Question 1

What is HCPCS code Q0163?

Accepted Answer

HCPCS code Q0163 is "Diphenhydramine hcl 50mg". 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

Question 2

What category is Q0163 in?

Accepted Answer

Q0163 belongs to HCPCS Category Q (Temporary Codes).

Question 3

When should I use HCPCS code Q0163?

Accepted Answer

Use Q0163 when billing for diphenhydramine hcl 50mg. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is Q0163 covered by Medicare?

Accepted Answer

Coverage for Q0163 (Diphenhydramine hcl 50mg) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for Q0163?

Accepted Answer

Documentation for Q0163 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).