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    v1.0.28
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q0161-chlorpromazine-oral-anti-emetic-substitute-for-iv-chemotherapy
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    HCPCS Q0161: Chlorpromazine 5 mg Oral Anti-emetic for Chemotherapy

    HCPCS Level II code Q0161 describes chlorpromazine hydrochloride 5 mg oral, FDA-approved as an anti-emetic used as a complete therapeutic substitute for an IV anti-emetic during chemotherapy administration; service type is a short-course oral anti-emetic regimen (not to exceed 48 hours) provided at the infusion center or oncology clinic as part of chemotherapy supportive care.

    For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult oncology outpatient receiving moderately or highly emetogenic chemotherapy who requires an oral anti-emetic alternative to an IV agent at the time of treatment. The patient presents to the infusion clinic for scheduled chemotherapy. During pre-treatment assessment the nurse documents prior severe nausea with prior cycles or IV anti-emetic intolerance (e.g., IV access difficulty, prior IV reaction) and the oncologist orders an oral anti-emetic to be administered as a single-dose therapeutic substitute for an IV anti-emetic at the time of chemotherapy. Pharmacy dispenses Q0161 (chlorpromazine hydrochloride, 5 mg, oral) and the medication is given in the clinic immediately prior to or during chemotherapy. The regimen is limited to a maximum 48-hour dosage course per the code descriptor. Documentation includes indication (chemotherapy-induced nausea/vomiting prophylaxis or treatment), dose administered, timing relative to chemotherapy start, patient tolerance, and any subsequent anti-emetic orders for home use. Typical workflow participants include the oncologist, infusion nurse, clinic pharmacist, and medical billing staff who append appropriate modifiers and link to the supporting ICD-10 diagnosis for chemotherapy-induced nausea and vomiting or related codes when submitting claims to payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96413Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drugOften performed concurrently with Q0161 when oral anti-emetic is given as a substitute during an IV chemotherapy infusion
    96415Chemotherapy administration, each additional hour (List separately in addition to code for primary infusion)Billed when extended infusion time occurs and anti-emetic management is part of the extended care
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscularUsed when alternative anti-emetics are administered via injection in the same encounter as oral Q0161
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourRelated when IV anti-emetics are used and Q0161 is billed as the oral substitute in the chemotherapy visit
    99605Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, initial 15 minutesUsed in clinics that document pharmacist medication management or counseling when dispensing Q0161

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    333600000XPharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative servi…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    251T00000XPACE Provider OrganizationA PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated manage…
    3336L0003XLong Term Care PharmacyA pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermed…
    261QX0203XRadiation Oncology Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center

    Related ICD-10-CM Codes

    30 rows

    ICD-10-CM CodeDescription
    C15.9Malignant neoplasm of esophagus, unspecified
    C16.9Malignant neoplasm of stomach, unspecified
    C18.9Malignant neoplasm of colon, unspecified
    C20Malignant neoplasm of rectum
    C25.9Malignant neoplasm of pancreas, unspecified
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C50.912Malignant neoplasm of unspecified site of left female breast
    C53.9Malignant neoplasm of cervix uteri, unspecified
    C54.9Malignant neoplasm of corpus uteri, unspecified
    C56.9Malignant neoplasm of unspecified ovary

    Showing 1–10 of 30

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    9 rows

    PolicyPayerEffective Date
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

    HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

    HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

    HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

    HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

    HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

    HCPCS Level II Q0035: Cardiokymography

    HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

    HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

    HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

    HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

    HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

    HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

    HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

    HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

    HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

    HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

    HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

    HCPCS Q0092: Set-up Portable X-ray Equipment

    Showing 1–10 of 629

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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