No. Q5131 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code.

What is one billing unit of Q5131?

One unit of Q5131 is 20 mg, as stated in the code's descriptor. Units to report = dose given ÷ 20 mg.

Q5131 (Retired 2024) — Inj, idacio, 20 mg

Q5131 was retired on Dec 31, 2024

CMS ended Q5131 after Dec 31, 2024. Don’t report it for later dates of service. Current codes for the same drug:

Code

CMS HCPCS file

HCPCS codeQ5131

Billing unit20 mg

Descriptor: Injection, adalimumab-aacf (idacio), biosimilar, 20 mg
Short descriptor: Inj, idacio, 20 mg
Code set: HCPCS Level II, maintained by CMS
Effective: Jan 1, 2025

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Find the NDC

Med-Code hasn’t mapped Q5131 to specific products yet. Search the FDA NDC Directory for the drug named in the descriptor, and check the route and strength match the code.

Search NDCs for adalimumab-aacf

Q5131: common questions

Is Q5131 a CPT code?: No. Q5131 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What is one billing unit of Q5131?: One unit of Q5131 is 20 mg, as stated in the code's descriptor. Units to report = dose given ÷ 20 mg. J-code billing units.

Q5131 — Injection, adalimumab-aacf (idacio), biosimilar, 20 mg

Code

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Q5131: common questions

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