HCPCS Index 2017

Knee-ankle-foot orthosis (KAFO),   L2000 - L2039 , L2126 - L2136
Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bandscuffs (single bar 'ak' orthosis), custom fabricated   L2000
Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated   L2005
Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bandscuffs (single bar 'ak' orthosis), without knee joint, custom fabricated   L2010
Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bandscuffs (double bar 'ak' orthosis), custom fabricated   L2020
Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bandscuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated   L2030
Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated   L2034
Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment   L2035
Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated   L2036
Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated   L2037
Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated   L2038
Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated   L2126
Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated   L2128
Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment   L2132
Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment   L2134
Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment   L2136
Kanamycin sulfate,   J1840, J1850
Kartop patient lift, toilet or bathroom (see also Lift),   E0625
Ketorolac thomethamine,   J1885
ESRD supply,   A4650 - A4927
Peritoneal dialysis catheter anchoring device, belt, each   A4653
Syringe, with or without needle, each   A4657
Sphygmomanometerblood pressure apparatus with cuff and stethoscope   A4660
Implantable radiation dosimeter, each   A4650
Blood pressure cuff only   A4663
Calibrated microcapillary tube, each   A4651
Microcapillary tube sealant   A4652
Automatic blood pressure monitor   A4670
Disposable cycler set used with cycler dialysis machine, each   A4671
Drainage extension line, sterile, for dialysis, each   A4672
Extension line with easy lock connectors, used with dialysis   A4673
Chemicalsantiseptics solution used to cleansterilize dialysis equipment, per 8 oz   A4674
Activated carbon filter for hemodialysis, each   A4680
Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each   A4690
Bicarbonate concentrate, solution, for hemodialysis, per gallon   A4706
Bicarbonate concentrate, powder, for hemodialysis, per packet   A4707
Acetate concentrate solution, for hemodialysis, per gallon   A4708
Acid concentrate, solution, for hemodialysis, per gallon   A4709
Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon   A4714
y set tubing for peritoneal dialysis   A4719
Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis   A4720
Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis   A4721
Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis   A4722
Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis   A4723
Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis   A4724
Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis   A4725
Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis   A4726
Dialysate solution, non-dextrose containing, 500 ml   A4728
Fistula cannulation set for hemodialysis, each   A4730
Topical anesthetic, for dialysis, per gram   A4736
Injectable anesthetic, for dialysis, per 10 ml   A4737
Shunt accessory, for hemodialysis, any type, each   A4740
Blood tubing, arterial or venous, for hemodialysis, each   A4750
Blood tubing, arterial and venous combined, for hemodialysis, each   A4755
Dialysate solution test kit, for peritoneal dialysis, any type, each   A4760
Dialysate concentrate, powder, additive for peritoneal dialysis, per packet   A4765
Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml   A4766
Blood collection tube, vacuum, for dialysis, per 50   A4770
Serum clotting time tube, for dialysis, per 50   A4771
Blood glucose test strips, for dialysis, per 50   A4772
Occult blood test strips, for dialysis, per 50   A4773
Ammonia test strips, for dialysis, per 50   A4774
Protamine sulfate, for hemodialysis, per 50 mg   A4802
Disposable catheter tips for peritoneal dialysis, per 10   A4860
Plumbing andor electrical work for home hemodialysis equipment   A4870
Contracts, repair and maintenance, for hemodialysis equipment   A4890
Drain bagbottle, for dialysis, each   A4911
Miscellaneous dialysis supplies, not otherwise specified   A4913
Venous pressure clamp, for hemodialysis, each   A4918
Gloves, non-sterile, per 100   A4927
system,   E1510
wearable artificial,   E1632
enteral feeding supply (syringe) (pump) (gravity),   B4034 - B4036
Enteral feeding supply kit syringe fed, per day, includes but not limited to feedingflushing syringe, administration set tubing, dressings, tape   B4034
Enteral feeding supply kit pump fed, per day, includes but not limited to feedingflushing syringe, administration set tubing, dressings, tape   B4035
Enteral feeding supply kit gravity fed, per day, includes but not limited to feedingflushing syringe, administration set tubing, dressings, tape   B4036
fistula cannulation (set),   A4730
parenteral nutrition,   B4220 - B4224
Parenteral nutrition supply kit premix, per day   B4220
Parenteral nutrition supply kit home mix, per day   B4222
Parenteral nutrition administration kit, per day   B4224
surgical dressing (tray),   A4550
tracheostomy,   A4625
disarticulation, prosthesis,   L5150, L5160
joint, miniature,   L5826
orthosis (KO),   E1810, L1800 - L1885
Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)   L1860
Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, prefabricated, off-the-shelf   L1852
Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, prefabricated, off-the-shelf   L1851
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L1810
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment   L1820
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf   L1830
Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment   L1831
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L1832
Knee orthosis, without knee joint, rigid, custom fabricated   L1834
Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf   L1836
Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated   L1840
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L1843
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, custom fabricated   L1844
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L1845
Knee orthosis, elastic with joints, prefabricated, off-the-shelf   L1812
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varusvalgus adjustment, custom fabricated   L1846
Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L1847
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf   L1833
Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf   L1848
Knee orthosis, swedish type, prefabricated, off-the-shelf   L1850
Knee-ankle-foot orthosis (KAFO) addition, high strength, lightweight material,   L2755
Kyphosis pad,   L1020, L1025