coding & Reimbursement

Comprehensive Support to Help Streamline Claims Approval

Announcing the CIMERLI® Permanent Q-Code

Effective April 1, 2023

A permanent, product-specific Q-code has been established for CIMERLI® Q5128 , Injection, ranibizumab-eqrn, biosimilar (CIMERLI), 0.1 mg

CMS has established a new, permanent Q-code for CIMERLI®, effective April 1, 2023. For dates of service on or after April 1, 2023, CIMERLI® should be reported with Q5128, and this code should replace any miscellaneous codes previously used, such as J3490.

For dates of service prior to April 1, 2023, a miscellaneous code may still be required. Biosimilars receive permanent Q-codes, not J-codes.

Additional details:

Billable units:
0.5 mg: 5 billable units with NDC: 70114-0441-01
0.3 mg: 3 billable units with NDC: 70114-0440-01

For additional information regarding coding and billing or to complete a benefit verification, please contact CIMERLI Solutions™