |
Oral magnetic resonance contrast agent, per 100 ml |
| Q9955 |
Injection, perflexane lipid microspheres, per ml |
| Q9956 |
Injection, octafluoropropane microspheres, per ml |
| Q9957 |
Injection, perflutren lipid microspheres, per ml |
| Q9958 |
High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml |
| Q9959 |
High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml |
| Q9960 |
High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml |
| Q9961 |
High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml |
| Q9962 |
High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml |
| Q9963 |
High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml |
| Q9964 |
High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
| Q9968 |
Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
| Q9970 |
Injection, ferric carboxymaltose, 1mg |
| Q9972 |
Injection, epoetin beta, 1 microgram, (for esrd on dialysis) |
| Q9973 |
Injection, epoetin beta, 1 microgram, (non-esrd use) |
| Q9974 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
| Q9975 |
Injection, factor viii fc fusion protein (recombinant), per iu |
| Q9976 |
Injection, ferric pyrophosphate citrate solution, 0.1 mg of iron |
| Q9977 |
Compounded drug, not otherwise classified |
| Q9978 |
Netupitant 300 mg and palonosetron 0.5 mg |
| Q9979 |
Injection, alemtuzumab, 1 mg |
| Q9980 |
Hyaluronan or derivative, genvisc 850, for intra-articular injection, 1 mg |
| Q9981 |
Rolapitant, oral, 1 mg |
| Q9982 |
Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries |
| Q9983 |
Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries |
| Q9984 |
Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mg |
| Q9985 |
Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg |
| Q9986 |
Injection, hydroxyprogesterone caproate, (makena), 10 mg |
| Q9987 |
Pathogen(s) test for platelets |
| Q9988 |
Platelets, pheresis, pathogen-reduced, each unit |
| Q9989 |
Ustekinumab, for intravenous injection, 1 mg |
| Q9991 |
Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg |
| Q9992 |
Injection, buprenorphine extended-release (sublocade), greater than 100 mg |
| Q9993 |
Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg |
| Q9994 |
In-line cartridge containing digestive enzyme(s) for enteral feeding, each |
| Q9995 |
Injection, emicizumab-kxwh, 0.5 mg |