Summary & Overview
HCPCS Q5110: Filgrastim-aafi (Nivestym) Injection, 1 microgram
HCPCS Level II code Q5110 denotes the administration of filgrastim-aafi (Nivestym), a biosimilar granulocyte colony-stimulating factor dosed at 1 microgram. This code is used for billing the biologic injection that supports neutrophil recovery in patients undergoing myelosuppressive therapy and is important for oncology treatment pathways, supportive care workflows, and biosimilar adoption nationally. Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of the clinical role of filgrastim biosimilars, typical sites of service where the product is administered, and the billing context for Q5110. The publication summarizes payer coverage patterns and benchmarks where available, highlights policy or coding updates affecting biosimilar injections, and outlines operational considerations for facilities and billing teams. Data limitations are noted where input fields were not provided. The goal is to give clinicians, revenue cycle staff, and policy stakeholders a focused reference on use and billing of filgrastim-aafi via HCPCS Level II code Q5110 at a national level.
Billing Code Overview
HCPCS Level II code Q5110 describes an injection of filgrastim-aafi, biosimilar (Nivestym), 1 microgram. This code represents administration of a granulocyte colony-stimulating factor biosimilar used to stimulate neutrophil production, typically in patients receiving myelosuppressive chemotherapy or at risk for neutropenia.
Service type: Therapeutic injection (biosimilar biologic)
Typical site of service: Outpatient infusion clinic, oncology clinic, or physician office
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult undergoing chemotherapy for a solid tumor or hematologic malignancy who requires prophylaxis against chemotherapy-induced neutropenia. The patient presents to an outpatient infusion center or physician office for administration of the supportive biologic agent filgrastim-aafi (Q5110) to stimulate neutrophil production. The clinical workflow includes verification of the chemotherapy regimen and recent complete blood count (CBC) showing neutropenia or high risk for febrile neutropenia, informed consent, medication preparation and dosing calculated by weight (microgram dosing), administration via subcutaneous injection by a registered nurse, observation for immediate adverse reactions, documentation of lot number and expiration, and billing of the single microgram unit code Q5110 multiplied to reflect the total dose given. Typical sites of service are outpatient infusion centers, physician offices, hospital outpatient departments, and occasionally home health settings when injection services are rendered by a qualified clinician. Common clinical indications include prophylaxis following cytotoxic chemotherapy, treatment of severe chronic neutropenia, and mobilization of hematopoietic progenitor cells for collection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug discarded/unused portion not administered to any patient |