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    v1.0.30
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q5124-ranibizumab-nuna-byooviz-intravitreal-injection-01mg
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    HCPCS Level II Q5124: Ranibizumab-nuna (Byooviz) 0.1 mg intravitreal injection

    HCPCS Level II code Q5124 identifies an injection of ranibizumab-nuna (Byooviz) biosimilar, 0.1 mg, representing an intravitreal anti-VEGF therapeutic administration typically provided as an ophthalmology specialty drug infusion or injection in an outpatient clinic or ambulatory surgical center for treatment of retinal vascular diseases and related ocular conditions.

    For related coverage guidance, see recent payer policy updates: Truvada (Emtricitabine and Tenofovir Disoproxil Fumarate) for HIV Prevention and Treatment, HIV/AIDS Pharmacologic Prevention and Treatment, Long-Acting Injectable Antiretroviral Agents for HIV.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with neovascular (wet) age-related macular degeneration, diabetic macular edema, or retinal vein occlusion presenting to a retinal specialty clinic or ambulatory surgical center for intravitreal anti-VEGF therapy. The medication administered is Q5124 (injection, ranibizumab-nuna, biosimilar, (Byooviz), 0.1 mg). Clinical workflow: the retina specialist confirms indication and documents visual acuity, intraocular pressure, and a focused eye exam; obtains informed consent for intravitreal injection; performs pre-procedure antisepsis with povidone-iodine; may apply topical anesthesia and a lid speculum; administers the intravitreal injection of Q5124 under sterile technique; monitors the patient briefly for immediate complications; documents lot number and syringe disposal per hazardous drug rules (use of modifier JW may be applicable when reporting discarded portions of single‑use vials or syringes). Typical site of service is an ophthalmology clinic procedure room or ambulatory surgical center. The patient scenario commonly involves a planned series of injections (loading doses then maintenance) with follow-up visits for optical coherence tomography and visual acuity assessment.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    67028Intravitreal injection of a pharmacologic agentPrimary procedural CPT code that describes the intravitreal injection technique commonly performed when billing for administration of Q5124
    92250Fundus photography with interpretation and reportPerformed before or after injections to document retinal appearance when applicable
    92134Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report; unilateral or bilateralOptical coherence tomography (OCT) commonly performed to assess macular anatomy pre‑ and post‑injection
    92133Scanning computerized ophthalmic diagnostic imaging, posterior segment; unilateral or bilateral, with interpretation and report; extendedUsed when follow‑up imaging with additional interpretation is required
    99213Office or other outpatient visit, established patient, low to moderate complexityTypical evaluation and management visit associated with injection visits for established patients
    99214Office or other outpatient visit, established patient, moderate complexityUsed when higher complexity decision making accompanies the injection visit

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    53Modifier 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…
    52Modifier ‑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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RR0500X
    208D00000X
    363L00000X
    2278P1005X
    163WX1500X
    2085R0205X
    207VX0201X
    207RG0100X

    Related ICD-10-CM Codes

    11 rows

    ICD-10-CM CodeDescription
    E11.311Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
    H26.9Unspecified cataract
    H33.003Unspecified retinal detachment with retinal break, bilateral
    H33.033Retinal detachment with giant retinal tear, bilateral
    H35.351Cystoid macular degeneration, right eye
    H35.352Cystoid macular degeneration, left eye
    H35.353Cystoid macular degeneration, bilateral
    H35.40Unspecified peripheral retinal degeneration
    H53.8Other visual disturbances
    H54.7Unspecified visual loss

    Showing 1–10 of 11

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    10 rows

    PolicyPayerEffective Date
    Truvada (Emtricitabine and Tenofovir Disoproxil Fumarate) for HIV Prevention and Treatmentpremerabluecrossofwashington2026-10-01
    HIV/AIDS Pharmacologic Prevention and Treatmentpremerabluecrossofwashington2026-10-01
    Long-Acting Injectable Antiretroviral Agents for HIVColorado Rocky Mountain Health Plans2026-10-01
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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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