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HCPCS Q5104: Infliximab-abda (Renflexis), 10 mg injection
HCPCS Level II code Q5104 denotes the biosimilar infliximab-abda (Renflexis) in a 10 mg unit vial for parenteral administration. The code is used by outpatient infusion centers and hospital outpatient departments to bill for the biologic agent itself when administered as an intravenous infusion. Nationally, biosimilar infliximab products affect biologic utilization patterns and cost-management efforts across commercial insurers and Medicare.
Key payers included in coverage comparisons are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise view of how this code is used for billing the drug product, typical sites of service, and payer coverage context.
Readers will find benchmarks and operational guidance on claims coding for the drug product line, summaries of common modifier usage (input provided), and clinical context about infusion-based biologic therapy. The document highlights policy considerations relevant to biosimilar adoption, reimbursement coding practices for drug acquisition versus administration, and practical billing elements for outpatient infusion services. Data not available in the input is explicitly noted where applicable.
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Billing Code Overview
HCPCS Level II code Q5104 represents injection, infliximab-abda, biosimilar (Renflexis), 10 mg. This code denotes a biologic biosimilar formulation of infliximab supplied for parenteral administration.
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Service type: Intravenous biologic therapy (infusion)
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Typical site of service: Outpatient infusion clinic or hospital outpatient department