HCPCS Q5119: Injection, rituximab-pvvr (Ruxience), 10 mg

HCPCS Level II code Q5119 describes an injection of rituximab-pvvr (Ruxience) provided as a 10 mg unit; this code is used for billing administration of the biosimilar monoclonal antibody therapy typically delivered via intravenous infusion in outpatient infusion centers or hospital outpatient departments for conditions treated with rituximab products.

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HCPCS Q5119: Injection, rituximab-pvvr (Ruxience), 10 mg

Customize your policy alerts

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Get alerted when payer policies referencing Q5119 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a B-cell mediated hematologic or autoimmune condition such as non-Hodgkin lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, or a severe autoimmune cytopenia who is scheduled to receive intravenous biosimilar rituximab (Q5119, ruxience) as part of induction, maintenance, or rescue therapy. The patient arrives at an outpatient infusion center or hospital outpatient infusion clinic where nursing triage verifies diagnosis, weight, laboratory tests (including CBC and chemistries), and premedications (acetaminophen, antihistamine, corticosteroid) per protocol. A licensed clinician (oncologist, hematologist, or rheumatologist) documents the treatment plan and orders the rituximab dose in milligrams; pharmacy prepares the appropriate vial(s) of Q5119 (10 mg incremental billing units) and labels the infusion bag. The patient is consented for infusion-related risks; baseline vital signs are recorded. The infusion nurse establishes IV access, administers premedications, initiates the infusion at a protocol-defined rate with careful monitoring for infusion reactions, and documents administration, lot number, and amount billed using Q5119 units. Post-infusion monitoring is performed; any acute adverse events are managed per protocol. Billing captures the drug J3-equivalent HCPCS code Q5119 for the product, associated drug administration CPT codes for infusion time, and any applicable modifiers reflecting payer-specific circumstances such as professional component, reconstitution, partial administration, or billing by a qualifying alternative payer arrangement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96413`	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug	Often used for the initial infusion session when rituximab is administered over up to 1 hour (or per payer guidance for biologic administration).
`96415`	Chemotherapy administration, IV infusion; each additional hour (List separately in addition to code for primary service)	Used to report extended infusion time beyond the initial hour for rituximab when clinically required.
`96417`	Chemotherapy administration, IV infusion; push/intravenous bolus, each additional substance/drug	Used if additional IV push medications are administered during the same encounter (e.g., supportive medicines).
`96401`	Chemotherapy administration, subcutaneous or intramuscular; non-hormonal antineoplastic	May be relevant if concurrent non-IV antineoplastic agents are administered during the same visit.
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Used by some practices for non-chemotherapy biologic infusions when payer policy requires non-oncology infusion codes.
`96366`	Each additional hour (for `96365`)	Used to bill additional infusion time for non-chemotherapy biologic administration when applicable.

Related Modifiers

5 rows

Modifier	Description	When to Use
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RC0000X	Cardiovascular Disease Physician	An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
207RG0300X	Geriatric Medicine (Internal Medicine) Physician	An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects o…
2080P0207X	Pediatric Hematology & Oncology Physician	A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
2355S0801X	Speech-Language Assistant	Speech, Language and Hearing Service Providers · Specialist/Technologist
207ZN0500X	Neuropathology Physician	A neuropathologist is expert in the diagnosis of diseases of the nervous system and skeletal muscles and functions as a consultant primarily to neurol…
207N00000X	Dermatology Physician	A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…
224900000X	Mastectomy Fitter	An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.
261QV0200X	VA Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center

Related Payer Policy Updates

Specialty: Infectious Disease1 / 3

10 rows

Policy	Payer	Effective Date
B-Hemolytic Streptococcus Testing	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays	Oscar Health	2026-10-01
Hepatitis Testing (A, B, C, D) Coverage Criteria	Oscar Health	2026-10-01
Lyme Disease Testing Coverage Criteria	Oscar Health	2026-10-01
Pathogen Panel Testing	Oscar Health	2026-10-01
Diagnostic Testing of Common Sexually Transmitted Infections	Oscar Health	2026-10-01
Coronavirus Testing in the Outpatient Setting	Oscar Health	2026-10-01
Testing for Vector-Borne Infections	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV)	blue cross blue shield - louisiana	2026-09-15

HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

HCPCS Level II Q0035: Cardiokymography

HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

HCPCS Q0092: Set-up Portable X-ray Equipment

Showing 1–10 of 629

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96413`	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug	Often used for the initial infusion session when rituximab is administered over up to 1 hour (or per payer guidance for biologic administration).
`96415`	Chemotherapy administration, IV infusion; each additional hour (List separately in addition to code for primary service)	Used to report extended infusion time beyond the initial hour for rituximab when clinically required.
`96417`	Chemotherapy administration, IV infusion; push/intravenous bolus, each additional substance/drug	Used if additional IV push medications are administered during the same encounter (e.g., supportive medicines).
`96401`	Chemotherapy administration, subcutaneous or intramuscular; non-hormonal antineoplastic	May be relevant if concurrent non-IV antineoplastic agents are administered during the same visit.
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Used by some practices for non-chemotherapy biologic infusions when payer policy requires non-oncology infusion codes.
`96366`	Each additional hour (for `96365`)	Used to bill additional infusion time for non-chemotherapy biologic administration when applicable.

Related Modifiers

5 rows

Modifier	Description	When to Use
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RC0000X	Cardiovascular Disease Physician	An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
207RG0300X	Geriatric Medicine (Internal Medicine) Physician	An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects o…
2080P0207X	Pediatric Hematology & Oncology Physician	A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
2355S0801X	Speech-Language Assistant	Speech, Language and Hearing Service Providers · Specialist/Technologist
207ZN0500X	Neuropathology Physician	A neuropathologist is expert in the diagnosis of diseases of the nervous system and skeletal muscles and functions as a consultant primarily to neurol…
207N00000X	Dermatology Physician	A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…
224900000X	Mastectomy Fitter	An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.
261QV0200X	VA Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center

Related Payer Policy Updates

Specialty: Infectious Disease1 / 3

10 rows

Policy	Payer	Effective Date
B-Hemolytic Streptococcus Testing	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays	Oscar Health	2026-10-01
Hepatitis Testing (A, B, C, D) Coverage Criteria	Oscar Health	2026-10-01
Lyme Disease Testing Coverage Criteria	Oscar Health	2026-10-01
Pathogen Panel Testing	Oscar Health	2026-10-01
Diagnostic Testing of Common Sexually Transmitted Infections	Oscar Health	2026-10-01
Coronavirus Testing in the Outpatient Setting	Oscar Health	2026-10-01
Testing for Vector-Borne Infections	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV)	blue cross blue shield - louisiana	2026-09-15

HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

HCPCS Level II Q0035: Cardiokymography

HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

HCPCS Q0092: Set-up Portable X-ray Equipment

Showing 1–10 of 629

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS Q5119: Injection, rituximab-pvvr (Ruxience), 10 mg

Sign up for hcpcs Q5119 policy alerts

OpenPayer

HCPCS Q5119: Injection, rituximab-pvvr (Ruxience), 10 mg

Sign up for hcpcs Q5119 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

HCPCS Q5119: Injection, rituximab-pvvr (Ruxience), 10 mg

Sign up for hcpcs Q5119 policy alerts

HCPCS Q5119: Injection, rituximab-pvvr (Ruxience), 10 mg

Sign up for hcpcs Q5119 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS Q5119 represent and when is it used?

What clinical and documentation steps are described when billing Q5119?

Which CPT administration codes are commonly billed with Q5119?

Which diagnoses are commonly associated with Q5119 billing?

Which payers are referenced and does payer policy affect how Q5119 is billed?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS Q5119 represent and when is it used?

What clinical and documentation steps are described when billing Q5119?

Which CPT administration codes are commonly billed with Q5119?

Which diagnoses are commonly associated with Q5119 billing?

Which payers are referenced and does payer policy affect how Q5119 is billed?

References