HCPCS Code Section: HCPCS S Codes

Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets Short Description: Bupropion hcl sr 60 tablets Coverage Code: Not payable by Medicare Action Code: No maintenance …

Injection, nafcillin sodium, 2 grams Short Description: Injection, nafcillin sodium Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2000 Effective …

Zidovudine, oral, 100 mg Short Description: Zidovudine, oral, 100 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: October 1, 2002 Effective …

Injection, metronidazole, 500 mg Short Description: Injection, metronidazole Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2000 Effective Date: January …

Injection, morphine sulfate, 500 mg (loading dose for infusion pump) Short Description: Morphine 500 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date …

Injection, famotidine, 20 mg Short Description: Injection, famotidine, 20 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2000 Effective …

Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump) Short Description: Hydromorphone 250 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date …

Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166) Short Description: Granisetron 1mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this …

Sildenafil citrate, 25 mg Short Description: Sildenafil citrate, 25 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2000 Effective …

Imatinib, 100 mg Short Description: Imatinib 100 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2002 Effective Date: October …