Showing codes Q0084 (Chemotherapy administration by infusion technique only, per visit) — Q0177 (Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen)
Q0084 - Chemotherapy by infusion
Long description: Chemotherapy administration by infusion technique only, per visit
Code added date: 19920101.
Code effective date: 19960101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0085 - Chemo by both infusion and o
Long description: Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit
Code added date: 19920101.
Code effective date: 19960101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0090 - Skyla 13.5mg
Long description: Levonorgestrel-releasing intrauterine contraceptive system, (skyla), 13.5 mg
Code added date: 20130701.
Code effective date: 20140101.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: S (A code denoting Medicare coverage status).
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Q0091 - Obtaining screen pap smear
Long description: Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory
Code added date: 19920101.
Code effective date: 19960701.
Pricing Indicator Code(s):
11
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0092 - Set up port xray equipment
Long description: Set-up portable x-ray equipment
Code added date: 19930101.
Code effective date: 19960101.
Pricing Indicator Code(s):
11
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0111 - Wet mounts/ w preparations
Long description: Wet mounts, including preparations of vaginal, cervical or skin specimens
Code added date: 19940101.
Code effective date: 20200101.
Pricing Indicator Code(s):
21
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0112 - Potassium hydroxide preps
Long description: All potassium hydroxide (koh) preparations
Code added date: 19940101.
Code effective date: 19940101.
Pricing Indicator Code(s):
21
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0113 - Pinworm examinations
Long description: Pinworm examinations
Code added date: 19940101.
Code effective date: 19940101.
Pricing Indicator Code(s):
21
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0114 - Fern test
Long description: Fern test
Code added date: 19940101.
Code effective date: 20200101.
Pricing Indicator Code(s):
21
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0115 - Post-coital mucous exam
Long description: Post-coital direct, qualitative examinations of vaginal or cervical mucous
Code added date: 19940101.
Code effective date: 19940101.
Pricing Indicator Code(s):
21
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0138 - Ferumoxytol, non-esrd
Long description: Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)
Code added date: 20100101.
Code effective date: 20100101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0139 - Ferumoxytol, esrd use
Long description: Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)
Code added date: 20100101.
Code effective date: 20170101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0144 - Azithromycin dihydrate, oral
Long description: Azithromycin dihydrate, oral, capsules/powder, 1 gram
Code added date: 19960701.
Code effective date: 20020701.
Pricing Indicator Code(s):
00
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: M (A code denoting Medicare coverage status).
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Q0155 - Dronabinol (syndros) 0.1 mg
Long description: Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 20250101.
Code effective date: 20250101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0161 - Chlorpromazine hcl 5mg oral
Long description: Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 20140101.
Code effective date: 20140101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q0162 - Ondansetron oral
Long description: Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0163 - Diphenhydramine hcl 50mg
Long description: Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0164 - Prochlorperazine maleate 5mg
Long description: Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0165 - Prochlorperazine maleate10mg
Long description: Prochlorperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 20140101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0166 - Granisetron hcl 1 mg oral
Long description: Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen
Code added date: 19980401.
Code effective date: 20090101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0167 - Dronabinol 2.5mg oral
Long description: Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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PDF
Q0168 - Dronabinol 5mg oral
Long description: Dronabinol, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 20140101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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PDF
Q0169 - Promethazine hcl 12.5mg oral
Long description: Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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PDF
Q0170 - Promethazine hcl 25 mg oral
Long description: Promethazine hydrochloride, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 20140101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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PDF
Q0171 - Chlorpromazine hcl 10mg oral
Long description: Chlorpromazine hydrochloride, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 20140101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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PDF
Q0172 - Chlorpromazine hcl 25mg oral
Long description: Chlorpromazine hydrochloride, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 20140101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0173 - Trimethobenzamide hcl 250mg
Long description: Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0174 - Thiethylperazine maleate10mg
Long description: Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0175 - Perphenazine 4mg oral
Long description: Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0176 - Perphenazine 8mg oral
Long description: Perphenazine, 8mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 20140101.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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Q0177 - Hydroxyzine pamoate 25mg
Long description: Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Code added date: 19980401.
Code effective date: 19980401.
Pricing Indicator Code(s):
51
; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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PDF