HCPCS Index 2017

Betameth,   J070
Back supports,   L0621 - L0861 , L0960
Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)   L0700
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf   L0621
Halo procedure, cervical halo incorporated into jacket vest   L0810
Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)   L0710
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated   L0622
Halo procedure, cervical halo incorporated into plaster body jacket   L0820
Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf   L0623
Halo procedure, cervical halo incorporated into milwaukee type orthosis   L0830
Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated   L0624
Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material   L0859
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0641
Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf   L0625
Addition to halo procedure, replacement linerinterface material   L0861
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0642
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L0626
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L0627
Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0643
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0648
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0628
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior framepanel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0649
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated   L0629
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior framepanel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf   L0650
Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L0630
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf   L0651
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L0631
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated   L0632
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior framepanel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L0633
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior framepanel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated   L0634
Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior framepanel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment   L0635
Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior framepanels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated   L0636
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior framepanels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L0637
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior framepanels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral framepanels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated   L0638
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L0639
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated   L0640
Beclomethasone inhalation solution,   J7622
air fluidized,   E0194
cradle, any type,   E0280
drainage bag, bottle,   A4357, A5102
hospital,   E0250 - E0270 , E0300 - E0329
Hospital bed, fixed height, with any type side rails, with mattress   E0250
Hospital bed, fixed height, with any type side rails, without mattress   E0251
Hospital bed, variable height, hi-lo, with any type side rails, with mattress   E0255
Hospital bed, variable height, hi-lo, with any type side rails, without mattress   E0256
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress   E0260
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress   E0261
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress   E0265
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress   E0266
Hospital bed, institutional type includes oscillating, circulating and stryker frame, with mattress   E0270
Pediatric crib, hospital grade, fully enclosed, with or without top enclosure   E0300
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress   E0301
Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress   E0302
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress   E0303
Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress   E0304
Bed side rails, half length   E0305
Bed side rails, full length   E0310
Bed accessory board, table, or support device, any type   E0315
Safety enclosure framecanopy for use with hospital bed, any type   E0316
Urinal male, jug-type, any material   E0325
Urinal female, jug-type, any material   E0326
Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress   E0328
Hospital bed, pediatric, electric or semi-electric, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress   E0329
pan,   E0275, E0276
rail,   E0305, E0310
safety enclosure framecanopy,   E0316
Baclofen,   J0475, J0476
Bacterial sensitivity study,   P7001
drainage,   A4357
irrigation supply,   A4398
urinary,   A5112, A4358
Basiliximab,   J0480
chair,   E0240
stool or bench,   E0245, E0247 - E0248
Transfer bench for tub or toilet with or without commode opening   E0247
Transfer bench, heavy duty, for tub or toilet with or without commode opening   E0248
transfer rail,   E0246
wall rail,   E0241, E0242
Battery,   L7360, L7364 - L7368
Twelve volt battery, each   L7364
Battery charger, twelve volt, each   L7366
Lithium ion battery, rechargeable, replacement   L7367
Lithium ion battery charger, replacement only   L7368
charger,   E1066, L7362, L7366
replacement for blood glucose monitor,   A4233 - A4236
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each   A4233
Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each   A4234
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each   A4235
Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each   A4236
replacement for cochlear implant device,   L8623 - L8624
Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each   L8623
Lithium ion battery for use with cochlear implant device speech processor, ear level, replacement, each   L8624
replacement for TENS,   A4630
ventilator,   A4611 - A4613
Battery, heavy duty replacement for patient owned ventilator   A4611
Battery cables replacement for patient-owned ventilator   A4612
Battery charger replacement for patient-owned ventilator   A4613
BCG live, intravesical,   J9031
Belatacept,   J0485
Belimumab,   J0490
belt, strap, sleeve, garment, or covering, any type,   A4467
extremity,   E0945
ostomy,   A4367
pelvic,   E0944
safety,   K003
wheelchair,   E0978, E0979
Bench, bathtub (see also Bathtub),   E0245
Bendamustine HCl (Treanda) 1 mg,   J9033
Bendamustine HCl (Bendeka) 1 mg,   J9034
Benesch boot,   L3212 - L3214
Benesch boot, pair, infant   L3212
Benesch boot, pair, child   L3213
Benesch boot, pair, junior   L3214
Benztropine,   J0515
Betadine,   A4246, A4247
Betamethasone inhalation solution,   J7624
Betamethasone acetate and betamethasone sodium phosphate,   J0702
Bethanechol chloride,   J0520
Bevacizumab,   J9035, Q2024
Bifocal, glass or plastic,   V2200 - V2299
Sphere, bifocal, plano to plus or minus 400d, per lens   V2200
Sphere, bifocal, plus or minus 412 to plus or minus 700d, per lens   V2201
Sphere, bifocal, plus or minus 712 to plus or minus 2000d, per lens   V2202
Spherocylinder, bifocal, plano to plus or minus 400d sphere, 12 to 200d cylinder, per lens   V2203
Spherocylinder, bifocal, plano to plus or minus 400d sphere, 212 to 400d cylinder, per lens   V2204
Spherocylinder, bifocal, plano to plus or minus 400d sphere, 425 to 600d cylinder, per lens   V2205
Spherocylinder, bifocal, plano to plus or minus 400d sphere, over 600d cylinder, per lens   V2206
Spherocylinder, bifocal, plus or minus 425 to plus or minus 700d sphere,12 to 200d cylinder, per lens   V2207
Spherocylinder, bifocal, plus or minus 425 to plus or minus 700d sphere, 212 to 400d cylinder, per lens   V2208
Spherocylinder, bifocal, plus or minus 425 to plus or minus 700d sphere, 425 to 600d cylinder, per lens   V2209
Spherocylinder, bifocal, plus or minus 425 to plus or minus 700d sphere, over 600d cylinder, per lens   V2210
Spherocylinder, bifocal, plus or minus 725 to plus or minus 1200d sphere, 25 to 225d cylinder, per lens   V2211
Spherocylinder, bifocal, plus or minus 725 to plus or minus 1200d sphere, 225 to 400d cylinder, per lens   V2212
Spherocylinder, bifocal, plus or minus 725 to plus or minus 1200d sphere, 425 to 600d cylinder, per lens   V2213
Spherocylinder, bifocal, sphere over plus or minus 1200d, per lens   V2214
Lenticular (myodisc), per lens, bifocal   V2215
Aniseikonic, per lens, bifocal   V2218
Bifocal seg width over 28 mm   V2219
Bifocal add over 325d   V2220
Lenticular lens, per lens, bifocal   V2221
Specialty bifocal (by report)   V2299
Bilirubin (phototherapy) light,   E0202
Binder,   A4465
Biofeedback device,   E0746
Bioimpedance, electrical, cardiac output,   M030
Biosimilar (infliximab),   Q5102
Biperiden lactate,   J0190
Bitolterol mesylate, inhalation solution, concentrated,   J7628
Bitolterol mesylate, inhalation solution, unit dose,   J7629
Bivalirudin,   J0583
Bladder calculi irrigation solution,   Q2004
Bleomycin sulfate,   J9040
fresh frozen plasma,   P9017
glucose monitor,   E0607, E2100, E2101
glucose test,   A4253
granulocytes, pheresis,   P9050
ketone test,   A4252
leak detector, dialysis,   E1560
leukocyte poor,   P9016
mucoprotein,   P2038
platelets,   P9019
platelets, irradiated,   P9032
platelets, leukocytes reduced,   P9031
platelets, leukocytes reduced, irradiated,   P9033
platelets, pheresis,   P9034
platelets, pheresis, irradiated,   P9036
platelets, pheresis, leukocytes reduced,   P9035
platelets, pheresis, leukocytes reduced, irradiated,   P9037
pressure monitor,   A4660, A4663, A4670
pump, dialysis,   E1620
red blood cells, deglycerolized,   P9039
red blood cells, irradiated,   P9038
red blood cells, leukocytes reduced,   P9016
red blood cells, leukocytes reduced, irradiated,   P9040
red blood cells, washed,   P9022
strips,   A4253
supply,   P9010 - P9022
Blood (whole), for transfusion, per unit   P9010
Blood, split unit   P9011
Cryoprecipitate, each unit   P9012
Red blood cells, leukocytes reduced, each unit   P9016
Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit   P9017
Platelets, each unit   P9019
Platelet rich plasma, each unit   P9020
Red blood cells, each unit   P9021
Red blood cells, washed, each unit   P9022
testing supplies,   A4770
tubing,   A4750, A4755
Blood collection devices accessory,   A4257, E0620
scoliosis,   L1300, L1310
Body sock,   L0984
Bond or cement, ostomy skin,   A4364
pelvic,   E0944
surgical, ambulatory,   L3260
Bortezomib,   J9041
Brachytherapy radioelements,   Q3001
Breast prosthesis,   L8000 - L8035 , L8600
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type   L8000
Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type   L8001
Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type   L8002
Breast prosthesis, mastectomy sleeve   L8010
External breast prosthesis garment, with mastectomy form, post mastectomy   L8015
Breast prosthesis, mastectomy form   L8020
Breast prosthesis, silicone or equal, without integral adhesive   L8030
Breast prosthesis, silicone or equal, with integral adhesive   L8031
Nipple prosthesis, reusable, any type, each   L8032
Custom breast prosthesis, post mastectomy, molded to patient model   L8035
Breast prosthesis, adhesive skin support,   A4280
accessories,   A4281 - A4286
Tubing for breast pump, replacement   A4281
Adapter for breast pump, replacement   A4282
Cap for breast pump bottle, replacement   A4283
Breast shield and splash protector for use with breast pump, replacement   A4284
Polycarbonate bottle for use with breast pump, replacement   A4285
Locking ring for breast pump, replacement   A4286
electric, any type,   E0603
heavy duty, hospital grade,   E0604
manual, any type,   E0602
Breathing circuit,   A4618
Brentuximab Vedotin,   J9042
Brompheniramine maleate,   J0945
Budesonide inhalation solution,   J7626, J7627, J7633, J7634
Bulking agent,   L8604, L8607
Buprenorphine hydrochloride,   J0592
BuprenorphineNaloxone,   J0571 - J0575
Buprenorphine, oral, 1 mg   J0571
Buprenorphinenaloxone, oral, less than or equal to 3 mg buprenorphine   J0572
Buprenorphinenaloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine   J0573
Buprenorphinenaloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine   J0574
Buprenorphinenaloxone, oral, greater than 10 mg buprenorphine   J0575
Bus, nonemergency transportation,   A0110
Busulfan,   J0594, J8510
Butorphanol tartrate,   J0595