Ordering and Billing Information
Q Code: Q5168
| HCPCS Code | Description |
|---|---|
| Q5168 | Injection, ranibizumab-leyk (NUFYMCO), biosimilar, 0.1 mg7 |
| Billable Units | Example |
|---|---|
| 0.1 mg | 0.5 mg = 5 billable units |
| HCPCS Modifier | Description |
|---|---|
| JZ | Zero drug amount discard/not administered to any patient (new modifier to indicate administration of the full vial) |
| CPT Codes | Description |
|---|---|
| 67028 | Intravitreal injection of a pharmacologic agent (separate procedure) |
| CPT Modifier | Description |
|---|---|
| -RT | Right eye modifier |
| -LT | Left eye modifier |
| -50 | Bilateral |
| Patient Diagnosis Codes | Description |
|---|---|
| ICD-10-CM | ICD-10 codes vary by patient diagnosis |
| NDC | Description |
|---|---|
Single-dose glass vial designed to provide 0.05 mL for intravitreal injections: | |
| NDC 70710-2172-1 | 6 mg/mL solution (NUFYMCO 0.3 mg) |
| NDC 70710-2173-1 | 10 mg/mL solution (NUFYMCO 0.5 mg) |
Regional NUFYMCO Support
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Zydus and its agents make no guarantee regarding reimbursement for any service or item. The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and patient. For eligibility requirements, please contact a patient assistance specialist.
To report adverse events or product complaints please email medicalaffairs@zydususa.com,
call 877-993-8779, or fax +1-609-559-0699 or contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.