Q2017 Teniposide 50mg HCPCS Reimbursement

HCPCS Level II code Q2017 denotes a 50 mg injection of teniposide, an antineoplastic agent used in cancer chemotherapy. Nationally, accurate coding for specialty oncology drugs like teniposide matters for clinical documentation, claims processing, and payment accuracy across hospital outpatient departments and infusion centers. This code is primarily relevant to oncology practices, hospital-based infusion services, and payers that cover parenteral chemotherapy.

Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for teniposide administration, payer coverage considerations, common modifiers used with HCPCS Level II drug codes, and notes on typical sites of service. The publication presents benchmarking and payer-policy context where available, highlights billing and documentation elements relevant to chemotherapy drug coding, and summarizes potential reimbursement and claim submission considerations. Data not available in the input is noted where applicable.

Billing Code Overview

HCPCS Level II code Q2017 represents injection, teniposide, 50 mg. This code corresponds to the administration of a 50 mg dose of teniposide, an antineoplastic agent used in oncology care.

Service Type: Parenteral chemotherapy administration

Typical Site of Service: Outpatient infusion center or hospital outpatient department

Data not available in the input.

Clinical Context

A patient with a diagnosis of relapsed acute lymphoblastic leukemia or other chemosensitive malignancy is scheduled to receive intravenous teniposide for systemic chemotherapy. The patient typically presents to an oncology infusion center or hospital outpatient infusion clinic. Pre-infusion evaluation includes verification of diagnosis, review of prior chemotherapy and cumulative dosing, baseline laboratory assessment (complete blood count, liver and renal function tests), assessment of vascular access (peripheral IV or implanted port), and allergy history.

On the day of service the infusion nurse prepares Q2017 (injection, teniposide, 50 mg) to the ordered dose. The clinician documents the indication, dose calculation based on body surface area or established regimen, route (intravenous), rate of administration, antiemetic premedication if required, and monitoring plan for infusion reactions, myelosuppression, and other toxicities. If the patient requires complex preparation or additional time beyond the typical infusion process, an appropriate modifier may be appended to the billing claim. Common settings for this code include outpatient hospital infusion centers, freestanding oncology infusion suites, and inpatient hospital administration when given during a hospitalization.

Typical clinical workflow:

Patient check-in, consent verification, and vitals.
Laboratory review and clinician order verification.
Pharmacy compounds teniposide dose from Q2017 units; pharmacist checks compatibility and concentration.
Nursing verifies access, administers premedication as ordered, and initiates intravenous infusion.
Continuous monitoring for infusion-related reactions; post-infusion observation per protocol.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when administration required substantially greater resources or time than typical (e.g., complex infusion management or significant additional documentation).

23 | Unusual anesthesia | Use if general anesthesia is medically necessary for safe infusion administration.

52 | Reduced services | Use when the full planned chemotherapy administration is partially reduced or not completed.

53 | Discontinued procedure | Use when infusion is started but discontinued due to patient intolerance or adverse event.

54 | Surgical care only | Rare for this drug; not typically used for infusion-only services but listed for completeness when surgical team responsibility differs.

55 | Postoperative management only | Not commonly applicable to routine infusions; used when another provider continues postoperative care.

56 | Preoperative management only | Not commonly applicable to chemotherapy infusions.

62 | Two surgeons | Use when procedure requires co-surgeons; rarely applicable to chemotherapy administration.

78 | Return to OR for related procedure | Not typically used for infusion services; reserved for operative returns.

AS | Non‑participating anesthesiologist (Medicare) | Use when an anesthesiologist who does not participate in Medicare provides anesthesia services related to the infusion.

CO | Services related to a workers’ compensation case | Use when the infusion is billed under workers’ compensation coverage.

CQ | Service furnished under a Federal Tort Claims Act (FTCA) arrangement | Use when applicable for federally covered provider arrangements.

QK | Medical direction of two, three, or four CRNAs when one physician directs | Use if CRNA involvement with anesthesia care for infusion is billed under these rules.

QX | CRNA service with medical direction by physician | Use when a CRNA furnishes anesthesia and a physician medically directs.

QY | Medical direction of one CRNA by an anesthesiologist | Use when the anesthesiologist medically directs the CRNA.

Taxonomy Code	Specialty	Notes
`207L00000X`	Hematology & Oncology	Medical oncologists and hematologist-oncologists order and oversee systemic teniposide therapy.

207RG0300X | Medical Oncology | Physicians specializing in chemotherapy regimens and outpatient infusion therapy.

363A00000X | Registered Nurse | Oncology infusion nurses perform drug administration and monitoring.

3336C0002X | Clinical Pharmacist | Oncology pharmacists prepare, verify, and compound chemotherapeutic agents including teniposide.

207K00000X | Pediatric Hematology-Oncology | Pediatric specialists administer teniposide for pediatric leukemias and related indications.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C91.A0`	Acute lymphoblastic leukemia, B-cell, in remission	Teniposide is used in certain ALL regimens for relapsed or refractory disease and consolidation therapy.

C91.A1 | Acute lymphoblastic leukemia, B-cell, not having achieved remission | Indicates active disease where teniposide may be used as part of salvage chemotherapy.

C92.0 | Acute myeloblastic leukemia not having achieved remission | Teniposide can be used in salvage regimens for certain acute leukemias.

C83.9 | Non‑Hodgkin lymphoma, unspecified | Teniposide has historical and off‑label use in some lymphoma salvage protocols.

C80.1 | Malignant (primary) neoplasm, unspecified | Used as a general cancer diagnosis when the primary site is unspecified and chemotherapy such as teniposide is given.

D46.9 | Myelodysplastic syndrome, unspecified | Occasionally teniposide is used in treatment plans for marrow-based malignancies or in clinical trial contexts.

Z51.11 | Encounter for antineoplastic chemotherapy | Administrative code commonly reported to indicate the visit is for chemotherapy administration, applicable when billing for Q2017.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Often used to report the infusion administration time for the initial hour when `Q2017` is administered intravenously.

96366 | Intravenous infusion; each additional hour (List separately in addition to code for primary service) | Used when infusion of teniposide extends beyond the first hour and additional time-based reporting is required.

96413 | Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary service) | Used for multiple-hour chemotherapy infusions depending on payer guidance; may be selected based on local billing policies.

96417 | Chemotherapy administration, injection; each additional sequential intravenous push of a new drug | Used when multiple separate intravenous pushes or injections are administered during the same visit in addition to the primary drug.

36415 | Collection of venous blood by venipuncture | Used for pre-infusion laboratory monitoring and drug level testing as part of the chemotherapy visit when billed separately.

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Summary & Overview

HCPCS Q2017: Injection, Teniposide 50 mg