HCPCSA0000–A9999

HCPCS A — Transportation, Medical & Surgical Supplies, Administrative

Ambulance transport, dressings, ostomy and incontinence supplies, and the administrative codes that do not describe a service at all.

862 codes in the current CMS release, 853 of them still active.

A0021Ambulance service, outside state per mile, transport (medicaid only)
A0080Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest
A0090Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest
A0100Non-emergency transportation; taxi
A0110Non-emergency transportation and bus, intra or inter state carrier
A0120Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems
A0130Non-emergency transportation: wheelchair van
A0140Non-emergency transportation and air travel (private or commercial) intra or inter state
A0160Non-emergency transportation: per mile - case worker or social worker
A0170Transportation ancillary: parking fees, tolls, other
A0180Non-emergency transportation: ancillary: lodging-recipient
A0190Non-emergency transportation: ancillary: meals-recipient
A0200Non-emergency transportation: ancillary: lodging escort
A0210Non-emergency transportation: ancillary: meals-escort
A0225Ambulance service, neonatal transport, base rate, emergency transport, one way
A0380Bls mileage (per mile)
A0382Bls routine disposable supplies
A0384Bls specialized service disposable supplies; defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances)
A0390Als mileage (per mile)
A0392Als specialized service disposable supplies; defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances)
A0394Als specialized service disposable supplies; iv drug therapy
A0396Als specialized service disposable supplies; esophageal intubation
A0398Als routine disposable supplies
A0420Ambulance waiting time (als or bls), one half (1/2) hour increments
A0422Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation
A0424Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)
A0425Ground mileage, per statute mile
A0426Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)
A0427Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)
A0428Ambulance service, basic life support, non-emergency transport, (bls)
A0429Ambulance service, basic life support, emergency transport (bls-emergency)
A0430Ambulance service, conventional air services, transport, one way (fixed wing)
A0431Ambulance service, conventional air services, transport, one way (rotary wing)
A0432Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers
A0433Advanced life support, level 2 (als 2)
A0434Specialty care transport (sct)
A0435Fixed wing air mileage, per statute mile
A0436Rotary wing air mileage, per statute mile
A0888Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility)
A0998Ambulance response and treatment, no transport
A0999Unlisted ambulance service
A2001Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure)
A2002Mirragen advanced wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
A2004Xcellistem, 1 mg
A2005Microlyte matrix, per square centimeter (add-on, list separately in addition to primary procedure)
A2006Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)
A2007Restrata, per square centimeter (add-on, list separately in addition to primary procedure)
A2008Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)
A2009Symphony, per square centimeter (add-on, list separately in addition to primary procedure)
A2010Apis, per square centimeter (add-on, list separately in addition to primary procedure)
A2011Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)
A2012Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)
A2013Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)
A2014Omeza collagen matrix or omeza complete matrix, per 100 mg
A2015Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
A2016Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)
A2017Permeaderm glove, each
A2018Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)
A2019Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)
A2020Ac5 advanced wound system (ac5)
A2021Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)
A2022Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)
A2023Innovamatrix pd, 1 mg
A2024Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)
A2025Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)
A2026Restrata minimatrix, 5 mg
A2027Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)
A2028Micromatrix flex, per mg
A2029Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)
A2030Miro3d fibers, per milligram
A2031Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
A2032Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)
A2033Myriad morcells, 4 milligrams
A2034Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)
A2035Corplex p or theracor p or allacor p, per milligram
A2036Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)
A2037G4derm plus/suprello, per milliliter
A2038Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)
A2039Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)
A2040Microlyte painguard, per square centimeter
A2041Foundation drs+ duo, per square centimeter
A2042Foundation drs+ solo, per square centimeter
A2043Biobrane, per square centimeter
A2044Biobrane glove, each
A2045Novashield or novogen wound matrix, per square centimeter
A4100Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)
A4206Syringe with needle, sterile, 1 cc or less, each
A4207Syringe with needle, sterile 2 cc, each
A4208Syringe with needle, sterile 3 cc, each
A4209Syringe with needle, sterile 5 cc or greater, each
A4210Needle-free injection device, each
A4211Supplies for self-administered injections
A4212Non-coring needle or stylet with or without catheter
A4213Syringe, sterile, 20 cc or greater, each
A4215Needle, sterile, any size, each
A4216Sterile water, saline and/or dextrose, diluent/flush, 10 ml
A4217Sterile water/saline, 500 ml
A4218Sterile saline or water, metered dose dispenser, 10 ml
A4220Refill kit for implantable infusion pump
A4221Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)
A4222Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)
A4223Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
A4224Supplies for maintenance of insulin infusion catheter, per week
A4225Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
A4226Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week
A4230Infusion set for external insulin pump, non needle cannula type
A4231Infusion set for external insulin pump, needle type
A4232Syringe with needle for external insulin pump, sterile, 3 cc
A4233Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each
A4234Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each
A4235Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each
A4236Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each
A4238Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
A4239Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
A4244Alcohol or peroxide, per pint
A4245Alcohol wipes, per box
A4246Betadine or phisohex solution, per pint
A4247Betadine or iodine swabs/wipes, per box
A4248Chlorhexidine containing antiseptic, 1 ml
A4250Urine test or reagent strips or tablets (100 tablets or strips)
A4252Blood ketone test or reagent strip, each
A4253Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
A4255Platforms for home blood glucose monitor, 50 per box
A4256Normal, low and high calibrator solution / chips
A4257Replacement lens shield cartridge for use with laser skin piercing device, each
A4258Spring-powered device for lancet, each
A4259Lancets, per box of 100
A4261Cervical cap for contraceptive use
A4262Temporary, absorbable lacrimal duct implant, each
A4263Permanent, long term, non-dissolvable lacrimal duct implant, each
A4264Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
A4265Paraffin, per pound
A4266Diaphragm for contraceptive use
A4267Contraceptive supply, condom, male, each
A4268Contraceptive supply, condom, female, each
A4269Contraceptive supply, spermicide (e.g., foam, gel), each
A4270Disposable endoscope sheath, each
A4271Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests
A4280Adhesive skin support attachment for use with external breast prosthesis, each
A4281Tubing for breast pump, replacement
A4282Adapter for breast pump, replacement
A4283Cap for breast pump bottle, replacement
A4284Breast shield and splash protector for use with breast pump, replacement
A4285Polycarbonate bottle for use with breast pump, replacement
A4286Locking ring for breast pump, replacement
A4287Disposable collection and storage bag for breast milk, any size, any type, each
A4288Valve for breast pump, replacement
A4290Sacral nerve stimulation test lead, each
A4295Intermittent urinary catheter; straight tip, hydrophilic coating, each
A4296Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each
A4297Intermittent urinary catheter; hydrophilic coating, with insertion supplies
A4300Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access
A4301Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)
A4305Disposable drug delivery system, flow rate of 50 ml or greater per hour
A4306Disposable drug delivery system, flow rate of less than 50 ml per hour
A4310Insertion tray without drainage bag and without catheter (accessories only)
A4311Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
A4312Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone
A4313Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
A4314Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
A4315Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone
A4316Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
A4318Female external urinary collection cup, with or without ring attachment, per day
A4320Irrigation tray with bulb or piston syringe, any purpose
A4321Therapeutic agent for urinary catheter irrigation
A4322Irrigation syringe, bulb or piston, each
A4326Male external catheter with integral collection chamber, any type, each
A4327Female external urinary collection device; meatal cup, each
A4328Female external urinary collection device; pouch, each
A4330Perianal fecal collection pouch with adhesive, each
A4331Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each
A4332Lubricant, individual sterile packet, each
A4333Urinary catheter anchoring device, adhesive skin attachment, each
A4334Urinary catheter anchoring device, leg strap, each
A4335Incontinence supply; miscellaneous
A4336Incontinence supply, urethral insert, any type, each
A4337Incontinence supply, rectal insert, any type, each
A4338Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each
A4340Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each
A4341Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
A4342Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each
A4344Indwelling catheter, foley type, two-way, all silicone or polyurethane, each
A4346Indwelling catheter; foley type, three way for continuous irrigation, each
A4349Male external catheter, with or without adhesive, disposable, each
A4351Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each
A4352Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each
A4353Intermittent urinary catheter, with insertion supplies
A4354Insertion tray with drainage bag but without catheter
A4355Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each
A4356External urethral clamp or compression device (not to be used for catheter clamp), each
A4357Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each
A4358Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each
A4360Disposable external urethral clamp or compression device, with pad and/or pouch, each
A4361Ostomy faceplate, each
A4362Skin barrier; solid, 4 x 4 or equivalent; each
A4363Ostomy clamp, any type, replacement only, each
A4364Adhesive, liquid or equal, any type, per oz
A4366Ostomy vent, any type, each
A4367Ostomy belt, each
A4368Ostomy filter, any type, each
A4369Ostomy skin barrier, liquid (spray, brush, etc.), per oz
A4371Ostomy skin barrier, powder, per oz
A4372Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each
A4373Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each
A4375Ostomy pouch, drainable, with faceplate attached, plastic, each
A4376Ostomy pouch, drainable, with faceplate attached, rubber, each
A4377Ostomy pouch, drainable, for use on faceplate, plastic, each
A4378Ostomy pouch, drainable, for use on faceplate, rubber, each
A4379Ostomy pouch, urinary, with faceplate attached, plastic, each
A4380Ostomy pouch, urinary, with faceplate attached, rubber, each
A4381Ostomy pouch, urinary, for use on faceplate, plastic, each
A4382Ostomy pouch, urinary, for use on faceplate, heavy plastic, each
A4383Ostomy pouch, urinary, for use on faceplate, rubber, each
A4384Ostomy faceplate equivalent, silicone ring, each
A4385Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each
A4387Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each
A4388Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each
A4389Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each
A4390Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each
A4391Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each
A4392Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each
A4393Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each
A4394Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce
A4395Ostomy deodorant for use in ostomy pouch, solid, per tablet
A4396Ostomy belt with peristomal hernia support
A4397Irrigation supply; sleeve, eachterminated
A4398Ostomy irrigation supply; bag, each
A4399Ostomy irrigation supply; cone/catheter, with or without brush
A4400Ostomy irrigation set
A4402Lubricant, per ounce
A4404Ostomy ring, each
A4405Ostomy skin barrier, non-pectin based, paste, per ounce
A4406Ostomy skin barrier, pectin-based, paste, per ounce
A4407Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each
A4408Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each
A4409Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each
A4410Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each
A4411Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each
A4412Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each
A4413Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each
A4414Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each
A4415Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each
A4416Ostomy pouch, closed, with barrier attached, with filter (1 piece), each
A4417Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each
A4418Ostomy pouch, closed; without barrier attached, with filter (1 piece), each
A4419Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each
A4420Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each
A4421Ostomy supply; miscellaneous
A4422Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each
A4423Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each
A4424Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each
A4425Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each
A4426Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each
A4427Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each
A4428Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each
A4429Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
A4430Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
A4431Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each
A4432Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each
A4433Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each
A4434Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each
A4435Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each
A4436Irrigation supply; sleeve, reusable, per month
A4437Irrigation supply; sleeve, disposable, per month
A4438Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
A4450Tape, non-waterproof, per 18 square inches
A4452Tape, waterproof, per 18 square inches
A4453Rectal catheter with or without balloon, for use with any type transanal irrigation system, each
A4455Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
A4456Adhesive remover, wipes, any type, each
A4457Enema tube, with or without adapter, any type, replacement only, each
A4458Enema bag with tubing, reusable
A4459Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type
A4461Surgical dressing holder, non-reusable, each
A4463Surgical dressing holder, reusable, each
A4465Non-elastic binder for extremity
A4466Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, eachterminated
A4467Belt, strap, sleeve, garment, or covering, any type
A4468Exsufflation belt, includes all supplies and accessories
A4470Gravlee jet washer
A4479Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type
A4480Vabra aspirator
A4481Tracheostoma filter, any type, any size, each
A4483Moisture exchanger, disposable, for use with invasive mechanical ventilation
A4490Surgical stockings above knee length, each
A4495Surgical stockings thigh length, each
A4500Surgical stockings below knee length, each
A4510Surgical stockings full length, each
A4520Incontinence garment, any type, (e.g., brief, diaper), each
A4540Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
A4541Monthly supplies for use of device coded at e0733
A4542Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
A4543Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month
A4544Electrode for external lower extremity nerve stimulator for restless legs syndrome
A4545Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month
A4550Surgical trays
A4553Non-disposable underpads, all sizes
A4554Disposable underpads, all sizes
A4555Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only
A4556Electrodes, (e.g., apnea monitor), per pair
A4557Lead wires, (e.g., apnea monitor), per pair
A4558Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz
A4559Coupling gel or paste, for use with ultrasound device, per oz
A4560Neuromuscular electrical stimulator (nmes), disposable, replacement only
A4561Pessary, reusable, rubber, any type
A4562Pessary, reusable, non rubber, any type
A4563Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each
A4564Pessary, disposable, any type
A4565Slings
A4566Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment
A4570Splint
A4575Topical hyperbaric oxygen chamber, disposable
A4580Cast supplies (e.g., plaster)
A4590Special casting material (e.g., fiberglass)
A4593Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller
A4594Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each
A4595Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)
A4596Cranial electrotherapy stimulation (ces) system supplies and accessories, per month
A4600Sleeve for intermittent limb compression device, replacement only, each
A4601Lithium ion battery, rechargeable, for non-prosthetic use, replacement
A4602Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each
A4604Tubing with integrated heating element for use with positive airway pressure device
A4605Tracheal suction catheter, closed system, each
A4606Oxygen probe for use with oximeter device, replacement
A4608Transtracheal oxygen catheter, each
A4611Battery, heavy duty; replacement for patient owned ventilator
A4612Battery cables; replacement for patient-owned ventilator
A4613Battery charger; replacement for patient-owned ventilator
A4614Peak expiratory flow rate meter, hand held
A4615Cannula, nasal
A4616Tubing (oxygen), per foot
A4617Mouth piece
A4618Breathing circuits
A4619Face tent
A4620Variable concentration mask
A4623Tracheostomy, inner cannula
A4624Tracheal suction catheter, any type other than closed system, each
A4625Tracheostomy care kit for new tracheostomy
A4626Tracheostomy cleaning brush, each
A4627Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler
A4628Oral and/or oropharyngeal suction catheter, each
A4629Tracheostomy care kit for established tracheostomy
A4630Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient
A4633Replacement bulb/lamp for ultraviolet light therapy system, each
A4634Replacement bulb for therapeutic light box, tabletop model
A4635Underarm pad, crutch, replacement, each
A4636Replacement, handgrip, cane, crutch, or walker, each
A4637Replacement, tip, cane, crutch, walker, each.
A4638Replacement battery for patient-owned ear pulse generator, each
A4639Replacement pad for infrared heating pad system, each
A4640Replacement pad for use with medically necessary alternating pressure pad owned by patient
A4641Radiopharmaceutical, diagnostic, not otherwise classified
A4642Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
A4648Tissue marker, implantable, any type, each
A4649Surgical supply; miscellaneous
A4650Implantable radiation dosimeter, each
A4651Calibrated microcapillary tube, each
A4652Microcapillary tube sealant
A4653Peritoneal dialysis catheter anchoring device, belt, each
A4657Syringe, with or without needle, each
A4660Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
A4663Blood pressure cuff only
A4670Automatic blood pressure monitor
A4671Disposable cycler set used with cycler dialysis machine, each
A4672Drainage extension line, sterile, for dialysis, each
A4673Extension line with easy lock connectors, used with dialysis
A4674Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz
A4680Activated carbon filter for hemodialysis, each
A4690Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each
A4706Bicarbonate concentrate, solution, for hemodialysis, per gallon
A4707Bicarbonate concentrate, powder, for hemodialysis, per packet
A4708Acetate concentrate solution, for hemodialysis, per gallon
A4709Acid concentrate, solution, for hemodialysis, per gallon
A4714Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon
A4719"y set" tubing for peritoneal dialysis
A4720Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
A4721Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
A4722Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis
A4723Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis
A4724Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis
A4725Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis
A4726Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis
A4728Dialysate solution, non-dextrose containing, 500 ml
A4730Fistula cannulation set for hemodialysis, each
A4736Topical anesthetic, for dialysis, per gram
A4737Injectable anesthetic, for dialysis, per 10 ml
A4740Shunt accessory, for hemodialysis, any type, each
A4750Blood tubing, arterial or venous, for hemodialysis, each
A4755Blood tubing, arterial and venous combined, for hemodialysis, each
A4760Dialysate solution test kit, for peritoneal dialysis, any type, each
A4765Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
A4766Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml
A4770Blood collection tube, vacuum, for dialysis, per 50
A4771Serum clotting time tube, for dialysis, per 50
A4772Blood glucose test strips, for dialysis, per 50
A4773Occult blood test strips, for dialysis, per 50
A4774Ammonia test strips, for dialysis, per 50
A4802Protamine sulfate, for hemodialysis, per 50 mg
A4860Disposable catheter tips for peritoneal dialysis, per 10
A4870Plumbing and/or electrical work for home hemodialysis equipment
A4890Contracts, repair and maintenance, for hemodialysis equipment
A4911Drain bag/bottle, for dialysis, each
A4913Miscellaneous dialysis supplies, not otherwise specified
A4918Venous pressure clamp, for hemodialysis, each
A4927Gloves, non-sterile, per 100
A4928Surgical mask, per 20
A4929Tourniquet for dialysis, each
A4930Gloves, sterile, per pair
A4931Oral thermometer, reusable, any type, each
A4932Rectal thermometer, reusable, any type, each
A5051Ostomy pouch, closed; with barrier attached (1 piece), each
A5052Ostomy pouch, closed; without barrier attached (1 piece), each
A5053Ostomy pouch, closed; for use on faceplate, each
A5054Ostomy pouch, closed; for use on barrier with flange (2 piece), each
A5055Stoma cap
A5056Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each
A5057Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
A5061Ostomy pouch, drainable; with barrier attached, (1 piece), each
A5062Ostomy pouch, drainable; without barrier attached (1 piece), each
A5063Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each
A5071Ostomy pouch, urinary; with barrier attached (1 piece), each
A5072Ostomy pouch, urinary; without barrier attached (1 piece), each
A5073Ostomy pouch, urinary; for use on barrier with flange (2 piece), each
A5081Stoma plug or seal, any type
A5082Continent device; catheter for continent stoma
A5083Continent device, stoma absorptive cover for continent stoma
A5093Ostomy accessory; convex insert
A5102Bedside drainage bottle with or without tubing, rigid or expandable, each
A5105Urinary suspensory with leg bag, with or without tube, each
A5112Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each
A5113Leg strap; latex, replacement only, per set
A5114Leg strap; foam or fabric, replacement only, per set
A5120Skin barrier, wipes or swabs, each
A5121Skin barrier; solid, 6 x 6 or equivalent, each
A5122Skin barrier; solid, 8 x 8 or equivalent, each
A5126Adhesive or non-adhesive; disk or foam pad
A5131Appliance cleaner, incontinence and ostomy appliances, per 16 oz.
A5200Percutaneous catheter/tube anchoring device, adhesive skin attachment
A5500For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe
A5501For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe
A5503For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe
A5504For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe
A5505For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe
A5506For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe
A5507For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe
A5508For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe
A5510For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe
A5512For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each
A5513For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
A5514For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
A6000Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card
A6010Collagen based wound filler, dry form, sterile, per gram of collagen
A6011Collagen based wound filler, gel/paste, per gram of collagen
A6021Collagen dressing, sterile, size 16 sq. in. or less, each
A6022Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each
A6023Collagen dressing, sterile, size more than 48 sq. in., each
A6024Collagen dressing wound filler, sterile, per 6 inches
A6025Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each
A6154Wound pouch, each
A6196Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing
A6197Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
A6198Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing
A6199Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches
A6203Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6204Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
A6205Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6206Contact layer, sterile, 16 sq. in. or less, each dressing
A6207Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
A6208Contact layer, sterile, more than 48 sq. in., each dressing
A6209Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6210Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
A6211Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6212Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6213Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
A6214Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6215Foam dressing, wound filler, sterile, per gram
A6216Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6217Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
A6218Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6219Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6220Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
A6221Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6222Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6223Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing
A6224Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6228Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6229Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
A6230Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6231Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing
A6232Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing
A6233Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing
A6234Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6235Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
A6236Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6237Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6238Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
A6239Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6240Hydrocolloid dressing, wound filler, paste, sterile, per ounce
A6241Hydrocolloid dressing, wound filler, dry form, sterile, per gram
A6242Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6243Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
A6244Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6245Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6246Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
A6247Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6248Hydrogel dressing, wound filler, gel, per fluid ounce
A6250Skin sealants, protectants, moisturizers, ointments, any type, any size
A6251Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6252Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
A6253Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6254Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6255Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
A6256Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6257Transparent film, sterile, 16 sq. in. or less, each dressing
A6258Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
A6259Transparent film, sterile, more than 48 sq. in., each dressing
A6260Wound cleansers, any type, any size
A6261Wound filler, gel/paste, per fluid ounce, not otherwise specified
A6262Wound filler, dry form, per gram, not otherwise specified
A6266Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard
A6402Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6403Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing
A6404Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6407Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard
A6410Eye pad, sterile, each
A6411Eye pad, non-sterile, each
A6412Eye patch, occlusive, each
A6413Adhesive bandage, first-aid type, any size, each
A6441Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard
A6442Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard
A6443Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard
A6444Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard
A6445Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard
A6446Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard
A6447Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard
A6448Light compression bandage, elastic, knitted/woven, width less than three inches, per yard
A6449Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard
A6450Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard
A6451Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard
A6452High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard
A6453Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard
A6454Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard
A6455Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard
A6456Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard
A6457Tubular dressing with or without elastic, any width, per linear yard
A6460Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6461Synthetic resorbable wound dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
A6501Compression burn garment, bodysuit (head to foot), custom fabricated
A6502Compression burn garment, chin strap, custom fabricated
A6503Compression burn garment, facial hood, custom fabricated
A6504Compression burn garment, glove to wrist, custom fabricated
A6505Compression burn garment, glove to elbow, custom fabricated
A6506Compression burn garment, glove to axilla, custom fabricated
A6507Compression burn garment, foot to knee length, custom fabricated
A6508Compression burn garment, foot to thigh length, custom fabricated
A6509Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated
A6510Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated
A6511Compression burn garment, lower trunk including leg openings (panty), custom fabricated
A6512Compression burn garment, not otherwise classified
A6513Compression burn mask, face and/or neck, plastic or equal, custom fabricated
A6515Gradient compression wrap with adjustable straps, full leg, each, custom
A6516Gradient compression wrap with adjustable straps, foot, each, custom
A6517Gradient compression wrap with adjustable straps, below knee, each, custom
A6518Gradient compression wrap with adjustable straps, arm, each, custom
A6519Gradient compression garment, not otherwise specified, for nighttime use, each
A6520Gradient compression garment, glove, padded, for nighttime use, each
A6521Gradient compression garment, glove, padded, for nighttime use, custom, each
A6522Gradient compression garment, arm, padded, for nighttime use, each
A6523Gradient compression garment, arm, padded, for nighttime use, custom, each
A6524Gradient compression garment, lower leg and foot, padded, for nighttime use, each
A6525Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each
A6526Gradient compression garment, full leg and foot, padded, for nighttime use, each
A6527Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each
A6528Gradient compression garment, bra, for nighttime use, each
A6529Gradient compression garment, bra, for nighttime use, custom, each
A6530Gradient compression stocking, below knee, 18-30 mmhg, each
A6531Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each
A6532Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each
A6533Gradient compression stocking, thigh length, 18-30 mmhg, each
A6534Gradient compression stocking, thigh length, 30-40 mmhg, each
A6535Gradient compression stocking, thigh length, 40 mmhg or greater, each
A6536Gradient compression stocking, full length/chap style, 18-30 mmhg, each
A6537Gradient compression stocking, full length/chap style, 30-40 mmhg, each
A6538Gradient compression stocking, full length/chap style, 40 mmhg or greater, each
A6539Gradient compression stocking, waist length, 18-30 mmhg, each
A6540Gradient compression stocking, waist length, 30-40 mmhg, each
A6541Gradient compression stocking, waist length, 40 mmhg or greater, each
A6544Gradient compression stocking, garter belt
A6545Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each
A6548Accessory to custom gradient compression garment, silicone band, any size
A6549Gradient compression garment, not otherwise specified, for daytime use, each
A6550Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories
A6552Gradient compression stocking, below knee, 30-40 mmhg, each
A6553Gradient compression stocking, below knee, 30-40 mmhg, custom, each
A6554Gradient compression stocking, below knee, 40 mmhg or greater, each
A6555Gradient compression stocking, below knee, 40 mmhg or greater, custom, each
A6556Gradient compression stocking, thigh length, 18-30 mmhg, custom, each
A6557Gradient compression stocking, thigh length, 30-40 mmhg, custom, each
A6558Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each
A6559Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each
A6560Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each
A6561Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each
A6562Gradient compression stocking, waist length, 18-30 mmhg, custom, each
A6563Gradient compression stocking, waist length, 30-40 mmhg, custom, each
A6564Gradient compression stocking, waist length, 40 mmhg or greater, custom, each
A6565Gradient compression gauntlet, custom, each
A6566Gradient compression garment, neck/head, each
A6567Gradient compression garment, neck/head, custom, each
A6568Gradient compression garment, torso and shoulder, each
A6569Gradient compression garment, torso/shoulder, custom, each
A6570Gradient compression garment, genital region, each
A6571Gradient compression garment, genital region, custom, each
A6572Gradient compression garment, toe caps, each
A6573Gradient compression garment, toe caps, custom, each
A6574Gradient compression arm sleeve and glove combination, custom, each
A6575Gradient compression arm sleeve and glove combination, each
A6576Gradient compression arm sleeve, custom, medium weight, each
A6577Gradient compression arm sleeve, custom, heavy weight, each
A6578Gradient compression arm sleeve, each
A6579Gradient compression glove, custom, medium weight, each
A6580Gradient compression glove, custom, heavy weight, each
A6581Gradient compression glove, each
A6582Gradient compression gauntlet, each
A6583Gradient compression wrap with adjustable straps, below knee, each
A6584Gradient compression wrap with adjustable straps, not otherwise specified
A6585Gradient compression wrap with adjustable straps, above knee, each
A6586Gradient compression wrap with adjustable straps, full leg, each
A6587Gradient compression wrap with adjustable straps, foot, each
A6588Gradient compression wrap with adjustable straps, arm, each
A6589Gradient pressure wrap with adjustable straps, bra, each
A6590External urinary catheters; disposable, with wicking material, for use with suction pump, per month
A6591External urinary catheter; non-disposable, for use with suction pump, per month
A6593Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified
A6594Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each
A6595Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each
A6596Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each
A6597Gradient compression bandage roll, elastic long stretch, linear yard, any width, each
A6598Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each
A6599Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each
A6600Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each
A6601Gradient compression bandaging supply, high density foam pad, any size or shape, each
A6602Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each
A6603Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each
A6604Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each
A6605Gradient compression bandaging supply, padded foam, per linear yard, any width, each
A6606Gradient compression bandaging supply, padded textile, per linear yard, any width, each
A6607Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each
A6608Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each
A6609Gradient compression bandaging supply, not otherwise specified
A6610Gradient compression stocking, below knee, 18-30 mmhg, custom, each
A6611Gradient compression wrap with adjustable straps, above knee, each, custom
A7000Canister, disposable, used with suction pump, each
A7001Canister, non-disposable, used with suction pump, each
A7002Tubing, used with suction pump, each
A7003Administration set, with small volume nonfiltered pneumatic nebulizer, disposable
A7004Small volume nonfiltered pneumatic nebulizer, disposable
A7005Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable
A7006Administration set, with small volume filtered pneumatic nebulizer
A7007Large volume nebulizer, disposable, unfilled, used with aerosol compressor
A7008Large volume nebulizer, disposable, prefilled, used with aerosol compressor
A7009Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer
A7010Corrugated tubing, disposable, used with large volume nebulizer, 100 feet
A7011Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feetterminated
A7012Water collection device, used with large volume nebulizer
A7013Filter, disposable, used with aerosol compressor or ultrasonic generator
A7014Filter, nondisposable, used with aerosol compressor or ultrasonic generator
A7015Aerosol mask, used with dme nebulizer
A7016Dome and mouthpiece, used with small volume ultrasonic nebulizer
A7017Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen
A7018Water, distilled, used with large volume nebulizer, 1000 ml
A7020Interface for cough stimulating device, includes all components, replacement only
A7021Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)
A7023Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical
A7025High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each
A7026High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each
A7027Combination oral/nasal mask, used with continuous positive airway pressure device, each
A7028Oral cushion for combination oral/nasal mask, replacement only, each
A7029Nasal pillows for combination oral/nasal mask, replacement only, pair
A7030Full face mask used with positive airway pressure device, each
A7031Face mask interface, replacement for full face mask, each
A7032Cushion for use on nasal mask interface, replacement only, each
A7033Pillow for use on nasal cannula type interface, replacement only, pair
A7034Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap
A7035Headgear used with positive airway pressure device
A7036Chinstrap used with positive airway pressure device
A7037Tubing used with positive airway pressure device
A7038Filter, disposable, used with positive airway pressure device
A7039Filter, non disposable, used with positive airway pressure device
A7040One way chest drain valve
A7041Water seal drainage container and tubing for use with implanted chest tube
A7042Implanted pleural catheter, eachterminated
A7043Vacuum drainage bottle and tubing for use with implanted catheterterminated
A7044Oral interface used with positive airway pressure device, each
A7045Exhalation port with or without swivel used with accessories for positive airway devices, replacement only
A7046Water chamber for humidifier, used with positive airway pressure device, replacement, each
A7047Oral interface used with respiratory suction pump, each
A7048Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each
A7049Expiratory positive airway pressure intranasal resistance valve
A7501Tracheostoma valve, including diaphragm, each
A7502Replacement diaphragm/faceplate for tracheostoma valve, each
A7503Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each
A7504Filter for use in a tracheostoma heat and moisture exchange system, each
A7505Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each
A7506Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each
A7507Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each
A7508Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each
A7509Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each
A7520Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each
A7521Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each
A7522Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each
A7523Tracheostomy shower protector, each
A7524Tracheostoma stent/stud/button, each
A7525Tracheostomy mask, each
A7526Tracheostomy tube collar/holder, each
A7527Tracheostomy/laryngectomy tube plug/stop, each
A8000Helmet, protective, soft, prefabricated, includes all components and accessories
A8001Helmet, protective, hard, prefabricated, includes all components and accessories
A8002Helmet, protective, soft, custom fabricated, includes all components and accessories
A8003Helmet, protective, hard, custom fabricated, includes all components and accessories
A8004Soft interface for helmet, replacement only
A8005Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted
A8006Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only
A9150Non-prescription drugs
A9152Single vitamin/mineral/trace element, oral, per dose, not otherwise specified
A9153Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified
A9154Artificial saliva, 1 ml
A9155Artificial saliva, 30 mlterminated
A9156Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml
A9180Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker
A9268Programmer for transient, orally ingested capsule
A9269Programable, transient, orally ingested capsule, for use with external programmer, per month
A9270Non-covered item or service
A9272Wound suction, disposable, includes dressing, all accessories and components, any type, each
A9273Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type
A9274External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories
A9275Home glucose disposable monitor, includes test strips
A9276Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply
A9277Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system
A9278Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system
A9279Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified
A9280Alert or alarm device, not otherwise classified
A9281Reaching/grabbing device, any type, any length, each
A9282Wig, any type, each
A9283Foot pressure off loading/supportive device, any type, each
A9284Spirometer, non-electronic, includes all accessories
A9285Inversion/eversion correction device
A9286Hygienic item or device, disposable or non-disposable, any type, each
A9291Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment
A9292Prescription digital visual therapy, software-only, fda cleared, per course of treatment
A9293Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)
A9294Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment
A9300Exercise equipment
A9500Technetium tc-99m sestamibi, diagnostic, per study dose
A9501Technetium tc-99m teboroxime, diagnostic, per study dose
A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose
A9503Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries
A9504Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries
A9505Thallium tl-201 thallous chloride, diagnostic, per millicurie
A9506Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible
A9507Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries
A9508Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie
A9509Iodine i-123 sodium iodide, diagnostic, per millicurie
A9510Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries
A9512Technetium tc-99m pertechnetate, diagnostic, per millicurie
A9513Lutetium lu 177, dotatate, therapeutic, 1 millicurie
A9515Choline c-11, diagnostic, per study dose up to 20 millicuries
A9516Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries
A9517Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie
A9520Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries
A9521Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
A9524Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries
A9526Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries
A9527Iodine i-125, sodium iodide solution, therapeutic, per millicurie
A9528Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie
A9529Iodine i-131 sodium iodide solution, diagnostic, per millicurie
A9530Iodine i-131 sodium iodide solution, therapeutic, per millicurie
A9531Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)
A9532Iodine i-125 serum albumin, diagnostic, per 5 microcuries
A9536Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries
A9537Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries
A9538Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries
A9539Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries
A9540Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries
A9541Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries
A9542Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries
A9543Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries
A9544Iodine i-131 tositumomab, diagnostic, per study doseterminated
A9545Iodine i-131 tositumomab, therapeutic, per treatment doseterminated
A9546Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie
A9547Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie
A9548Indium in-111 pentetate, diagnostic, per 0.5 millicurie
A9550Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie
A9551Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries
A9552Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries
A9553Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries
A9554Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries
A9555Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries
A9556Gallium ga-67 citrate, diagnostic, per millicurie
A9557Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries
A9558Xenon xe-133 gas, diagnostic, per 10 millicuries
A9559Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie
A9560Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries
A9561Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries
A9562Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries
A9563Sodium phosphate p-32, therapeutic, per millicurie
A9564Chromic phosphate p-32 suspension, therapeutic, per millicurie
A9566Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries
A9567Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries
A9568Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries
A9569Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
A9570Indium in-111 labeled autologous white blood cells, diagnostic, per study dose
A9571Indium in-111 labeled autologous platelets, diagnostic, per study dose
A9572Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
A9573Injection, gadopiclenol, 1 ml
A9574Injection, ferumoxytol, 1 mg
A9575Injection, gadoterate meglumine, 0.1 ml
A9576Injection, gadoteridol, (prohance multipack), per ml
A9577Injection, gadobenate dimeglumine (multihance), per ml
A9578Injection, gadobenate dimeglumine (multihance multipack), per ml
A9579Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml
A9580Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
A9581Injection, gadoxetate disodium, 1 ml
A9582Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
A9583Injection, gadofosveset trisodium, 1 ml
A9584Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries
A9585Injection, gadobutrol, 0.1 ml
A9586Florbetapir f18, diagnostic, per study dose, up to 10 millicuries
A9587Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
A9588Fluciclovine f-18, diagnostic, 1 millicurie
A9589Instillation, hexaminolevulinate hydrochloride, 100 mg
A9590Iodine i-131, iobenguane, 1 millicurie
A9591Fluoroestradiol f 18, diagnostic, 1 millicurie
A9592Copper cu-64, dotatate, diagnostic, 1 millicurie
A9593Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie
A9594Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie
A9595Piflufolastat f-18, diagnostic, 1 millicurie
A9596Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
A9597Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
A9598Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified
A9599Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specifiedterminated
A9600Strontium sr-89 chloride, therapeutic, per millicurie
A9601Flortaucipir f 18 injection, diagnostic, 1 millicurie
A9602Fluorodopa f-18, diagnostic, per millicurie
A9603Injection, pafolacianine, 0.1 mg
A9604Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
A9606Radium ra-223 dichloride, therapeutic, per microcurie
A9607Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie
A9608Flotufolastat f 18, diagnostic, 1 millicurie
A9609Fludeoxyglucose f18 up to 15 millicuries
A9610Xenon xe-129 hyperpolarized gas, diagnostic, per study dose
A9611Flurpiridaz f 18, diagnostic, 1 millicurie
A9612Injection, fluorescein, 1 mg
A9615Injection, pegulicianine, 1 mg
A9616Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie
A9697Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose
A9698Non-radioactive contrast imaging material, not otherwise classified, per study
A9699Radiopharmaceutical, therapeutic, not otherwise classified
A9700Supply of injectable contrast material for use in echocardiography, per study
A9800Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie
A9900Miscellaneous dme supply, accessory, and/or service component of another hcpcs code
A9901Dme delivery, set up, and/or dispensing service component of another hcpcs code
A9999Miscellaneous dme supply or accessory, not otherwise specified