HCPCS Level II Q5161: Denosumab-kyqq (Aukelso/Bosaya) injection, 1 mg

HCPCS Level II code Q5161 describes a single 1 mg injection of denosumab-kyqq (Aukelso/Bosaya), a biosimilar monoclonal antibody product used for bone-related indications; the service is an injectable biologic medication typically administered via subcutaneous injection in outpatient infusion clinics, physician offices, or ambulatory procedure settings and is reported for the specific biosimilar product and dose.

Customize your policy alerts

Sign up for hcpcs Q5161 policy alerts

Get alerted when payer policies referencing Q5161 are released or updated.

Monitor payer policy activity

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

Explore openpayer tools

View all tools

HCPCS Level II Q5161: Denosumab-kyqq (Aukelso/Bosaya) injection, 1 mg

Customize your policy alerts

Sign up for hcpcs Q5161 policy alerts

Get alerted when payer policies referencing Q5161 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 a postmenopausal woman or an adult with osteoporosis, or a patient with bone loss due to metastatic cancer therapy, who receives a subcutaneous injection of the biosimilar denosumab product Q5161 (denosumab-kyqq, aukelso/bosaya) dosed per milligram. The clinical workflow begins with an office visit or infusion center encounter for evaluation of bone health, review of calcium and vitamin D status, and verification of indication (for example osteoporosis with high fracture risk or prevention of skeletal-related events in malignancy). Baseline laboratory testing (serum calcium, renal function) is verified prior to administration. The patient is positioned for a subcutaneous injection, usually in the upper arm, abdomen, or thigh. The licensed clinician or registered nurse documents the product name denosumab-kyqq, lot number, dose administered (converted from milligrams to the appropriate unit), site of injection, and any immediate adverse reactions. Follow-up instructions include monitoring for hypocalcemia, scheduling of subsequent doses per indication, and documentation of payer, consent, and vaccine/medication administration records when required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify route)	Common code used to report the subcutaneous administration of denosumab in an office setting.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Often billed the same day when an E/M service is performed related to initiation or follow-up of denosumab therapy (use modifier as appropriate).
`36415`	Collection of venous blood by venipuncture	Performed for baseline and follow-up labs such as serum calcium and renal function before administration.
`90471`	Immunization administration (not typically for denosumab)	Included here for workflow analogy; not used for denosumab which is reported with injection administration codes like `96372`.
`G0008`	Administration of influenza vaccine (Medicare specific)	Not applicable to denosumab administration; listed only as a payer-specific administrative code contrast in workflow contexts.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
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…
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…
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2080P0208X	Pediatric Infectious Diseases Physician	A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific know…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
363LA2200X	Adult Health Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
163WC1400X	College Health Registered Nurse	Nursing Service Providers · Registered Nurse
374U00000X	Home Health Aide	A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.
2471C3402X	Radiography Radiologic Technologist	A radiologic technologist who specializes in radiography (also known as x-rays) and is appropriately educated and trained, consistent with nationally …
333600000X	Pharmacy	A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative servi…

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
Coronavirus Testing in the Outpatient Setting	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	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.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify route)	Common code used to report the subcutaneous administration of denosumab in an office setting.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Often billed the same day when an E/M service is performed related to initiation or follow-up of denosumab therapy (use modifier as appropriate).
`36415`	Collection of venous blood by venipuncture	Performed for baseline and follow-up labs such as serum calcium and renal function before administration.
`90471`	Immunization administration (not typically for denosumab)	Included here for workflow analogy; not used for denosumab which is reported with injection administration codes like `96372`.
`G0008`	Administration of influenza vaccine (Medicare specific)	Not applicable to denosumab administration; listed only as a payer-specific administrative code contrast in workflow contexts.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
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…
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…
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2080P0208X	Pediatric Infectious Diseases Physician	A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific know…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
363LA2200X	Adult Health Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
163WC1400X	College Health Registered Nurse	Nursing Service Providers · Registered Nurse
374U00000X	Home Health Aide	A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.
2471C3402X	Radiography Radiologic Technologist	A radiologic technologist who specializes in radiography (also known as x-rays) and is appropriately educated and trained, consistent with nationally …
333600000X	Pharmacy	A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative servi…

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
Coronavirus Testing in the Outpatient Setting	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	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 Q5161: Denosumab-kyqq (Aukelso/Bosaya) injection, 1 mg

Sign up for hcpcs Q5161 policy alerts

OpenPayer

HCPCS Level II Q5161: Denosumab-kyqq (Aukelso/Bosaya) injection, 1 mg

Sign up for hcpcs Q5161 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 Level II Q5161: Denosumab-kyqq (Aukelso/Bosaya) injection, 1 mg

Sign up for hcpcs Q5161 policy alerts

HCPCS Level II Q5161: Denosumab-kyqq (Aukelso/Bosaya) injection, 1 mg

Sign up for hcpcs Q5161 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 Q5161 represent?

Which patients and clinical workflow scenarios are associated with Q5161 administration?

Which CPT codes are commonly used alongside Q5161 for billing administration and related services?

What modifiers should billing teams consider when reporting Q5161?

Which payers are noted for Q5161 coverage and where can I find reimbursement details?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS code Q5161 represent?

Which patients and clinical workflow scenarios are associated with Q5161 administration?

Which CPT codes are commonly used alongside Q5161 for billing administration and related services?

What modifiers should billing teams consider when reporting Q5161?

Which payers are noted for Q5161 coverage and where can I find reimbursement details?

References