| HCPCS Code: |
Q0165 |
| 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 |
| Short Description: |
Prochlorperazine maleate10mg |
| Pricing Indicator 1: |
51 (Drugs) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
4557 |
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
O1D (Chemotherapy) |
| Type of Service Code 1: |
1 (Medical care) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-04-1998 |
| Action Effective Date: |
01-01-2014 |
| Termination Date: |
31-12-2013 |
| Action Code: |
D (Discontinue procedure or modifier code) |
