HCPCS code Q0177 — Hydroxyzine pamoate 25mg.
Status: Active.
Effective Apr 1, 1998.
Source: CMS HCPCS Level II.
Q0177
ActiveHydroxyzine pamoate 25mg
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
Category:
Temporary
Section:
Q-codes: Temporary Codes
Effective:
Apr 1, 1998
Code type:
alphanumeric
OPPS Status:
N
— Items / services packaged into APC rates
MUE — Medically Unlikely Edits
Maximum units of Q0177 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| DME Supplier | 36 |
| Outpatient Hospital | 16 |
| Practitioner Services | 0 |
Source: CMS Medicare NCCI Medically Unlikely Edits