Table of content for "Perphenazine 4mg oral" (HCPCS Q0175)
General information on the “Q0175” code
HCPCS Code: Q0175
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
Short Description: Perphenazine 4mg oral
Original information is taken from Q0175 page
Pricing indicators
Pricing Indicator Code 1: 51 – Drugs
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): O1D – Chemotherapy
Type Of Service 1: 1 – Medical care
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 19980401
Code Effective Date: 19980401
Action Code: N – No maintenance for this code