HCPCS Index 2017

Occipitalmandibular support, cervical,   L0160
Ocriplasmin,   J7316
Octafluoropropane,   Q9956
Octagam,   J1568
Octreotide acetate,   J2353, J2354
Ocular prosthetic implant,   L8610
Ofatumumab,   J9302
Olanzapine,   J2358
Omacetaxine Mepesuccinate,   J9262
Omalizumab,   J2357
OnabotulinumtoxinA,   J0585
Ondansetron HCl,   J2405
Ondansetron oral,   Q0162
One arm, drive attachment,   K010
Oprelvekin,   J2355
O P supplyaccessoryservice,   L9900
Oral deviceappliance,   E0485 - E0486
Oral deviceappliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment   E0485
Oral deviceappliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment   E0486
Oral interface,   A7047
Oralnasal mask,   A7027
nasal pillows,   A7029
oral cushion,   A7028
Oritavancin,   J2407
Oropharyngeal suction catheter,   A4628
Orphenadrine,   J2360
arch support,   L3040 - L3100
Foot, arch support, non-removable attached to shoe, longitudinal, each   L3070
Foot, arch support, removable, premolded, longitudinal, each   L3040
Foot, arch support, non-removable attached to shoe, metatarsal, each   L3080
Foot, arch support, removable, premolded, metatarsal, each   L3050
Foot, arch support, removable, premolded, longitudinal metatarsal, each   L3060
Foot, arch support, non-removable attached to shoe, longitudinalmetatarsal, each   L3090
Hallus-valgus night dynamic splint, prefabricated, off-the-shelf   L3100
footwear,   L3201 - L3265
Orthopedic shoe, oxford with supinator or pronator, infant   L3201
Orthopedic shoe, oxford with supinator or pronator, child   L3202
Orthopedic shoe, oxford with supinator or pronator, junior   L3203
Orthopedic shoe, hightop with supinator or pronator, infant   L3204
Orthopedic shoe, hightop with supinator or pronator, child   L3206
Orthopedic shoe, hightop with supinator or pronator, junior   L3207
Surgical boot, each, infant   L3208
Surgical boot, each, child   L3209
Surgical boot, each, junior   L3211
Benesch boot, pair, infant   L3212
Benesch boot, pair, child   L3213
Benesch boot, pair, junior   L3214
Orthopedic footwear, ladies shoe, oxford, each   L3215
Orthopedic footwear, ladies shoe, depth inlay, each   L3216
Orthopedic footwear, ladies shoe, hightop, depth inlay, each   L3217
Orthopedic footwear, mens shoe, oxford, each   L3219
Orthopedic footwear, mens shoe, depth inlay, each   L3221
Orthopedic footwear, mens shoe, hightop, depth inlay, each   L3222
Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)   L3224
Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)   L3225
Orthopedic footwear, custom shoe, depth inlay, each   L3230
Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each   L3250
Foot, shoe molded to patient model, silicone shoe, each   L3251
Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each   L3252
Foot, molded shoe plastazote (or similar) custom fitted, each   L3253
Non-standard size or width   L3254
Non-standard size or length   L3255
Orthopedic footwear, additional charge for split size   L3257
Surgical bootshoe, each   L3260
Plastazote sandal, each   L3265
insert,   L3000 - L3030
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each   L3000
Foot, insert, removable, molded to patient model, spenco, each   L3001
Foot, insert, removable, molded to patient model, plastazote or equal, each   L3002
Foot, insert, removable, molded to patient model, silicone gel, each   L3003
Foot, insert, removable, molded to patient model, longitudinal arch support, each   L3010
Foot, insert, removable, molded to patient model, longitudinal metatarsal support, each   L3020
Foot, insert, removable, formed to patient foot, each   L3030
lift,   L3300 - L3334
Lift, elevation, heel, tapered to metatarsals, per inch   L3300
Lift, elevation, heel and sole, neoprene, per inch   L3310
Lift, elevation, heel and sole, cork, per inch   L3320
Lift, elevation, metal extension (skate)   L3330
Lift, elevation, inside shoe, tapered, up to one-half inch   L3332
Lift, elevation, heel, per inch   L3334
miscellaneous additions,   L3500 - L3595
Orthopedic shoe addition, insole, leather   L3500
Orthopedic shoe addition, insole, rubber   L3510
Orthopedic shoe addition, insole, felt covered with leather   L3520
Orthopedic shoe addition, sole, half   L3530
Orthopedic shoe addition, sole, full   L3540
Orthopedic shoe addition, toe tap standard   L3550
Orthopedic shoe addition, toe tap, horseshoe   L3560
Orthopedic shoe addition, special extension to instep (leather with eyelets)   L3570
Orthopedic shoe addition, convert instep to velcro closure   L3580
Orthopedic shoe addition, convert firm shoe counter to soft counter   L3590
Orthopedic shoe addition, march bar   L3595
positioning device,   L3140 - L3170
Foot, abduction rotation bar, including shoes   L3140
Foot, abduction rotation bar, without shoes   L3150
Foot, adjustable shoe-styled positioning device   L3160
Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each   L3170
transfer,   L3600 - L3649
Transfer of an orthosis from one shoe to another, caliper plate, existing   L3600
Transfer of an orthosis from one shoe to another, caliper plate, new   L3610
Transfer of an orthosis from one shoe to another, solid stirrup, existing   L3620
Transfer of an orthosis from one shoe to another, solid stirrup, new   L3630
Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes   L3640
Orthopedic shoe, modification, addition or transfer, not otherwise specified   L3649
wedge,   L3340 - L3420
Heel wedge, sach   L3340
Heel wedge   L3350
Sole wedge, outside sole   L3360
Sole wedge, between sole   L3370
Clubfoot wedge   L3380
Outflare wedge   L3390
Metatarsal bar wedge, rocker   L3400
Metatarsal bar wedge, between sole   L3410
Full sole and heel wedge, between sole   L3420
carbon graphite lamination,   L2755
fracture,   L2180 - L2192 , L3995
Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints   L2180
Addition to lower extremity fracture orthosis, drop lock knee joint   L2182
Addition to lower extremity fracture orthosis, limited motion knee joint   L2184
Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type   L2186
Addition to lower extremity fracture orthosis, quadrilateral brim   L2188
Addition to lower extremity fracture orthosis, waist belt   L2190
Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt   L2192
halo,   L086
lower extremity,   L2200 - L2999 , L4320
Addition to lower extremity, thighweight bearing, gluteal ischial weight bearing, ring   L2500
Addition to lower extremity orthosis, plating chrome or nickel, per bar   L2750
Addition to knee joint, drop lock, each   L2405
Addition to lower extremity, limited ankle motion, each joint   L2200
Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each   L2570
Addition to lower extremity orthosis, high strength, lightweight material, all hybrid laminationprepreg composite, per segment, for custom fabricated orthosis only   L2755
Addition to lower extremity, thighweight bearing, quadri- lateral brim, molded to patient model   L2510
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint   L2210
Addition to lower extremity, pelvic control, pelvic sling   L2580
Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint   L2415
Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)   L2760
Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each   L2600
Addition to lower extremity, dorsiflexion and plantar flexion assistresist, each joint   L2220
Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint   L2425
Addition to lower extremity, thighweight bearing, quadri- lateral brim, custom fitted   L2520
Addition to lower extremity, thighweight bearing, ischial containmentnarrow m-l brim molded to patient model   L2525
Addition to knee joint, ratchet lock for active and progressive knee extension, each joint   L2430
Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each   L2610
Addition to lower extremity, split flat caliper stirrups and plate attachment   L2230
Orthotic side bar disconnect device, per bar   L2768
Addition to lower extremity orthosis, non-corrosive finish, per bar   L2780
Addition to knee joint, lift loop for drop lock ring   L2492
Addition to lower extremity, thighweight bearing, ischial containmentnarrow m-l brim, custom fitted   L2526
Addition to lower extremity, pelvic control, hip joint, heavy duty, each   L2620
Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only   L2232
Addition to lower extremity, round caliper and plate attachment   L2240
Addition to lower extremity, thigh-weight bearing, lacer, non-molded   L2530
Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each   L2622
Addition to lower extremity orthosis, drop lock retainer, each   L2785
Addition to lower extremity, thighweight bearing, lacer, molded to patient model   L2540
Addition to lower extremity, foot plate, molded to patient model, stirrup attachment   L2250
Addition to lower extremity orthosis, knee control, full kneecap   L2795
Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each   L2624
Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables   L2627
Addition to lower extremity, reinforced solid stirrup (scott-craig type)   L2260
Addition to lower extremity, thighweight bearing, high roll cuff   L2550
Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only   L2800
Addition to lower extremity, long tongue stirrup   L2265
Addition to lower extremity orthosis, knee control, condylar pad   L2810
Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables   L2628
Addition to lower extremity, pelvic control, band and belt, unilateral   L2630
Addition to lower extremity, varusvalgus correction ('t') strap, paddedlined or malleolus pad   L2270
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section   L2820
Addition to lower extremity, varusvalgus correction, plastic modification, paddedlined   L2275
Addition to lower extremity, pelvic control, band and belt, bilateral   L2640
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section   L2830
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each   L2840
Addition to lower extremity, pelvic and thoracic control, gluteal pad, each   L2650
Addition to lower extremity, molded inner boot   L2280
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable   L2300
Addition to lower extremity, thoracic control, thoracic band   L2660
Addition to lower extremity orthosis, femoral length sock, fracture or equal, each   L2850
Addition to lower extremity, thoracic control, paraspinal uprights   L2670
Addition to lower extremity, abduction bar-straight   L2310
Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each   L2861
Lower extremity orthoses, not otherwise specified   L2999
Addition to lower extremity, thoracic control, lateral support uprights   L2680
Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only   L2320
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only   L2330
Addition to lower extremity, anterior swing band   L2335
Addition to lower extremity, pre-tibial shell, molded to patient model   L2340
Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)   L2350
Addition to lower extremity, extended steel shank   L2360
Addition to lower extremity, patten bottom   L2370
Addition to lower extremity, torsion control, ankle joint and half solid stirrup   L2375
Addition to lower extremity, torsion control, straight knee joint, each joint   L2380
Addition to lower extremity, straight knee joint, heavy duty, each joint   L2385
Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint   L2387
Addition to lower extremity, offset knee joint, each joint   L2390
Addition to lower extremity, offset knee joint, heavy duty, each joint   L2395
Addition to lower extremity orthosis, suspension sleeve   L2397
ratchet lock,   L2430
scoliosis,   L1010 - L1120 , L1210 - L1290
Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling   L1010
Addition to ctlso or scoliosis orthosis, kyphosis pad   L1020
Addition to ctlso or scoliosis orthosis, kyphosis pad, floating   L1025
Addition to ctlso or scoliosis orthosis, lumbar bolster pad   L1030
Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad   L1040
Addition to ctlso or scoliosis orthosis, sternal pad   L1050
Addition to ctlso or scoliosis orthosis, thoracic pad   L1060
Addition to ctlso or scoliosis orthosis, trapezius sling   L1070
Addition to ctlso or scoliosis orthosis, outrigger   L1080
Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions   L1085
Addition to ctlso or scoliosis orthosis, lumbar sling   L1090
Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather   L1100
Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model   L1110
Addition to ctlso, scoliosis orthosis, cover for upright, each   L1120
Addition to tlso, (low profile), lateral thoracic extension   L1210
Addition to tlso, (low profile), anterior thoracic extension   L1220
Addition to tlso, (low profile), milwaukee type superstructure   L1230
Addition to tlso, (low profile), lumbar derotation pad   L1240
Addition to tlso, (low profile), anterior asis pad   L1250
Addition to tlso, (low profile), anterior thoracic derotation pad   L1260
Addition to tlso, (low profile), abdominal pad   L1270
Addition to tlso, (low profile), rib gusset (elastic), each   L1280
Addition to tlso, (low profile), lateral trochanteric pad   L1290
shoe,   L3300 - L3595 , L3649
Heel wedge, sach   L3340
Orthopedic shoe addition, insole, leather   L3500
Heel, counter, plastic reinforced   L3430
Lift, elevation, heel, tapered to metatarsals, per inch   L3300
Lift, elevation, heel and sole, neoprene, per inch   L3310
Heel wedge   L3350
Orthopedic shoe addition, insole, rubber   L3510
Heel, counter, leather reinforced   L3440
Orthopedic shoe addition, insole, felt covered with leather   L3520
Sole wedge, outside sole   L3360
Lift, elevation, heel and sole, cork, per inch   L3320
Heel, sach cushion type   L3450
Heel, new leather, standard   L3455
Sole wedge, between sole   L3370
Lift, elevation, metal extension (skate)   L3330
Orthopedic shoe addition, sole, half   L3530
Clubfoot wedge   L3380
Orthopedic shoe addition, sole, full   L3540
Heel, new rubber, standard   L3460
Lift, elevation, inside shoe, tapered, up to one-half inch   L3332
Heel, thomas with wedge   L3465
Outflare wedge   L3390
Lift, elevation, heel, per inch   L3334
Orthopedic shoe addition, toe tap standard   L3550
Metatarsal bar wedge, rocker   L3400
Heel, thomas extended to ball   L3470
Orthopedic shoe addition, toe tap, horseshoe   L3560
Metatarsal bar wedge, between sole   L3410
Orthopedic shoe addition, special extension to instep (leather with eyelets)   L3570
Heel, pad and depression for spur   L3480
Full sole and heel wedge, between sole   L3420
Heel, pad, removable for spur   L3485
Orthopedic shoe addition, convert instep to velcro closure   L3580
Orthopedic shoe addition, convert firm shoe counter to soft counter   L3590
Orthopedic shoe addition, march bar   L3595
spinal,   L0970 - L0984
Tlso, corset front   L0970
Lso, corset front   L0972
Tlso, full corset   L0974
Lso, full corset   L0976
Axillary crutch extension   L0978
Peroneal straps, prefabricated, off-the-shelf, pair   L0980
Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)   L0982
Protective body sock, prefabricated, off-the-shelf, each   L0984
upper limb,   L3810 - L3890 , L3970 - L3974 , L3995
Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3971
Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3973
elbow (EO),   E1800, E1801, L3700 - L3740
Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3702
Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf   L3710
Elbow orthosis, double upright with forearmarm cuffs, free motion, custom fabricated   L3720
Elbow orthosis, double upright with forearmarm cuffs, extension flexion assist, custom fabricated   L3730
Elbow orthosis, double upright with forearmarm cuffs, adjustable position lock with active control, custom fabricated   L3740
ankle-foot (AFO see also Orthopedic shoes),   E1815, E1816, E1830, L1900 - L1990 , L2102 - L2116 , L3160, L4361
Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated   L1900
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf   L1902
Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated   L1904
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf   L1906
Ankle orthosis, supramalleolar with straps, with or without interfacepads, custom fabricated   L1907
Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment   L1910
Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated   L1920
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment   L1930
Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment   L1932
Ankle foot orthosis, plastic or other material, custom fabricated   L1940
Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated   L1945
Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated   L1950
Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment   L1951
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated   L1960
Ankle foot orthosis, plastic with ankle joint, custom fabricated   L1970
Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment   L1971
Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf bandcuff (single bar 'bk' orthosis), custom fabricated   L1980
Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf bandcuff (double bar 'bk' orthosis), custom fabricated   L1990
Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated   L2106
Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated   L2108
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment   L2112
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment   L2114
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment   L2116
anterior-posterior-lateral,   L0700, L0710
cervical,   L0100 - L0200
Cervical, multiple post collar, occipitalmandibular supports, adjustable   L0180
Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated   L0112
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars (somi, guilford, taylor types)   L0190
Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment   L0113
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars, and thoracic extension   L0200
Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)   L0120
Cervical, flexible, thermoplastic collar, molded to patient   L0130
Cervical, semi-rigid, adjustable (plastic collar)   L0140
Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibularoccipital piece)   L0150
Cervical, semi-rigid, wire frame occipitalmandibular support, prefabricated, off-the-shelf   L0160
Cervical, collar, molded to patient model   L0170
Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf   L0172
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf   L0174
cervical-thoracic-lumbar-sacral (CTLSO),   L0700, L0710
fracture,   L2102 - L2136 , L3980 - L3986
Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated   L2106
Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated   L2108
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment   L2112
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment   L2114
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment   L2116
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
Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment   L3980
Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments   L3981
Upper extremity fracture orthosis, radiusulnar, prefabricated, includes fitting and adjustment   L3982
Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment   L3984
halo,   L0810 - L0830
Halo procedure, cervical halo incorporated into jacket vest   L0810
Halo procedure, cervical halo incorporated into plaster body jacket   L0820
Halo procedure, cervical halo incorporated into milwaukee type orthosis   L0830
hand, finger, prefabricated,   L3923
hand, (WHFO),   E1805, E1825, L3807, L3900 - L3954
Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension flexion, finger flexionextension, wrist or finger driven, custom fabricated   L3900
Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3905
Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension flexion, finger flexionextension, cable driven, custom fabricated   L3901
Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3906
Wrist hand finger orthosis, external powered, electric, custom fabricated   L3904
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf   L3908
Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf   L3912
Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3913
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L3915
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf   L3916
Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L3917
Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf   L3918
Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3919
Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3921
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L3923
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf   L3924
Finger orthosis, proximal interphalangeal (pip)distal interphalangeal (dip), non torsion jointspring, extensionflexion, may include soft interface material, prefabricated, off-the-shelf   L3925
Finger orthosis, proximal interphalangeal (pip)distal interphalangeal (dip), without jointspring, extensionflexion (eg, static or ring type), may include soft interface material, prefabricated, off-the-shelf   L3927
Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bandssprings, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L3929
Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bandssprings, may include soft interface material, straps, prefabricated, off-the-shelf   L3930
Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bandssprings, may include soft interface material, straps, prefabricated, includes fitting and adjustment   L3931
Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment   L3933
Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment   L3935
hip (HO),   L1600 - L1690
Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise   L1600
Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L1610
Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L1620
Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated   L1630
Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated   L1640
Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment   L1650
Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type   L1652
Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment   L1660
Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated   L1680
Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated   L1685
Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment   L1686
Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment   L1690
hip-knee-ankle-foot (HKAFO),   L2040 - L2090
Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic bandbelt, custom fabricated   L2040
Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic bandbelt, custom fabricated   L2050
Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band belt, custom fabricated   L2060
Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic bandbelt, custom fabricated   L2070
Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic bandbelt, custom fabricated   L2080
Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band belt, custom fabricated   L2090
interface material,   E1820
knee (KO),   E1810, E1811, L1800 - L1885
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 orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)   L1860
knee-ankle-foot (KAFO see also Orthopedic shoes),   L2000 - L2038 , 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
Legg Perthes,   L1700 - L1755
Legg perthes orthosis, (toronto type), custom fabricated   L1700
Legg perthes orthosis, (newington type), custom fabricated   L1710
Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated   L1720
Legg perthes orthosis, (scottish rite type), custom fabricated   L1730
Legg perthes orthosis, (patten bottom type), custom fabricated   L1755
multiple post collar,   L0180 - L0200
Cervical, multiple post collar, occipitalmandibular supports, adjustable   L0180
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars (somi, guilford, taylor types)   L0190
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars, and thoracic extension   L0200
not otherwise specified,   L0999, L1499, L2999, L3999, L5999, L7499, L8039, L8239
pneumatic splint,   L4350 - L4380
Ankle control orthosis, stirrup style, rigid, includes any type interface (eg, pneumatic, gel), prefabricated, off-the-shelf   L4350
Walking boot, pneumatic andor vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L4360
Pneumatic full leg splint, prefabricated, off-the-shelf   L4370
Walking boot, pneumatic andor vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf   L4361
pronationsupination,   E1818
repair or replacement,   L4000 - L4210
Replace girdle for spinal orthosis (ctlso or so)   L4000
Repair of orthotic device, labor component, per 15 minutes   L4205
Repair of orthotic device, repair or replace minor parts   L4210
Replacement strap, any orthosis, includes all components, any length, any type   L4002
Replace trilateral socket brim   L4010
Replace quadrilateral socket brim, molded to patient model   L4020
Replace quadrilateral socket brim, custom fitted   L4030
Replace molded thigh lacer, for custom fabricated orthosis only   L4040
Replace non-molded thigh lacer, for custom fabricated orthosis only   L4045
Replace molded calf lacer, for custom fabricated orthosis only   L4050
Replace non-molded calf lacer, for custom fabricated orthosis only   L4055
Replace high roll cuff   L4060
Replace proximal and distal upright for kafo   L4070
Replace metal bands kafo, proximal thigh   L4080
Replace metal bands kafo-afo, calf or distal thigh   L4090
Replace leather cuff kafo, proximal thigh   L4100
Replace leather cuff kafo-afo, calf or distal thigh   L4110
Replace pretibial shell   L4130
replace soft interface material,   L4390 - L4394
Replacement, soft interface material, static afo   L4392
Replace soft interface material, foot drop splint   L4394
sacroiliac,   L0600 - L0620
scoliosis,   L1000 - L1499
Other scoliosis procedure, body jacket molded to patient model   L1300
Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only   L1200
Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model   L1000
Other scoliosis procedure, post-operative body jacket   L1310
Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment   L1001
Addition to tlso, (low profile), lateral thoracic extension   L1210
Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment   L1005
Spinal orthosis, not otherwise specified   L1499
Addition to tlso, (low profile), anterior thoracic extension   L1220
Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling   L1010
Addition to tlso, (low profile), milwaukee type superstructure   L1230
Addition to ctlso or scoliosis orthosis, kyphosis pad   L1020
Addition to tlso, (low profile), lumbar derotation pad   L1240
Addition to ctlso or scoliosis orthosis, kyphosis pad, floating   L1025
Addition to tlso, (low profile), anterior asis pad   L1250
Addition to tlso, (low profile), anterior thoracic derotation pad   L1260
Addition to ctlso or scoliosis orthosis, lumbar bolster pad   L1030
Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad   L1040
Addition to tlso, (low profile), abdominal pad   L1270
Addition to ctlso or scoliosis orthosis, sternal pad   L1050
Addition to tlso, (low profile), rib gusset (elastic), each   L1280
Addition to tlso, (low profile), lateral trochanteric pad   L1290
Addition to ctlso or scoliosis orthosis, thoracic pad   L1060
Addition to ctlso or scoliosis orthosis, trapezius sling   L1070
Addition to ctlso or scoliosis orthosis, outrigger   L1080
Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions   L1085
Addition to ctlso or scoliosis orthosis, lumbar sling   L1090
Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather   L1100
Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model   L1110
Addition to ctlso, scoliosis orthosis, cover for upright, each   L1120
shoulder (SO),   L1840, L3650, L3674
shoulder-elbow-wrist-hand (SEWHO),   L3960 - L3978
Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment   L3960
Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3971
Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3973
Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3961
Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment   L3962
Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3975
Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3967
Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3976
Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3977
Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3978
side bar disconnect,   L2768
spinal, cervical,   L0100 - L0200
Cervical, multiple post collar, occipitalmandibular supports, adjustable   L0180
Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated   L0112
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars (somi, guilford, taylor types)   L0190
Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment   L0113
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars, and thoracic extension   L0200
Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)   L0120
Cervical, flexible, thermoplastic collar, molded to patient   L0130
Cervical, semi-rigid, adjustable (plastic collar)   L0140
Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibularoccipital piece)   L0150
Cervical, semi-rigid, wire frame occipitalmandibular support, prefabricated, off-the-shelf   L0160
Cervical, collar, molded to patient model   L0170
Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf   L0172
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf   L0174
spinal, DME,   K0112 - K0116
thoracic,   L021
thoracic-hip-knee-ankle (THKO),   L1500 - L1520
toe,   E1830
wrist-hand-finger (WHFO),   E1805, E1806, E1825, L3900 - L3954
Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension flexion, finger flexionextension, wrist or finger driven, custom fabricated   L3900
Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3905
Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension flexion, finger flexionextension, cable driven, custom fabricated   L3901
Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3906
Wrist hand finger orthosis, external powered, electric, custom fabricated   L3904
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf   L3908
Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf   L3912
Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3913
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L3915
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf   L3916
Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L3917
Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf   L3918
Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3919
Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment   L3921
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L3923
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf   L3924
Finger orthosis, proximal interphalangeal (pip)distal interphalangeal (dip), non torsion jointspring, extensionflexion, may include soft interface material, prefabricated, off-the-shelf   L3925
Finger orthosis, proximal interphalangeal (pip)distal interphalangeal (dip), without jointspring, extensionflexion (eg, static or ring type), may include soft interface material, prefabricated, off-the-shelf   L3927
Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bandssprings, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise   L3929
Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bandssprings, may include soft interface material, straps, prefabricated, off-the-shelf   L3930
Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bandssprings, may include soft interface material, straps, prefabricated, includes fitting and adjustment   L3931
Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment   L3933
Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment   L3935
Orthovisc,   J7324
Ossicula prosthetic implant,   L8613
Osteogenesis stimulator,   E0747 - E0749 , E0760
Osteogenesis stimulator, electrical, non-invasive, other than spinal applications   E0747
Osteogenesis stimulator, electrical, non-invasive, spinal applications   E0748
Osteogenesis stimulator, electrical, surgically implanted   E0749
accessories,   A5093
belt,   A4396
pouches,   A4416 - A4435
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each   A4416
Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each   A4417
Ostomy pouch, closed without barrier attached, with filter (1 piece), each   A4418
Ostomy pouch, closed for use on barrier with non-locking flange, with filter (2 piece), each   A4419
Ostomy pouch, closed for use on barrier with locking flange (2 piece), each   A4420
Ostomy supply miscellaneous   A4421
Ostomy absorbent material (sheetpadcrystal packet) for use in ostomy pouch to thicken liquid stomal output, each   A4422
Ostomy pouch, closed for use on barrier with locking flange, with filter (2 piece), each   A4423
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each   A4424
Ostomy pouch, drainable for use on barrier with non-locking flange, with filter (2 piece system), each   A4425
Ostomy pouch, drainable for use on barrier with locking flange (2 piece system), each   A4426
Ostomy pouch, drainable for use on barrier with locking flange, with filter (2 piece system), each   A4427
Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each   A4428
Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each   A4429
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each   A4430
Ostomy pouch, urinary with barrier attached, with faucet-type tap with valve (1 piece), each   A4431
Ostomy pouch, urinary for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each   A4432
Ostomy pouch, urinary for use on barrier with locking flange (2 piece), each   A4433
Ostomy pouch, urinary for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each   A4434
Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each   A4435
skin barrier,   A4401 - A4449
Lubricant, per ounce   A4402
Ostomy ring, each   A4404
Ostomy skin barrier, non-pectin based, paste, per ounce   A4405
Ostomy skin barrier, pectin-based, paste, per ounce   A4406
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each   A4407
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each   A4408
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each   A4409
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each   A4410
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each   A4411
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each   A4412
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each   A4413
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each   A4414
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each   A4415
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each   A4416
Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each   A4417
Ostomy pouch, closed without barrier attached, with filter (1 piece), each   A4418
Ostomy pouch, closed for use on barrier with non-locking flange, with filter (2 piece), each   A4419
Ostomy pouch, closed for use on barrier with locking flange (2 piece), each   A4420
Ostomy supply miscellaneous   A4421
Ostomy absorbent material (sheetpadcrystal packet) for use in ostomy pouch to thicken liquid stomal output, each   A4422
Ostomy pouch, closed for use on barrier with locking flange, with filter (2 piece), each   A4423
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each   A4424
Ostomy pouch, drainable for use on barrier with non-locking flange, with filter (2 piece system), each   A4425
Ostomy pouch, drainable for use on barrier with locking flange (2 piece system), each   A4426
Ostomy pouch, drainable for use on barrier with locking flange, with filter (2 piece system), each   A4427
Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each   A4428
Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each   A4429
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each   A4430
Ostomy pouch, urinary with barrier attached, with faucet-type tap with valve (1 piece), each   A4431
Ostomy pouch, urinary for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each   A4432
Ostomy pouch, urinary for use on barrier with locking flange (2 piece), each   A4433
Ostomy pouch, urinary for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each   A4434
Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each   A4435
supplies,   A4361 - A4421 , A5051 - A5149
Ostomy faceplate, each   A4361
Skin barrier solid, 4 x 4 or equivalent each   A4362
Ostomy clamp, any type, replacement only, each   A4363
Adhesive, liquid or equal, any type, per oz   A4364
Ostomy vent, any type, each   A4366
Ostomy belt, each   A4367
Ostomy filter, any type, each   A4368
Ostomy skin barrier, liquid (spray, brush, etc), per oz   A4369
Ostomy skin barrier, powder, per oz   A4371
Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each   A4372
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each   A4373
Ostomy pouch, drainable, with faceplate attached, plastic, each   A4375
Ostomy pouch, drainable, with faceplate attached, rubber, each   A4376
Ostomy pouch, drainable, for use on faceplate, plastic, each   A4377
Ostomy pouch, drainable, for use on faceplate, rubber, each   A4378
Ostomy pouch, urinary, with faceplate attached, plastic, each   A4379
Ostomy pouch, urinary, with faceplate attached, rubber, each   A4380
Ostomy pouch, urinary, for use on faceplate, plastic, each   A4381
Ostomy pouch, urinary, for use on faceplate, heavy plastic, each   A4382
Ostomy pouch, urinary, for use on faceplate, rubber, each   A4383
Ostomy faceplate equivalent, silicone ring, each   A4384
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each   A4385
Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each   A4387
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each   A4388
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each   A4389
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each   A4390
Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each   A4391
Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each   A4392
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each   A4393
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce   A4394
Ostomy deodorant for use in ostomy pouch, solid, per tablet   A4395
Ostomy belt with peristomal hernia support   A4396
Irrigation supply sleeve, each   A4397
Ostomy irrigation supply bag, each   A4398
Ostomy irrigation supply conecatheter, with or without brush   A4399
Ostomy irrigation set   A4400
Lubricant, per ounce   A4402
Ostomy ring, each   A4404
Ostomy skin barrier, non-pectin based, paste, per ounce   A4405
Ostomy skin barrier, pectin-based, paste, per ounce   A4406
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each   A4407
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each   A4408
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each   A4409
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each   A4410
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each   A4411
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each   A4412
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each   A4413
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each   A4414
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each   A4415
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each   A4416
Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each   A4417
Ostomy pouch, closed without barrier attached, with filter (1 piece), each   A4418
Ostomy pouch, closed for use on barrier with non-locking flange, with filter (2 piece), each   A4419
Ostomy pouch, closed for use on barrier with locking flange (2 piece), each   A4420
Ostomy supply miscellaneous   A4421
Bedside drainage bottle with or without tubing, rigid or expandable, each   A5102
Ostomy pouch, closed with barrier attached (1 piece), each   A5051
Skin barrier, wipes or swabs, each   A5120
Ostomy pouch, closed without barrier attached (1 piece), each   A5052
Skin barrier solid, 6 x 6 or equivalent, each   A5121
Urinary suspensory with leg bag, with or without tube, each   A5105
Ostomy pouch, closed for use on faceplate, each   A5053
Skin barrier solid, 8 x 8 or equivalent, each   A5122
Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each   A5112
Ostomy pouch, closed for use on barrier with flange (2 piece), each   A5054
Adhesive or non-adhesive disk or foam pad   A5126
Leg strap latex, replacement only, per set   A5113
Leg strap foam or fabric, replacement only, per set   A5114
Stoma cap   A5055
Appliance cleaner, incontinence and ostomy appliances, per 16 oz   A5131
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each   A5056
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each   A5057
Ostomy pouch, drainable with barrier attached, (1 piece), each   A5061
Ostomy pouch, drainable without barrier attached (1 piece), each   A5062
Ostomy pouch, drainable for use on barrier with flange (2 piece system), each   A5063
Ostomy pouch, urinary with barrier attached (1 piece), each   A5071
Ostomy pouch, urinary without barrier attached (1 piece), each   A5072
Ostomy pouch, urinary for use on barrier with flange (2 piece), each   A5073
Stoma plug or seal, any type   A5081
Continent device catheter for continent stoma   A5082
Continent device, stoma absorptive cover for continent stoma   A5083
Ostomy accessory convex insert   A5093
Oxacillin sodium,   J2700
Oxaliplatin,   J9263
ambulance,   A0422
battery charger,   E1357
battery packcartridge,   E1356
catheter, transtracheal,   A7018
chamber, hyperbaric, topical,   A4575
concentrator,   E1390 - E1391
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate   E1390
Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each   E1391
DC power adapter,   E1358
Liquid oxygen system,   E0433
mask,   A4620
medication supplies,   A4611 - A4627
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
Peak expiratory flow rate meter, hand held   A4614
Cannula, nasal   A4615
Tubing (oxygen), per foot   A4616
Mouth piece   A4617
Breathing circuits   A4618
Face tent   A4619
Variable concentration mask   A4620
Tracheostomy, inner cannula   A4623
Tracheal suction catheter, any type other than closed system, each   A4624
Tracheostomy care kit for new tracheostomy   A4625
Tracheostomy cleaning brush, each   A4626
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler   A4627
rackstand,   E1355
regulator,   E1352, E1353
respiratory equipmentsupplies,   A4611 - A4627 , E0424 - E0480
Peak expiratory flow rate meter, hand held   A4614
Cannula, nasal   A4615
Tubing (oxygen), per foot   A4616
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
Mouth piece   A4617
Breathing circuits   A4618
Face tent   A4619
Variable concentration mask   A4620
Tracheostomy, inner cannula   A4623
Tracheal suction catheter, any type other than closed system, each   A4624
Tracheostomy care kit for new tracheostomy   A4625
Tracheostomy cleaning brush, each   A4626
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler   A4627
Stationary compressed gaseous oxygen system, rental includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing   E0424
Stationary compressed gas system, purchase includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing   E0425
Portable gaseous oxygen system, purchase includes regulator, flowmeter, humidifier, cannula or mask, and tubing   E0430
Portable gaseous oxygen system, rental includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing   E0431
Portable liquid oxygen system, rental home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge   E0433
Portable liquid oxygen system, rental includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing   E0434
Portable liquid oxygen system, purchase includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor   E0435
Stationary liquid oxygen system, rental includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, tubing   E0439
Stationary liquid oxygen system, purchase includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing   E0440
Stationary oxygen contents, gaseous, 1 month's supply 1 unit   E0441
Stationary oxygen contents, liquid, 1 month's supply 1 unit   E0442
Portable oxygen contents, gaseous, 1 month's supply 1 unit   E0443
Portable oxygen contents, liquid, 1 month's supply 1 unit   E0444
Oximeter device for measuring blood oxygen levels non-invasively   E0445
Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories   E0446
Oxygen tent, excluding croup or pediatric tents   E0455
Chest shell (cuirass)   E0457
Chest wrap   E0459
Rocking bed with or without side rails   E0462
Home ventilator, any type, used with invasive interface, (eg, tracheostomy tube)   E0465
Home ventilator, any type, used with non-invasive interface, (eg, mask, chest shell)   E0466
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, eg, nasal or facial mask (intermittent assist device with continuous positive airway pressure device)   E0470
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, eg, nasal or facial mask (intermittent assist device with continuous positive airway pressure device)   E0471
Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, eg, tracheostomy tube (intermittent assist device with continuous positive airway pressure device)   E0472
Percussor, electric or pneumatic, home model   E0480
supplies and equipment,   E0425 - E0444 , E0455
Stationary compressed gas system, purchase includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing   E0425
Portable gaseous oxygen system, purchase includes regulator, flowmeter, humidifier, cannula or mask, and tubing   E0430
Portable gaseous oxygen system, rental includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing   E0431
Portable liquid oxygen system, rental home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge   E0433
Portable liquid oxygen system, rental includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing   E0434
Portable liquid oxygen system, purchase includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor   E0435
Stationary liquid oxygen system, rental includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, tubing   E0439
Stationary liquid oxygen system, purchase includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing   E0440
Stationary oxygen contents, gaseous, 1 month's supply 1 unit   E0441
Stationary oxygen contents, liquid, 1 month's supply 1 unit   E0442
Portable oxygen contents, gaseous, 1 month's supply 1 unit   E0443
Portable oxygen contents, liquid, 1 month's supply 1 unit   E0444
tent,   E0455
tubing,   A4616
water vapor enriching system,   E1405, E1406
wheeled cart,   E1354
Oxymorphone HCl,   J2410
Oxytetracycline HCl,   J2460
Oxytocin,   J2590