Question 1

What is HCPCS code Q0511?

Accepted Answer

HCPCS code Q0511 is "Sup fee antiem,antica,immuno". Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period

Question 2

What category is Q0511 in?

Accepted Answer

Q0511 belongs to HCPCS Category Q (Temporary Codes).

Question 3

When should I use HCPCS code Q0511?

Accepted Answer

Use Q0511 when billing for sup fee antiem,antica,immuno. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is Q0511 covered by Medicare?

Accepted Answer

Coverage for Q0511 (Sup fee antiem,antica,immuno) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for Q0511?

Accepted Answer

Documentation for Q0511 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).