HCPCS Level II · Miscellaneous services (temporary codes)
Q0177Hydroxyzine 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
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Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About Q0177
Q0177 is an HCPCS Level II code in the Q series (miscellaneous services (temporary codes)), describing 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.
It was added to HCPCS effective 04/01/1998.
Its Medicare coverage code is "D", meaning special Medicare coverage instructions apply.
Details
- Short description
- Hydroxyzine pamoate 25mg
- Date added
- 04/01/1998
- Action effective
- 04/01/1998
- BETOS
- O1D
Related Q01xx codes
- Q0111Wet mounts, including preparations of vaginal, cervical or skin specimens
- Q0112All potassium hydroxide (koh) preparations
- Q0113Pinworm examinations
- Q0114Fern test
- Q0115Post-coital direct, qualitative examinations of vaginal or cervical mucous
- Q0138Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)
- Q0139Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd on dialysis)
- Q0144Azithromycin dihydrate, oral, capsules/powder, 1 gram
- Q0155Dronabinol (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
- Q0161Chlorpromazine 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
- Q0162Ondansetron 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
- Q0163Diphenhydramine 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
Common questions about Q0177
Is HCPCS Q0177 still valid?
- Yes. Q0177 is active in the CMS October 2026 HCPCS file.
Does Medicare cover Q0177?
- Its coverage code is "D": special Medicare coverage instructions apply. Check the local coverage determination for your region.