Q0113 HCPCS code: Pinworm examinations
Q0113 is the HCPCS Level II code for pinworm examinations. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 21 — Priced on the Clinical Laboratory Fee Schedule |
| BETOS category | T1H |
| Added | 1994-01-01 |
| Last action effective | 1994-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Nature of Service/Procedure |
| practitioner claims | 1 | Nature of Service/Procedure |
What changed for Q0113
- 1994-01-01: Q0113 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code Q0113?
Q0113 is the HCPCS Level II code for pinworm examinations. Short descriptor: "Pinworm examinations".
Does Medicare cover Q0113?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of Q0113 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related Q01 codes
- Q0111 — Wet mounts, including preparations of vaginal, cervical or skin specimens
- Q0112 — All potassium hydroxide (koh) preparations
- Q0114 — Fern test
- Q0115 — Post-coital direct, qualitative examinations of vaginal or cervical mucous
- Q0138 — Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)
- Q0139 — Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)
- Q0144 — Azithromycin dihydrate, oral, capsules/powder, 1 gram
- Q0155 — 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
- Q0161 — 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
- Q0162 — 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
- Q0163 — 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
- Q0164 — 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
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Next steps
- Run a reimbursement report for a device billed under Q0113
- Watch Q0113 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q0113
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.