2025 HCPCS Code 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
TAGS: prescription dosage chemotherapy exceed substitute regimen approved therapeutic complete hydroxyzine| Short Description | Hydroxyzine pamoate 25mg |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Coverage Code | D - Special coverage instructions apply |
| HCPCS Code Added Date | April 01, 1998 |
| HCPCS Action Effective Date | April 01, 1998 |
| HCPCS Pricing Indicator Code | 51 - Drugs |
| HCPCS Type Of Service Code | 1 - Medical care |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Anesthesia Base Unit Quantity | 0 |
| HCPCS Coverage Issues Manual Reference Section Number |
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