|
Abatacept, J0129
| |
|
Abciximab, J0130
| |
|
dressing,holderbinder A446 |
|
|
pad,low,profile L1270
| |
|
Abduction,control,each L2624
| |
|
Abduction,rotation,bar,foot 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
| |
|
AbobotulinumtoxintypeA, J0586
| |
|
Absorption,dressing A6251 - A6256 |
|
|
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq in or less, without adhesive border, each dressing A6251
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing A6252
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing A6253
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq in or less, with any size adhesive border, each dressing A6254
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing A6255
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing A6256
| |
|
Access,system A4301
| |
|
ambulation,devices E0153 - E0159 |
|
|
Platform attachment, forearm crutch, each E0153
| |
|
Platform attachment, walker, each E0154
| |
|
Wheel attachment, rigid pick-up walker, per pair E0155
| |
|
Seat attachment, walker E0156
| |
|
Crutch attachment, walker, each E0157
| |
|
Leg extensions for walker, per set of four (4) E0158
| |
|
Brake attachment for wheeled walker, replacement, each E0159
| |
|
artificial,kidney,and,machine,(see,also,ESRD) E1510 - E1699 |
|
|
Kidney, dialysate delivery syst kidney machine, pump recirculating, air removal syst, flowrate meter, power off, heater and temperature control with alarm, iv poles, pressure gauge, concentrate container E1510
| |
|
Heparin infusion pump for hemodialysis E1520
| |
|
Air bubble detector for hemodialysis, each, replacement E1530
| |
|
Pressure alarm for hemodialysis, each, replacement E1540
| |
|
Bath conductivity meter for hemodialysis, each E1550
| |
|
Blood leak detector for hemodialysis, each, replacement E1560
| |
|
Adjustable chair, for esrd patients E1570
| |
|
Transducer protectorsfluid barriers, for hemodialysis, any size, per 10 E1575
| |
|
Unipuncture control system for hemodialysis E1580
| |
|
Hemodialysis machine E1590
| |
|
Automatic intermittent peritoneal dialysis system E1592
| |
|
Cycler dialysis machine for peritoneal dialysis E1594
| |
|
Delivery andor installation charges for hemodialysis equipment E1600
| |
|
Reverse osmosis water purification system, for hemodialysis E1610
| |
|
Deionizer water purification system, for hemodialysis E1615
| |
|
Blood pump for hemodialysis, replacement E1620
| |
|
Water softening system, for hemodialysis E1625
| |
|
Reciprocating peritoneal dialysis system E1630
| |
|
Wearable artificial kidney, each E1632
| |
|
Peritoneal dialysis clamps, each E1634
| |
|
Compact (portable) travel hemodialyzer system E1635
| |
|
Sorbent cartridges, for hemodialysis, per 10 E1636
| |
|
Hemostats, each E1637
| |
|
Scale, each E1639
| |
|
Dialysis equipment, not otherwise specified E1699
| |
|
beds E0271 - E0280 , E0300 - E0326 |
|
|
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
| |
|
Mattress, innerspring E0271
| |
|
Mattress, foam rubber E0272
| |
|
Bed board E0273
| |
|
Over-bed table E0274
| |
|
Bed pan, standard, metal or plastic E0275
| |
|
Bed pan, fracture, metal or plastic E0276
| |
|
Powered pressure-reducing air mattress E0277
| |
|
Bed cradle, any type E0280
| |
|
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
| |
|
wheelchairs E0950 - E1030 , E1050 - E1298 , E2300 - E2399 , K0001 - K0109 |
|
|
Standard wheelchair K0001
| |
|
Standard hemi (low seat) wheelchair K0002
| |
|
Lightweight wheelchair K0003
| |
|
High strength, lightweight wheelchair K0004
| |
|
Ultralightweight wheelchair K0005
| |
|
Heavy duty wheelchair K0006
| |
|
Extra heavy duty wheelchair K0007
| |
|
Custom manual wheelchairbase K0008
| |
|
Other manual wheelchairbase K0009
| |
|
Standard - weight frame motorizedpower wheelchair K0010
| |
|
Standard - weight frame motorizedpower wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking K0011
| |
|
Lightweight portable motorizedpower wheelchair K0012
| |
|
Custom motorizedpower wheelchair base K0013
| |
|
Other motorizedpower wheelchair base K0014
| |
|
Detachable, non-adjustable height armrest, replacement only, each K0015
| |
|
Detachable, adjustable height armrest, base, replacement only, each K0017
| |
|
Detachable, adjustable height armrest, upper portion, replacement only, each K0018
| |
|
Arm pad, replacement only, each K0019
| |
|
Fixed, adjustable height armrest, pair K0020
| |
|
High mount flip-up footrest, replacement only, each K0037
| |
|
Leg strap, each K0038
| |
|
Leg strap, h style, each K0039
| |
|
Adjustable angle footplate, each K0040
| |
|
Large size footplate, each K0041
| |
|
Standard size footplate, replacement only, each K0042
| |
|
Footrest, lower extension tube, replacement only, each K0043
| |
|
Footrest, upper hanger bracket, replacement only, each K0044
| |
|
Footrest, complete assembly, replacement only, each K0045
| |
|
Elevating legrest, lower extension tube, replacement only, each K0046
| |
|
Elevating legrest, upper hanger bracket, replacement only, each K0047
| |
|
Ratchet assembly, replacement only K0050
| |
|
Cam release assembly, footrest or legrest, replacement only, each K0051
| |
|
Swingaway, detachable footrests, replacement only, each K0052
| |
|
Elevating footrests, articulating (telescoping), each K0053
| |
|
Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair K0056
| |
|
Spoke protectors, each K0065
| |
|
Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each K0069
| |
|
Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each K0070
| |
|
Front caster assembly, complete, with pneumatic tire, replacement only, each K0071
| |
|
Front caster assembly, complete, with semi-pneumatic tire, replacement only, each K0072
| |
|
Caster pin lock, each K0073
| |
|
Front caster assembly, complete, with solid tire, replacement only, each K0077
| |
|
Drive belt for power wheelchair, replacement only K0098
| |
|
Iv hanger, each K0105
| |
|
Wheelchair component or accessory, not otherwise specified K0108
| |
|
Wheelchair accessory, tray, each E0950
| |
|
Heel loopholder, any type, with or without ankle strap, each E0951
| |
|
Toe loopholder, any type, each E0952
| |
|
Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each E0953
| |
|
Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot E0954
| |
|
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each E0955
| |
|
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each E0956
| |
|
Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each E0957
| |
|
Manual wheelchair accessory, one-arm drive attachment, each E0958
| |
|
Manual wheelchair accessory, adapter for amputee, each E0959
| |
|
Wheelchair accessory, shoulder harnessstraps or chest strap, including any type mounting hardware E0960
| |
|
Manual wheelchair accessory, wheel lock brake extension (handle), each E0961
| |
|
Manual wheelchair accessory, headrest extension, each E0966
| |
|
Manual wheelchair accessory, hand rim with projections, any type, replacement only, each E0967
| |
|
Commode seat, wheelchair E0968
| |
|
Narrowing device, wheelchair E0969
| |
|
No 2 footplates, except for elevating leg rest E0970
| |
|
Manual wheelchair accessory, anti-tipping device, each E0971
| |
|
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each E0973
| |
|
Manual wheelchair accessory, anti-rollback device, each E0974
| |
|
Wheelchair accessory, positioning beltsafety beltpelvic strap, each E0978
| |
|
Safety vest, wheelchair E0980
| |
|
Wheelchair accessory, seat upholstery, replacement only, each E0981
| |
|
Wheelchair accessory, back upholstery, replacement only, each E0982
| |
|
Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control E0983
| |
|
Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control E0984
| |
|
Wheelchair accessory, seat lift mechanism E0985
| |
|
Manual wheelchair accessory, push-rim activated power assist system E0986
| |
|
Manual wheelchair accessory, lever-activated, wheel drive, pair E0988
| |
|
Wheelchair accessory, elevating leg rest, complete assembly, each E0990
| |
|
Manual wheelchair accessory, solid seat insert E0992
| |
|
Arm rest, each E0994
| |
|
Wheelchair accessory, calf restpad, replacement only, each E0995
| |
|
Wheelchair accessory, power seating system, tilt only E1002
| |
|
Wheelchair accessory, power seating system, recline only, without shear reduction E1003
| |
|
Wheelchair accessory, power seating system, recline only, with mechanical shear reduction E1004
| |
|
Wheelchair accessory, power seatng system, recline only, with power shear reduction E1005
| |
|
Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction E1006
| |
|
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction E1007
| |
|
Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction E1008
| |
|
Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each E1009
| |
|
Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair E1010
| |
|
Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair) E1011
| |
|
Wheelchair accessory, addition to power seating system, center mount power elevating leg restplatform, complete system, any type, each E1012
| |
|
Reclining back, addition to pediatric size wheelchair E1014
| |
|
Shock absorber for manual wheelchair, each E1015
| |
|
Shock absorber for power wheelchair, each E1016
| |
|
Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each E1017
| |
|
Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each E1018
| |
|
Residual limb support system for wheelchair, any type E1020
| |
|
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory E1028
| |
|
Wheelchair accessory, ventilator tray, fixed E1029
| |
|
Wheelchair accessory, ventilator tray, gimbaled E1030
| |
|
Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest E1240
| |
|
Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests E1050
| |
|
Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests E1170
| |
|
Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests E1280
| |
|
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests E1130
| |
|
Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests E1100
| |
|
Wheelchair specially sized or constructed, (indicate brand name, model number, if any) and justification E1220
| |
|
Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests E1060
| |
|
Lightweight wheelchair, fixed full length arms, swing away detachable footrest E1250
| |
|
Wheelchair, detachable arms, desk or full length, swing away detachable footrests E1140
| |
|
Amputee wheelchair, fixed full length arms, without footrests or legrest E1171
| |
|
Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest E1110
| |
|
Heavy duty wheelchair, fixed full length arms, swing away detachable footrest E1285
| |
|
Wheelchair with fixed arm, footrests E1221
| |
|
Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest E1290
| |
|
Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests E1150
| |
|
Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest E1260
| |
|
Wheelchair with fixed arm, elevating legrests E1222
| |
|
Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest E1172
| |
|
Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest E1070
| |
|
Wheelchair, fixed full length arms, swing away detachable elevating legrests E1160
| |
|
Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests E1180
| |
|
Wheelchair with detachable arms, footrests E1223
| |
|
Heavy duty wheelchair, fixed full length arms, elevating legrest E1295
| |
|
Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest E1083
| |
|
Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests E1270
| |
|
Special wheelchair seat height from floor E1296
| |
|
Wheelchair with detachable arms, elevating legrests E1224
| |
|
Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests E1084
| |
|
Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests E1190
| |
|
Manual adult size wheelchair, includes tilt in space E1161
| |
|
Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests E1195
| |
|
Special wheelchair seat depth, by upholstery E1297
| |
|
Hemi-wheelchair, fixed full length arms, swing away detachable foot rests E1085
| |
|
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each E1225
| |
|
Amputee wheelchair, fixed full length arms, swing away detachable footrest E1200
| |
|
Special wheelchair seat depth andor width, by construction E1298
| |
|
Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests E1086
| |
|
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each E1226
| |
|
Special height arms for wheelchair E1227
| |
|
High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests E1087
| |
|
Special back height for wheelchair E1228
| |
|
High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests E1088
| |
|
Wheelchair, pediatric size, not otherwise specified E1229
| |
|
High strength lightweight wheelchair, fixed length arms, swing away detachable footrest E1089
| |
|
Power operated vehicle (three or four wheel nonhighway) specify brand name and model number E1230
| |
|
High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable foot rests E1090
| |
|
Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests E1092
| |
|
Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system E1231
| |
|
Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system E1232
| |
|
Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests E1093
| |
|
Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system E1233
| |
|
Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system E1234
| |
|
Wheelchair, pediatric size, rigid, adjustable, with seating system E1235
| |
|
Wheelchair, pediatric size, folding, adjustable, with seating system E1236
| |
|
Wheelchair, pediatric size, rigid, adjustable, without seating system E1237
| |
|
Wheelchair, pediatric size, folding, adjustable, without seating system E1238
| |
|
Power wheelchair, pediatric size, not otherwise specified E1239
| |
|
Wheelchair accessory, power seat elevation system, any type E2300
| |
|
Wheelchair accessory, power standing system, any type E2301
| |
|
Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware E2310
| |
|
Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware E2311
| |
|
Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware E2312
| |
|
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each E2313
| |
|
Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware E2321
| |
|
Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware E2322
| |
|
Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated E2323
| |
|
Power wheelchair accessory, chin cup for chin control interface E2324
| |
|
Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware E2325
| |
|
Power wheelchair accessory, breath tube kit for sip and puff interface E2326
| |
|
Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware E2327
| |
|
Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware E2328
| |
|
Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware E2329
| |
|
Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware E2330
| |
|
Power wheelchair accessory, attendant control, proportional, including all related electronics and fixed mounting hardware E2331
| |
|
Power wheelchair accessory, nonstandard seat frame width, 20-23 inches E2340
| |
|
Power wheelchair accessory, nonstandard seat frame width, 24-27 inches E2341
| |
|
Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches E2342
| |
|
Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches E2343
| |
|
Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface E2351
| |
|
Power wheelchair accessory, group 34 non-sealed lead acid battery, each E2358
| |
|
Power wheelchair accessory, group 34 sealed lead acid battery, each (eg, gel cell, absorbed glassmat) E2359
| |
|
Power wheelchair accessory, 22nf non-sealed lead acid battery, each E2360
| |
|
Power wheelchair accessory, 22nf sealed lead acid battery, each, (eg, gel cell, absorbed glassmat) E2361
| |
|
Power wheelchair accessory, group 24 non-sealed lead acid battery, each E2362
| |
|
Power wheelchair accessory, group 24 sealed lead acid battery, each (eg, gel cell, absorbed glassmat) E2363
| |
|
Power wheelchair accessory, u-1 non-sealed lead acid battery, each E2364
| |
|
Power wheelchair accessory, u-1 sealed lead acid battery, each (eg, gel cell, absorbed glassmat) E2365
| |
|
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each E2366
| |
|
Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each E2367
| |
|
Power wheelchair component, drive wheel motor, replacement only E2368
| |
|
Power wheelchair component, drive wheel gear box, replacement only E2369
| |
|
Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only E2370
| |
|
Power wheelchair accessory, group 27 sealed lead acid battery, (eg, gel cell, absorbed glassmat), each E2371
| |
|
Power wheelchair accessory, group 27 non-sealed lead acid battery, each E2372
| |
|
Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware E2373
| |
|
Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only E2374
| |
|
Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only E2375
| |
|
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only E2376
| |
|
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue E2377
| |
|
Power wheelchair component, actuator, replacement only E2378
| |
|
Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each E2381
| |
|
Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each E2382
| |
|
Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each E2383
| |
|
Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each E2384
| |
|
Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each E2385
| |
|
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each E2386
| |
|
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each E2387
| |
|
Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each E2388
| |
|
Power wheelchair accessory, foam caster tire, any size, replacement only, each E2389
| |
|
Power wheelchair accessory, solid (rubberplastic) drive wheel tire, any size, replacement only, each E2390
| |
|
Power wheelchair accessory, solid (rubberplastic) caster tire (removable), any size, replacement only, each E2391
| |
|
Power wheelchair accessory, solid (rubberplastic) caster tire with integrated wheel, any size, replacement only, each E2392
| |
|
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each E2394
| |
|
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each E2395
| |
|
Power wheelchair accessory, caster fork, any size, replacement only, each E2396
| |
|
Power wheelchair accessory, lithium-based battery, each E2397
| |
|
Standard wheelchair K0001
| |
|
Standard hemi (low seat) wheelchair K0002
| |
|
Lightweight wheelchair K0003
| |
|
High strength, lightweight wheelchair K0004
| |
|
Ultralightweight wheelchair K0005
| |
|
Heavy duty wheelchair K0006
| |
|
Extra heavy duty wheelchair K0007
| |
|
Custom manual wheelchairbase K0008
| |
|
Other manual wheelchairbase K0009
| |
|
Standard - weight frame motorizedpower wheelchair K0010
| |
|
Standard - weight frame motorizedpower wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking K0011
| |
|
Lightweight portable motorizedpower wheelchair K0012
| |
|
Custom motorizedpower wheelchair base K0013
| |
|
Other motorizedpower wheelchair base K0014
| |
|
Detachable, non-adjustable height armrest, replacement only, each K0015
| |
|
Detachable, adjustable height armrest, base, replacement only, each K0017
| |
|
Detachable, adjustable height armrest, upper portion, replacement only, each K0018
| |
|
Arm pad, replacement only, each K0019
| |
|
Fixed, adjustable height armrest, pair K0020
| |
|
High mount flip-up footrest, replacement only, each K0037
| |
|
Leg strap, each K0038
| |
|
Leg strap, h style, each K0039
| |
|
Adjustable angle footplate, each K0040
| |
|
Large size footplate, each K0041
| |
|
Standard size footplate, replacement only, each K0042
| |
|
Footrest, lower extension tube, replacement only, each K0043
| |
|
Footrest, upper hanger bracket, replacement only, each K0044
| |
|
Footrest, complete assembly, replacement only, each K0045
| |
|
Elevating legrest, lower extension tube, replacement only, each K0046
| |
|
Elevating legrest, upper hanger bracket, replacement only, each K0047
| |
|
Ratchet assembly, replacement only K0050
| |
|
Cam release assembly, footrest or legrest, replacement only, each K0051
| |
|
Swingaway, detachable footrests, replacement only, each K0052
| |
|
Elevating footrests, articulating (telescoping), each K0053
| |
|
Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair K0056
| |
|
Spoke protectors, each K0065
| |
|
Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each K0069
| |
|
Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each K0070
| |
|
Front caster assembly, complete, with pneumatic tire, replacement only, each K0071
| |
|
Front caster assembly, complete, with semi-pneumatic tire, replacement only, each K0072
| |
|
Caster pin lock, each K0073
| |
|
Front caster assembly, complete, with solid tire, replacement only, each K0077
| |
|
Drive belt for power wheelchair, replacement only K0098
| |
|
Iv hanger, each K0105
| |
|
Wheelchair component or accessory, not otherwise specified K0108
| |
|
Acetaminophen, J0131
| |
|
Acetazolamide,sodium J1120
| |
|
Acetylcysteine,inhalation,solution J7604, J7608 |
|
|
Acetylcysteine,injection J0132
| |
|
Acyclovir, J0133
| |
|
Adalimumab, J0135
| |
|
Adenosine J0151, J0153 |
|
|
Adhesive, A4364
| |
|
bandage, A6413
| |
|
disc,or,foam,pad A5126
| |
|
remover A4455, A4456 |
|
|
support,breast,prosthesis A4280
| |
|
Administrative,Miscellaneous,and,Investigational A9000 - A9999 |
|
|
Non-prescription drugs A9150
| |
|
Technetium tc-99m sestamibi, diagnostic, per study dose A9500
| |
|
Miscellaneous dme supply, accessory, andor service component of another hcpcs code A9900
| |
|
Single vitaminmineraltrace element, oral, per dose, not otherwise specified A9152
| |
|
Dme delivery, set up, andor dispensing service component of another hcpcs code A9901
| |
|
Technetium tc-99m teboroxime, diagnostic, per study dose A9501
| |
|
Miscellaneous dme supply or accessory, not otherwise specified A9999
| |
|
Technetium tc-99m tetrofosmin, diagnostic, per study dose A9502
| |
|
Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified A9153
| |
|
Artificial saliva, 30 ml A9155
| |
|
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries A9503
| |
|
Pediculosis (lice infestation) treatment, topical, for administration by patientcaretaker A9180
| |
|
Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries A9504
| |
|
Thallium tl-201 thallous chloride, diagnostic, per millicurie A9505
| |
|
Non-covered item or service A9270
| |
|
Wound suction, disposable, includes dressing, all accessories and components, any type, each A9272
| |
|
Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries A9507
| |
|
Iodine i-131 iobenguane sulfate, diagnostic, per 05 millicurie A9508
| |
|
Hot water bottle, ice cap or collar, heat andor cold wrap, any type A9273
| |
|
Iodine i-123 sodium iodide, diagnostic, per millicurie A9509
| |
|
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories A9274
| |
|
Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries A9510
| |
|
Home glucose disposable monitor, includes test strips A9275
| |
|
Sensor invasive (eg, subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, one unit 1 day supply A9276
| |
|
Technetium tc-99m pertechnetate, diagnostic, per millicurie A9512
| |
|
Choline c-11, diagnostic, per study dose up to 20 millicuries A9515
| |
|
Transmitter external, for use with interstitial continuous glucose monitoring system A9277
| |
|
Receiver (monitor) external, for use with interstitial continuous glucose monitoring system A9278
| |
|
Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries A9516
| |
|
Monitoring featuredevice, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified A9279
| |
|
Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie A9517
| |
|
Alert or alarm device, not otherwise classified A9280
| |
|
Technetium tc-99m tilmanocept, diagnostic, up to 05 millicuries A9520
| |
|
Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries A9521
| |
|
Reachinggrabbing device, any type, any length, each A9281
| |
|
Wig, any type, each A9282
| |
|
Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries A9524
| |
|
Foot pressure off loadingsupportive device, any type, each A9283
| |
|
Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries A9526
| |
|
Iodine i-125, sodium iodide solution, therapeutic, per millicurie A9527
| |
|
Spirometer, non-electronic, includes all accessories A9284
| |
|
Inversioneversion correction device A9285
| |
|
Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie A9528
| |
|
Iodine i-131 sodium iodide solution, diagnostic, per millicurie A9529
| |
|
Hygienic item or device, disposable or non-disposable, any type, each A9286
| |
|
Exercise equipment A9300
| |
|
Iodine i-131 sodium iodide solution, therapeutic, per millicurie A9530
| |
|
Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries) A9531
| |
|
Iodine i-125 serum albumin, diagnostic, per 5 microcuries A9532
| |
|
Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries A9536
| |
|
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries A9537
| |
|
Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries A9538
| |
|
Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries A9539
| |
|
Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries A9540
| |
|
Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries A9541
| |
|
Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries A9542
| |
|
Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries A9543
| |
|
Cobalt co-5758, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie A9546
| |
|
Indium in-111 oxyquinoline, diagnostic, per 05 millicurie A9547
| |
|
Indium in-111 pentetate, diagnostic, per 05 millicurie A9548
| |
|
Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie A9550
| |
|
Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries A9551
| |
|
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries A9552
| |
|
Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries A9553
| |
|
Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries A9554
| |
|
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries A9555
| |
|
Gallium ga-67 citrate, diagnostic, per millicurie A9556
| |
|
Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries A9557
| |
|
Xenon xe-133 gas, diagnostic, per 10 millicuries A9558
| |
|
Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie A9559
| |
|
Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries A9560
| |
|
Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries A9561
| |
|
Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries A9562
| |
|
Sodium phosphate p-32, therapeutic, per millicurie A9563
| |
|
Chromic phosphate p-32 suspension, therapeutic, per millicurie A9564
| |
|
Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries A9566
| |
|
Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries A9567
| |
|
Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries A9568
| |
|
Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose A9569
| |
|
Indium in-111 labeled autologous white blood cells, diagnostic, per study dose A9570
| |
|
Indium in-111 labeled autologous platelets, diagnostic, per study dose A9571
| |
|
Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries A9572
| |
|
Injection, gadoterate meglumine, 01 ml A9575
| |
|
Injection, gadoteridol, (prohance multipack), per ml A9576
| |
|
Injection, gadobenate dimeglumine (multihance), per ml A9577
| |
|
Injection, gadobenate dimeglumine (multihance multipack), per ml A9578
| |
|
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml A9579
| |
|
Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries A9580
| |
|
Injection, gadoxetate disodium, 1 ml A9581
| |
|
Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries A9582
| |
|
Injection, gadofosveset trisodium, 1 ml A9583
| |
|
Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries A9584
| |
|
Injection, gadobutrol, 01 ml A9585
| |
|
Florbetapir f18, diagnostic, per study dose, up to 10 millicuries A9586
| |
|
Gallium ga-68, dotatate, diagnostic, 01 millicurie A9587
| |
|
Fluciclovine f-18, diagnostic, 1 millicurie A9588
| |
|
Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified A9597
| |
|
Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified A9598
| |
|
Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified A9599
| |
|
Strontium sr-89 chloride, therapeutic, per millicurie A9600
| |
|
Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries A9604
| |
|
Radium ra-223 dichloride, therapeutic, per microcurie A9606
| |
|
Non-radioactive contrast imaging material, not otherwise classified, per study A9698
| |
|
Radiopharmaceutical, therapeutic, not otherwise classified A9699
| |
|
Supply of injectable contrast material for use in echocardiography, per study A9700
| |
|
Ado-trastuzumab, J9354
| |
|
Adrenalin, J0171
| |
|
compressor E0571, E0572 |
|
|
compressor,filter K0178 - K0179 |
|
|
mask, K018 |
|
|
Aflibercept, J0178
| |
|
AFO E1815, E1830, L1900 - L1990 , L4392, L4396 |
|
|
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, 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
| |
|
Afstyla, J7210
| |
|
Agalsidase,beta J0180
| |
|
Aggrastat, J3245
| |
|
A-hydroCort, J1710
| |
|
Air,bubble,detector,dialysis E1530
| |
|
Air,fluidized,bed E0194
| |
|
Air,pressure,padmattress E0186, E0197 |
|
|
Air,travel,and,nonemergency,transportation A0140
| |
|
Alarm,pressure,dialysis E1540
| |
|
Alatrofloxacin,mesylate J0200
| |
|
Albumin,human P9041, P9042 |
|
|
Albuterol,all,formulations,inhalation,solution,concentrated J7610, J7611 |
|
|
Albuterol,all,formulations,inhalation,solution,unit,dose J7609, J7613 |
|
|
Albuterol,all,formulations,inhalation,solution J7620
| |
|
Alcohol, A4244
| |
|
Alcohol,wipes A4245
| |
|
Aldesleukin,(IL2) J9015
| |
|
Alefacept, J0215
| |
|
Alemtuzumab, J0202
| |
|
Alert,device A9280
| |
|
Alginate,dressing A6196 - A6199 |
|
|
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq in or less, each dressing A6196
| |
|
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, each dressing A6197
| |
|
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq in, each dressing A6198
| |
|
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches A6199
| |
|
Alglucerase, J0205
| |
|
Alglucosidase, J0220
| |
|
Alglucosidase,alfa J0221
| |
|
Alphanate, J7186
| |
|
Alpha-1-proteinase,inhibitor,human J0256, J0257 |
|
|
Alprostadil,injection J0270
| |
|
Alprostadil,urethral,supposity J0275
| |
|
Alteplase,recombinant J2997
| |
|
Alternating,pressure,mattresspad A4640, E0180, E0181, E0277 |
|
|
Ambulance, A0021 - A0999 |
|
|
Ambulance service, outside state per mile, transport (medicaid only) A0021
| |
|
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest A0080
| |
|
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest A0090
| |
|
Non-emergency transportation taxi A0100
| |
|
Non-emergency transportation and bus, intra or inter state carrier A0110
| |
|
Non-emergency transportation mini-bus, mountain area transports, or other transportation systems A0120
| |
|
Non-emergency transportation wheelchair van A0130
| |
|
Non-emergency transportation and air travel (private or commercial) intra or inter state A0140
| |
|
Non-emergency transportation per mile - case worker or social worker A0160
| |
|
Transportation ancillary parking fees, tolls, other A0170
| |
|
Non-emergency transportation ancillary lodging-recipient A0180
| |
|
Non-emergency transportation ancillary meals-recipient A0190
| |
|
Non-emergency transportation ancillary lodging escort A0200
| |
|
Non-emergency transportation ancillary meals-escort A0210
| |
|
Ambulance service, neonatal transport, base rate, emergency transport, one way A0225
| |
|
Bls mileage (per mile) A0380
| |
|
Bls routine disposable supplies A0382
| |
|
Bls specialized service disposable supplies defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances) A0384
| |
|
Als mileage (per mile) A0390
| |
|
Als specialized service disposable supplies defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances) A0392
| |
|
Als specialized service disposable supplies iv drug therapy A0394
| |
|
Als specialized service disposable supplies esophageal intubation A0396
| |
|
Als routine disposable supplies A0398
| |
|
Ambulance waiting time (als or bls), one half (12) hour increments A0420
| |
|
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation A0422
| |
|
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged) (requires medical review) A0424
| |
|
Ground mileage, per statute mile A0425
| |
|
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) A0426
| |
|
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) A0427
| |
|
Ambulance service, basic life support, non-emergency transport, (bls) A0428
| |
|
Ambulance service, basic life support, emergency transport (bls-emergency) A0429
| |
|
Ambulance service, conventional air services, transport, one way (fixed wing) A0430
| |
|
Ambulance service, conventional air services, transport, one way (rotary wing) A0431
| |
|
Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers A0432
| |
|
Advanced life support, level 2 (als 2) A0433
| |
|
Specialty care transport (sct) A0434
| |
|
Fixed wing air mileage, per statute mile A0435
| |
|
Rotary wing air mileage, per statute mile A0436
| |
|
Noncovered ambulance mileage, per mile (eg, for miles traveled beyond closest appropriate facility) A0888
| |
|
Ambulance response and treatment, no transport A0998
| |
|
Unlisted ambulance service A0999
| |
|
air A0430, A0431, A0435, A0436 |
|
|
disposable,supplies A0382 - A0398 |
|
|
Bls routine disposable supplies A0382
| |
|
Bls specialized service disposable supplies defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances) A0384
| |
|
Als mileage (per mile) A0390
| |
|
Als specialized service disposable supplies defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances) A0392
| |
|
Als specialized service disposable supplies iv drug therapy A0394
| |
|
Als specialized service disposable supplies esophageal intubation A0396
| |
|
Als routine disposable supplies A0398
| |
|
non-emergency,transport,fixed,wing S9960
| |
|
non-emergency,transport,rotary,wing S9961
| |
|
oxygen, A0422
| |
|
Ameluz, J7345
| |
|
Ambulation,device E0100 - E0159 |
|
|
Platform attachment, forearm crutch, each E0153
| |
|
Walker, rigid (pickup), adjustable or fixed height E0130
| |
|
Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips E0110
| |
|
Cane, includes canes of all materials, adjustable or fixed, with tip E0100
| |
|
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips E0105
| |
|
Walker, folding (pickup), adjustable or fixed height E0135
| |
|
Platform attachment, walker, each E0154
| |
|
Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips E0111
| |
|
Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips E0112
| |
|
Wheel attachment, rigid pick-up walker, per pair E0155
| |
|
Walker, with trunk support, adjustable or fixed height, any type E0140
| |
|
Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip E0113
| |
|
Walker, rigid, wheeled, adjustable or fixed height E0141
| |
|
Seat attachment, walker E0156
| |
|
Crutch attachment, walker, each E0157
| |
|
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips E0114
| |
|
Walker, folding, wheeled, adjustable or fixed height E0143
| |
|
Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each E0116
| |
|
Leg extensions for walker, per set of four (4) E0158
| |
|
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat E0144
| |
|
Walker, heavy duty, multiple braking system, variable wheel resistance E0147
| |
|
Crutch, underarm, articulating, spring assisted, each E0117
| |
|
Brake attachment for wheeled walker, replacement, each E0159
| |
|
Walker, heavy duty, without wheels, rigid or folding, any type, each E0148
| |
|
Crutch substitute, lower leg platform, with or without wheels, each E0118
| |
|
Walker, heavy duty, wheeled, rigid or folding, any type E0149
| |
|
Amikacin,Sulfate J0278
| |
|
Aminolevulinate, J7309
| |
|
Aminolevulinic,acid,HCl J7308
| |
|
Aminophylline, J0280
| |
|
Amiodarone,Hcl J0282
| |
|
Amitriptyline,HCI J1320
| |
|
Ammonia,N-13 A9526
| |
|
Ammonia,test,paper A4774
| |
|
Amniotic,membrane V2790
| |
|
Amobarbital, J0300
| |
|
Amphotericin,B J0285
| |
|
Amphotericin,B,Lipid,Complex J0287 - J0289 |
|
|
Injection, amphotericin b lipid complex, 10 mg J0287
| |
|
Injection, amphotericin b cholesteryl sulfate complex, 10 mg J0288
| |
|
Injection, amphotericin b liposome, 10 mg J0289
| |
|
Ampicillin,sodium J0290
| |
|
Ampicillin,sodiumsulbactam,sodium J0295
| |
|
adapter,wheelchair E0959
| |
|
prosthesis L5000 - L7510 , L7520, L7900, L8400 - L8465 |
|
|
Prosthetic sheath, below knee, each L8400
| |
|
Prosthetic sheath, above knee, each L8410
| |
|
Prosthetic sheath, upper limb, each L8415
| |
|
Prosthetic sheathsock, including a gel cushion layer, below knee or above knee, each L8417
| |
|
Prosthetic sock, multiple ply, below knee, each L8420
| |
|
Prosthetic sock, multiple ply, above knee, each L8430
| |
|
Prosthetic sock, multiple ply, upper limb, each L8435
| |
|
Prosthetic shrinker, below knee, each L8440
| |
|
Prosthetic shrinker, above knee, each L8460
| |
|
Prosthetic shrinker, upper limb, each L8465
| |
|
Above elbow, molded double wall socket, internal locking elbow, forearm L6250
| |
|
Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm L6350
| |
|
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee L5400
| |
|
Partial foot, shoe insert with longitudinal arch, toe filler L5000
| |
|
Ankle, symes, molded socket, sach foot L5050
| |
|
Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device L6920
| |
|
Addition, endoskeletal knee-shin system, single axis, manual lock L5810
| |
|
Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping L6570
| |
|
Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining L6900
| |
|
Replacement, socket, below knee, molded to patient model L5700
| |
|
Addition, exoskeletal knee-shin system, single axis, manual lock L5710
| |
|
Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal) L5654
| |
|
Addition to lower extremity, symes type, expandable wall socket L5630
| |
|
Addition to lower extremity, test socket, symes L5618
| |
|
Addition to lower extremity, endoskeletal system, above knee, hydracadence system L5610
| |
|
Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model L5510
| |
|
Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed L5500
| |
|
Hemipelvectomy, canadian type molded socket, hip joint, single axis constant friction knee, shin, sach foot L5280
| |
|
Six volt battery, each L7360
| |
|
Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) L5785
| |
|
Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot L5150
| |
|
Hip disarticulation, canadian type molded socket, hip joint, single axis constant friction knee, shin, sach foot L5250
| |
|
Above knee, molded socket, single axis constant friction knee, shin, sach foot L5200
| |
|
Below knee, molded socket, shin, sach foot L5100
| |
|
Upper extremity additions, polycentric hinge, pair L6600
| |
|
Electronic elbow, hosmer or equal, switch controlled L7170
| |
|
Partial hand, thumb remaining L6000
| |
|
Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad L6050
| |
|
Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment L6890
| |
|
Elbow disarticulation, molded socket, outside locking hinge, forearm L6200
| |
|
Terminal device, passive handmitt, any material, any size L6703
| |
|
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow L6380
| |
|
Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping L6550
| |
|
Below elbow, molded socket, flexible elbow hinge, triceps pad L6100
| |
|
Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping L6500
| |
|
Repair of prosthetic device, repair or replace minor parts L7510
| |
|
Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping L6400
| |
|
Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping L6450
| |
|
Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm L6300
| |
|
Below elbow, molded socket, (muenster or northwestern suspension types) L6110
| |
|
Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control L5611
| |
|
Below knee, plastic socket, joints and thigh lacer, sach foot L5105
| |
|
Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad L6055
| |
|
Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow L6382
| |
|
Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed L5520
| |
|
Shoulder disarticulation, passive restoration (complete prosthesis) L6310
| |
|
Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed L5505
| |
|
Upper extremity additions, single pivot hinge, pair L6605
| |
|
Interscapular thoracic, passive restoration (complete prosthesis) L6360
| |
|
Partial foot, molded socket, ankle height, with toe filler L5010
| |
|
Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated L6895
| |
|
Battery charger, six volt, each L7362
| |
|
Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm L6205
| |
|
Ankle, symes, metal frame, molded leather socket, articulated anklefoot L5060
| |
|
Electronic elbow, microprocessor sequential control of elbow and terminal device L7180
| |
|
Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) L5790
| |
|
Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material L5811
| |
|
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment L5410
| |
|
Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model L6580
| |
|
Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining L6905
| |
|
Replacement, socket, above kneeknee disarticulation, including attachment plate, molded to patient model L5701
| |
|
Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material L5711
| |
|
Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot L5160
| |
|
Hip disarticulation, tilt table type molded socket, locking hip joint, single axis constant friction knee, shin, sach foot L5270
| |
|
Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal) L5655
| |
|
Partial hand, little andor ring finger remaining L6010
| |
|
Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device L6925
| |
|
Below knee, molded socket, shin, sach foot, endoskeletal system L5301
| |
|
Terminal device, sportrecreationalwork attachment, any material, any size L6704
| |
|
Addition to lower extremity, above knee or knee disarticulation, acrylic socket L5631
| |
|
Addition to lower extremity, test socket, below knee L5620
| |
|
Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each L5210
| |
|
Addition to lower extremity, symes type, 'ptb' brim design socket L5632
| |
|
Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed L6582
| |
|
Partial foot, molded socket, tibial tubercle height, with toe filler L5020
| |
|
Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) L5812
| |
|
Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device L6930
| |
|
Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) L5795
| |
|
Electronic elbow, microprocessor simultaneous control of elbow and terminal device L7181
| |
|
Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined L6706
| |
|
Twelve volt battery, each L7364
| |
|
Below elbow, molded double wall split socket, step-up hinges, half cuff L6120
| |
|
Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic L6384
| |
|
Interscapular thoracic, passive restoration (shoulder cap only) L6370
| |
|
Shoulder disarticulation, passive restoration (shoulder cap only) L6320
| |
|
Partial hand, no finger remaining L6020
| |
|
Upper extremity additions, flexible metal hinge, pair L6610
| |
|
Above knee, short prosthesis, no knee joint ('stubbies'), with articulated anklefoot, dynamically aligned, each L5220
| |
|
Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system L5312
| |
|
Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model L5530
| |
|
Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control L5613
| |
|
Addition to lower extremity, test socket, knee disarticulation L5622
| |
|
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation L5420
| |
|
Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal) L5656
| |
|
Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining L6910
| |
|
Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) L5712
| |
|
Replacement, socket, hip disarticulation, including hip joint, molded to patient model L5702
| |
|
Addition to lower extremity, symes type, posterior opening (canadian) socket L5634
| |
|
Electronic elbow, adolescent, variety village or equal, switch controlled L7185
| |
|
Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only L5703
| |
|
Addition to upper extremity prosthesis, external powered, additional switch, any type L6611
| |
|
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined L6707
| |
|
Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model L6584
| |
|
Addition to lower extremity, test socket, above knee L5624
| |
|
Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock L5814
| |
|
Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control L5614
| |
|
Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket L5535
| |
|
Transcarpalmetacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s) L6026
| |
|
Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal) L5658
| |
|
Hand restoration (shading, and measurements included), replacement glove for above L6915
| |
|
Battery charger, twelve volt, each L7366
| |
|
Below elbow, molded double wall split socket, stump activated locking hinge, half cuff L6130
| |
|
Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot L5230
| |
|
Immediate post surgical or early fitting, each additional cast change and realignment L6386
| |
|
Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control L5714
| |
|
Immediate post surgical or early fitting, application of initial rigid dressing, incl fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment L5430
| |
|
Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee L5321
| |
|
Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device L6935
| |
|
Terminal device, hand, mechanical, voluntary opening, any material, any size L6708
| |
|
Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock L5816
| |
|
Custom shaped protective cover, below knee L5704
| |
|
Upper extremity addition, disconnect locking wrist unit L6615
| |
|
Electronic elbow, child, variety village or equal, switch controlled L7186
| |
|
Immediate post surgical or early fitting, application of rigid dressing only L6388
| |
|
Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot L5331
| |
|
Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed L6586
| |
|
Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee L5450
| |
|
Lithium ion battery, rechargeable, replacement L7367
| |
|
Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model L5540
| |
|
Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control L5616
| |
|
Addition to lower extremity, test socket, hip disarticulation L5626
| |
|
Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device L6940
| |
|
Addition to lower extremity, symes type, medial opening socket L5636
| |
|
Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock L5716
| |
|
Addition to lower extremity, socket insert, multi-durometer symes L5661
| |
|
Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control L5818
| |
|
Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each L5617
| |
|
Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device L6945
| |
|
Electronic elbow, adolescent, variety village or equal, myoelectronically controlled L7190
| |
|
Addition to lower extremity, test socket, hemipelvectomy L5628
| |
|
Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee L5460
| |
|
Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot L5341
| |
|
Addition to lower extremity, socket insert, multi-durometer, below knee L5665
| |
|
Addition to lower extremity, below knee, total contact L5637
| |
|
Upper extremity addition, additional disconnect insert for locking wrist unit, each L6616
| |
|
Terminal device, hand, mechanical, voluntary closing, any material, any size L6709
| |
|
Custom shaped protective cover, above knee L5705
| |
|
Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model L5560
| |
|
Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control L5718
| |
|
Lithium ion battery charger, replacement only L7368
| |
|
Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model L6588
| |
|
Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device L6950
| |
|
Addition to lower extremity, below knee, leather socket L5638
| |
|
Addition to upper extremity prosthesis, below elbowwrist disarticulation, ultralight material (titanium, carbon fiber or equal) L7400
| |
|
Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed L6590
| |
|
Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control L5722
| |
|
Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric L6711
| |
|
Addition to lower extremity, below knee, acrylic socket L5629
| |
|
Custom shaped protective cover, knee disarticulation L5706
| |
|
Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control L5822
| |
|
Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed L5570
| |
|
Upper extremity addition, flexionextension wrist unit, with or without friction L6620
| |
|
Addition to lower extremity, below knee, cuff suspension L5666
| |
|
Electronic elbow, child, variety village or equal, myoelectronically controlled L7191
| |
|
Addition, exoskeletal knee-shin system, single axis, fluid swing phase control L5724
| |
|
Upper extremity prosthesis addition, flexionextension wrist with or without friction, for use with external powered terminal device L6621
| |
|
Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device L6955
| |
|
Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model L5580
| |
|
Addition to lower extremity, below knee, wood socket L5639
| |
|
Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal) L7401
| |
|
Addition, endoskeletal knee-shin system, single axis, fluid swing phase control L5824
| |
|
Custom shaped protective cover, hip disarticulation L5707
| |
|
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric L6712
| |
|
Addition to lower extremity, below knee, molded distal cushion L5668
| |
|
Electronic wrist rotator, any type L7259
| |
|
Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame L5826
| |
|
Upper extremity addition, spring assisted rotational wrist unit with latch release L6623
| |
|
Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control L5726
| |
|
Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar) L5670
| |
|
Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket L5585
| |
|
Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device L6960
| |
|
Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric L6713
| |
|
Addition to upper extremity prosthesis, shoulder disarticulationinterscapular thoracic, ultralight material (titanium, carbon fiber or equal) L7402
| |
|
Addition to lower extremity, knee disarticulation, leather socket L5640
| |
|
Addition to lower extremity, above knee, leather socket L5642
| |
|
Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model L5590
| |
|
Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric L6714
| |
|
Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device L6965
| |
|
Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control L5728
| |
|
Addition to upper extremity prosthesis, below elbowwrist disarticulation, acrylic material L7403
| |
|
Upper extremity addition, flexionextension and rotation wrist unit L6624
| |
|
Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control L5828
| |
|
Addition to lower extremity, below knee above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert L5671
| |
|
Addition to lower extremity, below knee, removable medial brim suspension L5672
| |
|
Addition, endoskeletal knee-shin system, single axis, pneumatic swing phase control L5830
| |
|
Upper extremity addition, rotation wrist unit with cable lock L6625
| |
|
Addition, exoskeletal knee-shin system, single axis, pneumatichydra pneumatic swing phase control L5780
| |
|
Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model L5595
| |
|
Addition to lower extremity, hip disarticulation, flexible inner socket, external frame L5643
| |
|
Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material L7404
| |
|
Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device L6970
| |
|
Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement L6715
| |
|
Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined L6721
| |
|
Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model L5600
| |
|
Addition, endoskeletal kneeshin system, 4-bar linkage or multiaxial, pneumatic swing phase control L5840
| |
|
Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system L5781
| |
|
Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device L6975
| |
|
Addition to lower extremity, above knee, wood socket L5644
| |
|
Upper extremity addition, quick disconnect hook adapter, otto bock or equal L6628
| |
|
Addition to lower extremity, below kneeabove knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism L5673
| |
|
Addition to upper extremity prosthesis, shoulder disarticulationinterscapular thoracic, acrylic material L7405
| |
|
Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable L5845
| |
|
Additions to lower extremity, below knee, knee joints, single axis, pair L5676
| |
|
Electric hand, switch or myoelectric controlled, adult L7007
| |
|
Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty L5782
| |
|
Upper extremity prosthesis, not otherwise specified L7499
| |
|
Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal L6629
| |
|
Addition to lower extremity, below knee, flexible inner socket, external frame L5645
| |
|
Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined L6722
| |
|
Additions to lower extremity, below knee, knee joints, polycentric, pair L5677
| |
|
Electric hand, switch or myoelectric, controlled, pediatric L7008
| |
|
Upper extremity addition, stainless steel, any wrist L6630
| |
|
Addition to terminal device, modifier wrist unit L6805
| |
|
Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability L5848
| |
|
Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket L5646
| |
|
Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist L5850
| |
|
Addition to terminal device, precision pinch device L6810
| |
|
Addition to lower extremity, below knee suction socket L5647
| |
|
Additions to lower extremity, below knee, joint covers, pair L5678
| |
|
Electric hook, switch or myoelectric controlled, adult L7009
| |
|
Upper extremity addition, latex suspension sleeve, each L6632
| |
|
Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s) L6880
| |
|
Prehensile actuator, switch controlled L7040
| |
|
Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket L5648
| |
|
Addition to lower extremity, below kneeabove knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism L5679
| |
|
Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist L5855
| |
|
Upper extremity addition, lift assist for elbow L6635
| |
|
Addition to lower extremity, ischial containmentnarrow m-l socket L5649
| |
|
Automatic grasp feature, addition to upper limb electric prosthetic terminal device L6881
| |
|
Upper extremity addition, nudge control elbow lock L6637
| |
|
Addition to lower extremity, below knee, thigh lacer, nonmolded L5680
| |
|
Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type L5856
| |
|
Electric hook, switch or myoelectric controlled, pediatric L7045
| |
|
Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow L6638
| |
|
Addition to lower extremity, below kneeabove knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679) L5681
| |
|
Additions to lower extremity, total contact, above knee or knee disarticulation socket L5650
| |
|
Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type L5857
| |
|
Microprocessor control feature, addition to upper limb prosthetic terminal device L6882
| |
|
Addition to lower extremity, below knee, thigh lacer, glutealischial, molded L5682
| |
|
Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type L5858
| |
|
Addition to lower extremity, above knee, flexible inner socket, external frame L5651
| |
|
Upper extremity additions, shoulder abduction joint, pair L6640
| |
|
Replacement socket, below elbowwrist disarticulation, molded to patient model, for use with or without external power L6883
| |
|
Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s) L5969
| |
|
Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexionextension assist control, includes any type motor(s) L5859
| |
|
Addition to lower extremity, below kneeabove knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679) L5683
| |
|
Upper extremity addition, excursion amplifier, pulley type L6641
| |
|
Addition to lower extremity, suction suspension, above knee or knee disarticulation socket L5652
| |
|
Replacement socket, above elbowelbow disarticulation, molded to patient model, for use with or without external power L6884
| |
|
Addition to lower extremity, below knee, fork strap L5684
| |
|
Addition to lower extremity, knee disarticulation, expandable wall socket L5653
| |
|
Replacement socket, shoulder disarticulationinterscapular thoracic, molded to patient model, for use with or without external power L6885
| |
|
Upper extremity addition, excursion amplifier, lever type L6642
| |
|
Addition, endoskeletal system, below knee, alignable system L5910
| |
|
Upper extremity addition, shoulder flexion-abduction joint, each L6645
| |
|
Addition to lower extremity prosthesis, below knee, suspensionsealing sleeve, with or without valve, any material, each L5685
| |
|
Addition, endoskeletal system, above knee or hip disarticulation, alignable system L5920
| |
|
Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system L6646
| |
|
Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock L5925
| |
|
Addition to lower extremity, below knee, back check (extension control) L5686
| |
|
Addition to lower extremity, below knee, waist belt, webbing L5688
| |
|
Addition, endoskeletal system, high activity knee control frame L5930
| |
|
Upper extremity addition, shoulder lock mechanism, body powered actuator L6647
| |
|
Addition to lower extremity, below knee, waist belt, padded and lined L5690
| |
|
Upper extremity addition, shoulder lock mechanism, external powered actuator L6648
| |
|
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) L5940
| |
|
Addition to lower extremity, above knee, pelvic control belt, light L5692
| |
|
Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) L5950
| |
|
Upper extremity addition, shoulder universal joint, each L6650
| |
|
Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) L5960
| |
|
Addition to lower extremity, above knee, pelvic control belt, padded and lined L5694
| |
|
Upper extremity addition, standard control cable, extra L6655
| |
|
Upper extremity addition, heavy duty control cable L6660
| |
|
Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each L5695
| |
|
Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion andor extension control L5961
| |
|
Addition to lower extremity, above knee or knee disarticulation, pelvic joint L5696
| |
|
Addition, endoskeletal system, below knee, flexible protective outer surface covering system L5962
| |
|
Upper extremity addition, teflon, or equal, cable lining L6665
| |
|
Addition, endoskeletal system, above knee, flexible protective outer surface covering system L5964
| |
|
Addition to lower extremity, above knee or knee disarticulation, pelvic band L5697
| |
|
Upper extremity addition, hook to hand, cable adapter L6670
| |
|
Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system L5966
| |
|
Addition to lower extremity, above knee or knee disarticulation, silesian bandage L5698
| |
|
Upper extremity addition, harness, chest or shoulder, saddle type L6672
| |
|
Upper extremity addition, harness, (eg, figure of eight type), single cable design L6675
| |
|
Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature L5968
| |
|
All lower extremity prostheses, shoulder harness L5699
| |
|
All lower extremity prostheses, foot, external keel, sach foot L5970
| |
|
Upper extremity addition, harness, (eg, figure of eight type), dual cable design L6676
| |
|
All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only L5971
| |
|
Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow L6677
| |
|
Upper extremity addition, test socket, wrist disarticulation or below elbow L6680
| |
|
All lower extremity prostheses, foot, flexible keel L5972
| |
|
Upper extremity addition, test socket, elbow disarticulation or above elbow L6682
| |
|
Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion andor plantar flexion control, includes power source L5973
| |
|
Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic L6684
| |
|
All lower extremity prostheses, foot, single axis anklefoot L5974
| |
|
Upper extremity addition, suction socket L6686
| |
|
All lower extremity prosthesis, combination single axis ankle and flexible keel foot L5975
| |
|
All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal) L5976
| |
|
Upper extremity addition, frame type socket, below elbow or wrist disarticulation L6687
| |
|
Upper extremity addition, frame type socket, above elbow or elbow disarticulation L6688
| |
|
All lower extremity prostheses, foot, multiaxial anklefoot L5978
| |
|
Upper extremity addition, frame type socket, shoulder disarticulation L6689
| |
|
All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system L5979
| |
|
Upper extremity addition, frame type socket, interscapular-thoracic L6690
| |
|
All lower extremity prostheses, flex foot system L5980
| |
|
All lower extremity prostheses, flex-walk system or equal L5981
| |
|
Upper extremity addition, removable insert, each L6691
| |
|
All exoskeletal lower extremity prostheses, axial rotation unit L5982
| |
|
Upper extremity addition, silicone gel insert or equal, each L6692
| |
|
All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability L5984
| |
|
Upper extremity addition, locking elbow, forearm counterbalance L6693
| |
|
Addition to upper extremity prosthesis, below elbowabove elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism L6694
| |
|
All endoskeletal lower extremity prostheses, dynamic prosthetic pylon L5985
| |
|
All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal) L5986
| |
|
Addition to upper extremity prosthesis, below elbowabove elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism L6695
| |
|
Addition to upper extremity prosthesis, below elbowabove elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695) L6696
| |
|
All lower extremity prosthesis, shank foot system with vertical loading pylon L5987
| |
|
Addition to lower limb prosthesis, vertical shock reducing pylon feature L5988
| |
|
Addition to upper extremity prosthesis, below elbowabove elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695) L6697
| |
|
Addition to lower extremity prosthesis, user adjustable heel height L5990
| |
|
Addition to upper extremity prosthesis, below elbowabove elbow, lock mechanism, excludes socket insert L6698
| |
|
Lower extremity prosthesis, not otherwise specified L5999
| |
|
Prosthetic sheath, below knee, each L8400
| |
|
Prosthetic sheath, above knee, each L8410
| |
|
Prosthetic sheath, upper limb, each L8415
| |
|
Prosthetic sheathsock, including a gel cushion layer, below knee or above knee, each L8417
| |
|
Prosthetic sock, multiple ply, below knee, each L8420
| |
|
Prosthetic sock, multiple ply, above knee, each L8430
| |
|
Prosthetic sock, multiple ply, upper limb, each L8435
| |
|
Prosthetic shrinker, below knee, each L8440
| |
|
Prosthetic shrinker, above knee, each L8460
| |
|
Prosthetic shrinker, upper limb, each L8465
| |
|
stump,sock L8470 - L8485 |
|
|
Prosthetic sock, single ply, fitting, below knee, each L8470
| |
|
Prosthetic sock, single ply, fitting, above knee, each L8480
| |
|
Prosthetic sock, single ply, fitting, upper limb, each L8485
| |
|
wheelchair E1170 - E1190 , E1200, K0100 |
|
|
Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests E1170
| |
|
Amputee wheelchair, fixed full length arms, without footrests or legrest E1171
| |
|
Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest E1172
| |
|
Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests E1180
| |
|
Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests E1190
| |
|
Amygdalin, J3570
| |
|
Anadulafungin, J0348
| |
|
Anistreplase, J0350
| |
|
Ankle,splint,recumbent K0126 - K0130 |
|
|
Ankle-foot,orthosis,(AFO) L1900 - L1990 , L2106 - L2116 , L4361, L4392, L4396 |
|
|
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,orthosis L0700, L0710 |
|
|
Anti-emetic,oral Q0163 - Q0181 , J8498, J8597 |
|
|
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen Q0163
| |
|
Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q0164
| |
|
Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen Q0166
| |
|
Dronabinol, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q0167
| |
|
Promethazine hydrochloride, 125 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q0169
| |
|
Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q0173
| |
|
Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q0174
| |
|
Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q0175
| |
|
Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q0177
| |
|
Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen Q0180
| |
|
Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen Q0181
| |
|
Anti-hemophilic,factor,(Factor,VIII) J7190 - J7192 |
|
|
Factor viii (antihemophilic factor, human) per iu J7190
| |
|
Factor viii (antihemophilic factor (porcine)), per iu J7191
| |
|
Factor viii (antihemophilic factor, recombinant) per iu, not otherwise specified J7192
| |
|
Anti-inhibitors,per,IU J7198
| |
|
Anti-neoplastic,drug,NOC J9999
| |
|
Antithrombin,III J7197
| |
|
Antithrombin,recombinant J7196
| |
|
Apomorphine, J0364
| |
|
cleaner, A5131
| |
|
pneumatic, E0655 - E0673 |
|
|
Non-segmental pneumatic appliance for use with pneumatic compressor, half arm E0655
| |
|
Segmental pneumatic appliance for use with pneumatic compressor, trunk E0656
| |
|
Segmental pneumatic appliance for use with pneumatic compressor, chest E0657
| |
|
Non-segmental pneumatic appliance for use with pneumatic compressor, full leg E0660
| |
|
Non-segmental pneumatic appliance for use with pneumatic compressor, full arm E0665
| |
|
Non-segmental pneumatic appliance for use with pneumatic compressor, half leg E0666
| |
|
Segmental pneumatic appliance for use with pneumatic compressor, full leg E0667
| |
|
Segmental pneumatic appliance for use with pneumatic compressor, full arm E0668
| |
|
Segmental pneumatic appliance for use with pneumatic compressor, half leg E0669
| |
|
Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk E0670
| |
|
Segmental gradient pressure pneumatic appliance, full leg E0671
| |
|
Segmental gradient pressure pneumatic appliance, full arm E0672
| |
|
Segmental gradient pressure pneumatic appliance, half leg E0673
| |
|
Aprotinin, J0365
| |
|
shunt, L8612
| |
|
sterile, J705 |
|
|
Arbutamine,HCl J0395
| |
|
Arch,support L3040 - L3100 |
|
|
Foot, arch support, removable, premolded, longitudinal, each L3040
| |
|
Foot, arch support, non-removable attached to shoe, longitudinal, each L3070
| |
|
Foot, arch support, removable, premolded, metatarsal, each L3050
| |
|
Foot, arch support, non-removable attached to shoe, metatarsal, each L3080
| |
|
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
| |
|
Intralesional, J3302
| |
|
Arformoterol, J7605
| |
|
Argatroban, J0883 - J0884 |
|
|
Injection, argatroban, 1 mg (for non-esrd use) J0883
| |
|
Injection, argatroban, 1 mg (for esrd on dialysis) J0884
| |
|
Aripiprazole J0400, J0401, J1942 |
|
|
Arm,wheelchair E0973
| |
|
Arsenic,trioxide J9017
| |
|
Cornea, L8609
| |
|
kidney,machines,and,accessories,(see,also,Dialysis) E1510 - E1699 |
|
|
Kidney, dialysate delivery syst kidney machine, pump recirculating, air removal syst, flowrate meter, power off, heater and temperature control with alarm, iv poles, pressure gauge, concentrate container E1510
| |
|
Heparin infusion pump for hemodialysis E1520
| |
|
Air bubble detector for hemodialysis, each, replacement E1530
| |
|
Pressure alarm for hemodialysis, each, replacement E1540
| |
|
Bath conductivity meter for hemodialysis, each E1550
| |
|
Blood leak detector for hemodialysis, each, replacement E1560
| |
|
Adjustable chair, for esrd patients E1570
| |
|
Transducer protectorsfluid barriers, for hemodialysis, any size, per 10 E1575
| |
|
Unipuncture control system for hemodialysis E1580
| |
|
Hemodialysis machine E1590
| |
|
Automatic intermittent peritoneal dialysis system E1592
| |
|
Cycler dialysis machine for peritoneal dialysis E1594
| |
|
Delivery andor installation charges for hemodialysis equipment E1600
| |
|
Reverse osmosis water purification system, for hemodialysis E1610
| |
|
Deionizer water purification system, for hemodialysis E1615
| |
|
Blood pump for hemodialysis, replacement E1620
| |
|
Water softening system, for hemodialysis E1625
| |
|
Reciprocating peritoneal dialysis system E1630
| |
|
Wearable artificial kidney, each E1632
| |
|
Peritoneal dialysis clamps, each E1634
| |
|
Compact (portable) travel hemodialyzer system E1635
| |
|
Sorbent cartridges, for hemodialysis, per 10 E1636
| |
|
Hemostats, each E1637
| |
|
Scale, each E1639
| |
|
Dialysis equipment, not otherwise specified E1699
| |
|
larynx, L8500
| |
|
saliva, A9155
| |
|
heart,system,miscellaneous,component,supply,or,accessory L8698
| |
|
Asparaginase, J9019 - J9020 |
|
|
Injection, asparaginase (erwinaze), 1,000 iu J9019
| |
|
Injection, asparaginase, not otherwise specified, 10,000 units J9020
| |
|
audiologic, V5008 - V5020 |
|
|
Hearing screening V5008
| |
|
Assessment for hearing aid V5010
| |
|
Fittingorientationchecking of hearing aid V5011
| |
|
Repairmodification of a hearing aid V5014
| |
|
Conformity evaluation V5020
| |
|
cardiac,output M030 |
|
|
speech, V5362 - V5364 |
|
|
Speech screening V5362
| |
|
Language screening V5363
| |
|
Dysphagia screening V5364
| |
|
Assistive,Listening,Devices,and,accessories V5281 - V5290 |
|
|
Assistive listening device, personal fmdm system, monaural, (1 receiver, transmitter, microphone), any type V5281
| |
|
Assistive listening device, personal fmdm system, binaural, (2 receivers, transmitter, microphone), any type V5282
| |
|
Assistive listening device, personal fmdm neck, loop induction receiver V5283
| |
|
Assistive listening device, personal fmdm, ear level receiver V5284
| |
|
Assistive listening device, personal fmdm, direct audio input receiver V5285
| |
|
Assistive listening device, personal blue tooth fmdm receiver V5286
| |
|
Assistive listening device, personal fmdm receiver, not otherwise specified V5287
| |
|
Assistive listening device, personal fmdm transmitter assistive listening device V5288
| |
|
Assistive listening device, personal fmdm adapterboot coupling device for receiver, any type V5289
| |
|
Assistive listening device, transmitter microphone, any type V5290
| |
|
Astramorph, J227 |
|
|
Atezolizumab, J9022
| |
|
Atropine,inhalation,solution,concentrated J7635
| |
|
Atropine,inhalation,solution,unit,dose J7636
| |
|
Atropine,sulfate J0461
| |
|
Avelumab, J9023
| |
|
Audiologic,assessment V5008 - V5020 |
|
|
Hearing screening V5008
| |
|
Assessment for hearing aid V5010
| |
|
Fittingorientationchecking of hearing aid V5011
| |
|
Repairmodification of a hearing aid V5014
| |
|
Conformity evaluation V5020
| |
|
Auditory,osseointegrated,device L8690 - L8694 |
|
|
Auditory osseointegrated device, includes all internal and external components L8690
| |
|
Auditory osseointegrated device, external sound processor, excludes transduceractuator, replacement only, each L8691
| |
|
Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment L8692
| |
|
Auditory osseointegrated device abutment, any length, replacement only L8693
| |
|
Auditory osseointegrated device, transduceractuator, replacement only, each L8694
| |
|
Aurothioglucose, J2910
| |
|
Azacitidine, J9025
| |
|
Azathioprine J7500, J7501 |
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|
Azithromycin,injection J0456
| |
