Summary & Overview
HCPCS Q5152: Eculizumab-aeeb (bkemv) biosimilar, 2 mg injection
HCPCS Level II code Q5152 denotes the 2 mg unit of eculizumab-aeeb (bkemv), a biosimilar formulation of the complement inhibitor eculizumab. The code is used to identify the billed drug product for infusion or injection encounters and is relevant for payers, providers, and pharmacy billing teams managing high-cost biologic therapies. Nationally, accurate use of this HCPCS code supports consistent drug identification, billing transparency, and payer adjudication for biosimilar eculizumab therapy.
Key payers covered in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find information on clinical context for eculizumab biosimilar use, expected service settings (outpatient infusion centers, office-based infusions, and hospital outpatient departments), and operational considerations for billing the drug product. The publication also summarizes benchmarks and policy-relevant topics such as coding consistency, payer coverage patterns, and billing best practices for high-cost biologic biosimilars where available.
Data not available in the input: payer-specific rates, associated taxonomies, ICD-10 diagnoses, related codes, and detailed service-line mappings.
Billing Code Overview
HCPCS Level II code Q5152 describes an injection of eculizumab-aeeb (bkemv), biosimilar, 2 mg. This code represents a biologic biosimilar medication administration product and is used to report the specific billed unit of the biosimilar formulation of eculizumab at the 2 mg strength.
Service type: Drug administration / drug product (biosimilar)
Typical site of service: Outpatient infusion center, physician office, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a complement-mediated disorder such as paroxysmal nocturnal hemoglobinuria (PNH) or atypical hemolytic uremic syndrome (aHUS) presenting for infusion therapy. The patient has been prescribed eculizumab-aeeb (biosimilar to eculizumab) dosed and supplied in 2 mg vial units (Q5152) by a specialty pharmacy. The service is administered in an outpatient infusion center, hospital outpatient department, or physician office where intravenous access, pre-infusion assessment, and post-infusion monitoring are available.
Clinical workflow: prior to the visit, the infusion nurse confirms identity, verifies vaccination status for Neisseria meningitidis per product guidance, and reviews current labs (CBC, renal function, hemolysis markers). The medication is reconstituted and dosed per prescribing provider orders; the nurse documents lot number and expiration. The infusion is delivered via IV push or short infusion per protocol; vital signs and infusion tolerance are monitored. After administration, the nurse documents the Q5152 drug administration, records any immediate adverse reactions, and schedules follow-up dosing or laboratory monitoring. Billing includes the product code Q5152 with applicable modifiers for the site of service, professional or technical circumstances, or unusual services.
Coding Specifications
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