HCPCS code Q2043 — Sipuleucel-t auto cd54+.
Status: Active.
Effective Jul 1, 2011.
Source: CMS HCPCS Level II.
Q2043
ActiveSipuleucel-t auto cd54+
Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion
Category:
Temporary
Section:
Q-codes: Temporary Codes
Effective:
Jul 1, 2011
Code type:
alphanumeric
OPPS Status:
K
— Non-pass-through drugs and biologicals
OPPS APC:
9273
MUE — Medically Unlikely Edits
Maximum units of Q2043 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 1 |
| Practitioner Services | 1 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits
The following codes cannot be billed together with Q2043 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0380 | Modifier may bypass edit |
| G0381 | Modifier may bypass edit |
| G0382 | Modifier may bypass edit |
| G0383 | Modifier may bypass edit |
| G0384 | Modifier may bypass edit |
| G0463 | Modifier may bypass edit |
| G0471 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)
NDC Crosswalk
National Drug Codes (NDCs) mapped to this HCPCS code.
| NDC | Drug Name |
|---|---|
| 30237-8900-06 | Provenge |