HCPCS Level II Q5137: Ustekinumab-auub (Wezlana) 1 mg Subcutaneous Injection

HCPCS Level II code Q5137 describes a subcutaneous injection of ustekinumab-auub (Wezlana) biosimilar provided as a 1 mg unit; this code is used to report administration of the biologic agent for outpatient ambulatory or clinic-based subcutaneous injections where the clinician or facility documents the specific drug and dosage administered.

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HCPCS Level II Q5137: Ustekinumab-auub (Wezlana) 1 mg Subcutaneous Injection

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Get alerted when payer policies referencing Q5137 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A 42-year-old patient with moderate to severe plaque psoriasis presents to an outpatient infusion clinic for a subcutaneous biologic injection of ustekinumab-auub (Q5137, wezlana), dosed per weight-based regimen. The patient was previously evaluated by a dermatologist who documented treatment indication, prior therapy failures or contraindications to TNF inhibitors, baseline screening for tuberculosis and hepatitis B/C, and updated immunization status. On the day of service a licensed nurse verifies identity, confirms informed consent and current medications, reviews recent labs and screening results, inspects the intended injection site, and administers the subcutaneous injection. The nurse documents lot number, expiration date, dose (milligrams given), route, site, and any immediate reactions. For payor billing the clinic appends applicable modifier(s) to Q5137 to indicate circumstances such as a partial dose, drug discarded, or medically complex administration. Typical follow-up includes dermatology or rheumatology monitoring visits and periodic laboratory assessment for infections and response to therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Commonly billed for the professional administration service of a subcutaneous biologic when payer requires a separate injection administration code in addition to the drug HCPCS code.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for routine follow-up visits to assess response and manage ongoing biologic therapy prior to or after injection visits.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate (not usually applicable)	Not typically related; included only when relevant behavioral counseling is provided at visit.
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Not applicable for subcutaneous injection but listed when intravenous biologic infusions are part of the same patient's treatment plan.
`99070`	Supplies and materials (except spectacles), provided by physician or other qualified health care professional	May be used to report additional sundries or supplies associated with the administration visit when allowed by payer.

Related Modifiers

5 rows

Modifier	Description	When to Use
33	Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…	- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…
99	Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…	- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…
8P	Modifier 8P—Performance Measure Reporting Modifier – Action Not Performed, Reason Not Otherwise Specified— is appended only to CPT Category II quality-reporting codes to indicate that the specified…	- Use modifier -8P only with CPT Category II codes when the quality-measure action was not performed for an eligible patient and there is no documented reason in the medical record for omitting the…
P5	Modifier P5 denotes a moribund patient who is not expected to survive without the operative procedure and is used only with anesthesia CPT codes 00100–01999. The anesthesia provider must append P5…	- Use modifier P5 only when the anesthesia provider determines the patient is moribund and not expected to survive without the operation, and append it only to anesthesia CPT codes 00100–01999…
63	Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…	- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Y00000X	Otolaryngology Physician	An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ea…
2080P0206X	Pediatric Gastroenterology Physician	A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This speciali…
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
2086S0129X	Vascular Surgery Physician	A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
2084N0400X	Neurology Physician	A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, auton…
2279E1000X	Educational Registered Respiratory Therapist	The focus of patient and family education activities is to promote knowledge of disease process, medical therapy, and self help. Respiratory therapis…
261QM0850X	Adult Mental Health Clinic/Center	An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disord…

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
Pathogen Panel Testing	Oscar Health	2026-10-01
Lyme Disease Testing Coverage Criteria	Oscar Health	2026-10-01
Diagnostic Testing of Common Sexually Transmitted Infections	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	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
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
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Commonly billed for the professional administration service of a subcutaneous biologic when payer requires a separate injection administration code in addition to the drug HCPCS code.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for routine follow-up visits to assess response and manage ongoing biologic therapy prior to or after injection visits.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate (not usually applicable)	Not typically related; included only when relevant behavioral counseling is provided at visit.
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Not applicable for subcutaneous injection but listed when intravenous biologic infusions are part of the same patient's treatment plan.
`99070`	Supplies and materials (except spectacles), provided by physician or other qualified health care professional	May be used to report additional sundries or supplies associated with the administration visit when allowed by payer.

Related Modifiers

5 rows

Modifier	Description	When to Use
33	Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…	- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…
99	Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…	- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…
8P	Modifier 8P—Performance Measure Reporting Modifier – Action Not Performed, Reason Not Otherwise Specified— is appended only to CPT Category II quality-reporting codes to indicate that the specified…	- Use modifier -8P only with CPT Category II codes when the quality-measure action was not performed for an eligible patient and there is no documented reason in the medical record for omitting the…
P5	Modifier P5 denotes a moribund patient who is not expected to survive without the operative procedure and is used only with anesthesia CPT codes 00100–01999. The anesthesia provider must append P5…	- Use modifier P5 only when the anesthesia provider determines the patient is moribund and not expected to survive without the operation, and append it only to anesthesia CPT codes 00100–01999…
63	Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…	- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Y00000X	Otolaryngology Physician	An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ea…
2080P0206X	Pediatric Gastroenterology Physician	A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This speciali…
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
2086S0129X	Vascular Surgery Physician	A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
2084N0400X	Neurology Physician	A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, auton…
2279E1000X	Educational Registered Respiratory Therapist	The focus of patient and family education activities is to promote knowledge of disease process, medical therapy, and self help. Respiratory therapis…
261QM0850X	Adult Mental Health Clinic/Center	An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disord…

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
Pathogen Panel Testing	Oscar Health	2026-10-01
Lyme Disease Testing Coverage Criteria	Oscar Health	2026-10-01
Diagnostic Testing of Common Sexually Transmitted Infections	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	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
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 Level II Q5137: Ustekinumab-auub (Wezlana) 1 mg Subcutaneous Injection

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OpenPayer

HCPCS Level II Q5137: Ustekinumab-auub (Wezlana) 1 mg Subcutaneous Injection

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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 Level II Q5137: Ustekinumab-auub (Wezlana) 1 mg Subcutaneous Injection

Sign up for hcpcs Q5137 policy alerts

HCPCS Level II Q5137: Ustekinumab-auub (Wezlana) 1 mg Subcutaneous Injection

Sign up for hcpcs Q5137 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS code Q5137 describe?

What clinical documentation and processes are described for administering Q5137?

Are modifiers or other procedure codes used with Q5137?

Which diagnosis codes are associated with Q5137 administration?

What related CPT codes and services are relevant to Q5137?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS code Q5137 describe?

What clinical documentation and processes are described for administering Q5137?

Are modifiers or other procedure codes used with Q5137?

Which diagnosis codes are associated with Q5137 administration?

What related CPT codes and services are relevant to Q5137?

References