Summary & Overview
HCPCS S0091: Granisetron Hydrochloride 1 mg, Antiemetic Supply
HCPCS Level II code S0091 designates granisetron hydrochloride, 1 mg, an antiemetic medication used to prevent or treat nausea and vomiting associated with chemotherapy or other clinical indications. Nationally, accurate coding for supportive oncology medications affects billing clarity, coverage determinations, and out-of-pocket costs for patients receiving outpatient antiemetic therapy. This code is notable because Medicare guidance explicitly directs use of q0166 for situations falling under the Medicare statute, and payers may apply specific rules around drug coverage and site-of-service billing.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical purpose of the code, typical service contexts where S0091 is billed, and which major payers are relevant for coverage considerations. The publication provides benchmarking context, common billing modifiers and payer interactions (where available), and an explanation of how this code fits into outpatient medication administration workflows. Data not available in the input will be identified where applicable. This summary is intended for coding professionals, billing managers, and policy analysts seeking a concise national-level overview of HCPCS Level II code S0091 and its role in outpatient antiemetic therapy.
Billing Code Overview
HCPCS Level II code S0091 represents granisetron hydrochloride, 1 mg. The description indicates this code is used for administration or supply of the antiemetic medication granisetron in a 1 mg dosage. Service type: medication administration/supply for antiemetic therapy. Typical site of service: outpatient infusion or clinic-based administration and other outpatient settings where injectable or supplied antiemetic agents are provided. Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult oncology patient receiving antiemetic therapy in an outpatient infusion center or clinic. The patient is scheduled for chemotherapy known to cause acute nausea and vomiting; the clinician orders an intravenous antiemetic. A nurse prepares and administers S0091 (granisetron hydrochloride, 1 mg) as a single-dose injection or as part of an antiemetic regimen immediately before or during chemotherapy. The typical workflow: order verification in the electronic health record, pharmacy preparation of the S0091 vial/dose, bedside medication administration documented in the infusion record, and billing submission using the HCPCS Level II code S0091. The usual site of service is an outpatient hospital infusion center, physician office infusion suite, or ambulatory infusion center. Common clinical reasons include prevention or treatment of chemotherapy-induced nausea and vomiting (CINV) for moderately to highly emetogenic chemotherapy, or for postoperative nausea and vomiting when granisetron is chosen by the treating clinician.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard billing | Use as the default when no specific modifier applies. |