Q0161 HCPCS code: 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
Q0161 is the HCPCS Level II code for 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. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 66 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2014-01-01 |
| Last action effective | 2014-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 66 | Clinical: Data |
| outpatient hospital claims | 66 | Clinical: Data |
Medicare policy articles for this code
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (1,280 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C00.0 | Malignant neoplasm of external upper lip | 1 |
| C00.1 | Malignant neoplasm of external lower lip | 1 |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | 1 |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | 1 |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | 1 |
| C00.8 | Malignant neoplasm of overlapping sites of lip | 1 |
| C01 | Malignant neoplasm of base of tongue | 1 |
| C02.0 | Malignant neoplasm of dorsal surface of tongue | 1 |
| C02.1 | Malignant neoplasm of border of tongue | 1 |
| C02.2 | Malignant neoplasm of ventral surface of tongue | 1 |
Showing 10 of 1,280. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for Q0161
- 2014-01-01: Q0161 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 Q0161?
Q0161 is the HCPCS Level II code for 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. Short descriptor: "Chlorpromazine hcl 5mg oral".
Does Medicare cover Q0161?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for Q0161?
Medicare policy articles that cite Q0161 list 1,280 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C00.0 (Malignant neoplasm of external upper lip), C00.1 (Malignant neoplasm of external lower lip), C00.3 (Malignant neoplasm of upper lip, inner aspect). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of Q0161 can be billed per day?
66 on DME suppliers; 66 on outpatient hospital 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
- Q0113 — Pinworm examinations
- 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
- 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 Q0161
- Watch Q0161 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q0161
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.