Question 1

What is HCPCS code Q2042?

Accepted Answer

HCPCS code Q2042 is "Tisagenlecleucel car-pos t". Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Question 2

What category is Q2042 in?

Accepted Answer

Q2042 belongs to HCPCS Category Q (Temporary Codes).

Question 3

When should I use HCPCS code Q2042?

Accepted Answer

Use Q2042 when billing for tisagenlecleucel car-pos t. 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 Q2042 covered by Medicare?

Accepted Answer

Coverage for Q2042 (Tisagenlecleucel car-pos t) 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 Q2042?

Accepted Answer

Documentation for Q2042 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).