|
Magnesium,sulphate J3475
| |
|
Maintenance,contract,ESRD A4890
| |
|
Mannitol J2150, J7665 |
|
|
aerosol, K018 |
|
|
oxygen, A4620
| |
|
bra, L8000
| |
|
form, L8020
| |
|
prosthesis L8030, L8600 |
|
|
sleeve, L8010
| |
|
air,pressure E0186
| |
|
alternating,pressure E0277
| |
|
dry,pressure E0184
| |
|
gel,pressure E0196
| |
|
hospital,bed E0271, E0272 |
|
|
non-powered,pressure,reducing E0373
| |
|
overlay, E0371 - E0372 |
|
|
Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width E0371
| |
|
Powered air overlay for mattress, standard mattress length and width E0372
| |
|
powered,pressure,reducing E0277
| |
|
water,pressure E0187
| |
|
Mecasermin, J2170
| |
|
Mechlorethamine,HCl J9230
| |
|
Medical,and,surgical,supplies A4206 - A8999 |
|
|
Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient A4630
| |
|
Bedside drainage bottle with or without tubing, rigid or expandable, each A5102
| |
|
Tape, non-waterproof, per 18 square inches A4450
| |
|
Radiopharmaceutical, diagnostic, not otherwise classified A4641
| |
|
Syringe with needle, sterile, 1 cc or less, each A4206
| |
|
Ostomy pouch, closed with barrier attached (1 piece), each A5051
| |
|
Gradient compression stocking, below knee, 18-30 mmhg, each A6530
| |
|
Skin barrier, wipes or swabs, each A5120
| |
|
Implantable access catheter, (eg, venous, arterial, epidural subarachnoid, or peritoneal, etc) external access A4300
| |
|
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500
| |
|
Tracheostomylaryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each A7520
| |
|
Canister, disposable, used with suction pump, each A7000
| |
|
External urethral clamp or compression device (not to be used for catheter clamp), each A4356
| |
|
Peritoneal dialysis catheter anchoring device, belt, each A4653
| |
|
Ostomy faceplate, each A4361
| |
|
Insertion tray without drainage bag and without catheter (accessories only) A4310
| |
|
Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card A6000
| |
|
Tissue marker, implantable, any type, each A4648
| |
|
Helmet, protective, soft, prefabricated, includes all components and accessories A8000
| |
|
Battery, heavy duty replacement for patient owned ventilator A4611
| |
|
Skin barrier solid, 6 x 6 or equivalent, each A5121
| |
|
Surgical supply miscellaneous A4649
| |
|
Canister, non-disposable, used with suction pump, each A7001
| |
|
For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe A5501
| |
|
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
| |
|
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc) A4311
| |
|
Collagen based wound filler, dry form, sterile, per gram of collagen A6010
| |
|
Battery cables replacement for patient-owned ventilator A4612
| |
|
Gradient compression stocking, below knee, 30-40 mmhg, each A6531
| |
|
Syringe with needle, sterile 2 cc, each A4207
| |
|
Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries A4642
| |
|
Tape, waterproof, per 18 square inches A4452
| |
|
Ostomy pouch, closed without barrier attached (1 piece), each A5052
| |
|
Skin barrier solid, 4 x 4 or equivalent each A4362
| |
|
Urinary suspensory with leg bag, with or without tube, each A5105
| |
|
Helmet, protective, hard, prefabricated, includes all components and accessories A8001
| |
|
Replacement bulblamp for ultraviolet light therapy system, each A4633
| |
|
Implantable access total catheter, portreservoir (eg, venous, arterial, epidural, subarachnoid, peritoneal, etc) A4301
| |
|
Syringe, with or without needle, each A4657
| |
|
Tracheostomylaryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each A7521
| |
|
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce A4455
| |
|
Ostomy pouch, closed for use on faceplate, each A5053
| |
|
Collagen based wound filler, gelpaste, per gram of collagen A6011
| |
|
Helmet, protective, soft, custom fabricated, includes all components and accessories A8002
| |
|
Sphygmomanometerblood pressure apparatus with cuff and stethoscope A4660
| |
|
Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone A4312
| |
|
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358
| |
|
Ostomy clamp, any type, replacement only, each A4363
| |
|
Syringe with needle, sterile 3 cc, each A4208
| |
|
Battery charger replacement for patient-owned ventilator A4613
| |
|
Disposable drug delivery system, flow rate of 50 ml or greater per hour A4305
| |
|
Skin barrier solid, 8 x 8 or equivalent, each A5122
| |
|
Gradient compression stocking, below knee, 40-50 mmhg, each A6532
| |
|
Implantable radiation dosimeter, each A4650
| |
|
Replacement bulb for therapeutic light box, tabletop model A4634
| |
|
Tracheostomylaryngectomy tube, stainless steel or equal (sterilizable and reusable), each A7522
| |
|
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe A5503
| |
|
Tubing, used with suction pump, each A7002
| |
|
Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each A5112
| |
|
Ostomy pouch, closed for use on barrier with flange (2 piece), each A5054
| |
|
Disposable drug delivery system, flow rate of less than 50 ml per hour A4306
| |
|
Gradient compression stocking, thigh length, 18-30 mmhg, each A6533
| |
|
Collagen dressing, sterile, size 16 sq in or less, each A6021
| |
|
Adhesive remover, wipes, any type, each A4456
| |
|
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
| |
|
Syringe with needle, sterile 5 cc or greater, each A4209
| |
|
Peak expiratory flow rate meter, hand held A4614
| |
|
Adhesive or non-adhesive disk or foam pad A5126
| |
|
Leg strap latex, replacement only, per set A5113
| |
|
Underarm pad, crutch, replacement, each A4635
| |
|
Adhesive, liquid or equal, any type, per oz A4364
| |
|
Calibrated microcapillary tube, each A4651
| |
|
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe A5504
| |
|
Blood pressure cuff only A4663
| |
|
Disposable external urethral clamp or compression device, with pad andor pouch, each A4360
| |
|
Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation A4313
| |
|
Tracheostomy shower protector, each A7523
| |
|
Helmet, protective, hard, custom fabricated, includes all components and accessories A8003
| |
|
Tracheostoma stentstudbutton, each A7524
| |
|
Microcapillary tube sealant A4652
| |
|
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe A5505
| |
|
Replacement, handgrip, cane, crutch, or walker, each A4636
| |
|
Needle-free injection device, each A4210
| |
|
Gradient compression stocking, thigh length, 30-40 mmhg, each A6534
| |
|
Leg strap foam or fabric, replacement only, per set A5114
| |
|
Ostomy vent, any type, each A4366
| |
|
Appliance cleaner, incontinence and ostomy appliances, per 16 oz A5131
| |
|
Enema bag with tubing, reusable A4458
| |
|
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc) A4314
| |
|
Soft interface for helmet, replacement only A8004
| |
|
Stoma cap A5055
| |
|
Automatic blood pressure monitor A4670
| |
|
Small volume nonfiltered pneumatic nebulizer, disposable A7004
| |
|
Cannula, nasal A4615
| |
|
Collagen dressing, sterile, size more than 16 sq in but less than or equal to 48 sq in, each A6022
| |
|
Gradient compression stocking, thigh length, 40-50 mmhg, each A6535
| |
|
Percutaneous cathetertube anchoring device, adhesive skin attachment A5200
| |
|
Replacement, tip, cane, crutch, walker, each A4637
| |
|
Tubing (oxygen), per foot A4616
| |
|
Disposable cycler set used with cycler dialysis machine, each A4671
| |
|
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone A4315
| |
|
Supplies for self-administered injections A4211
| |
|
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each A5056
| |
|
Tracheostomy mask, each A7525
| |
|
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe A5506
| |
|
Ostomy belt, each A4367
| |
|
Manual pump-operated enema system, includes balloon, catheter and all accessories, reusable, any type A4459
| |
|
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005
| |
|
Collagen dressing, sterile, size more than 48 sq in, each A6023
| |
|
For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe A5507
| |
|
Ostomy filter, any type, each A4368
| |
|
Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation A4316
| |
|
Non-coring needle or stylet with or without catheter A4212
| |
|
Replacement battery for patient-owned ear pulse generator, each A4638
| |
|
Surgical dressing holder, non-reusable, each A4461
| |
|
Mouth piece A4617
| |
|
Collagen dressing wound filler, sterile, per 6 inches A6024
| |
|
Drainage extension line, sterile, for dialysis, each A4672
| |
|
Tracheostomy tube collarholder, each A7526
| |
|
Gradient compression stocking, full lengthchap style, 18-30 mmhg, each A6536
| |
|
Administration set, with small volume filtered pneumatic nebulizer A7006
| |
|
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each A5057
| |
|
Breathing circuits A4618
| |
|
Ostomy pouch, drainable with barrier attached, (1 piece), each A5061
| |
|
Gradient compression stocking, full lengthchap style, 30-40 mmhg, each A6537
| |
|
Large volume nebulizer, disposable, unfilled, used with aerosol compressor A7007
| |
|
Surgical dressing holder, reusable, each A4463
| |
|
Syringe, sterile, 20 cc or greater, each A4213
| |
|
Replacement pad for infrared heating pad system, each A4639
| |
|
For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe A5508
| |
|
Ostomy skin barrier, liquid (spray, brush, etc), per oz A4369
| |
|
Gel sheet for dermal or epidermal application, (eg, silicone, hydrogel, other), each A6025
| |
|
Irrigation tray with bulb or piston syringe, any purpose A4320
| |
|
Tracheostomylaryngectomy tube plugstop, each A7527
| |
|
Extension line with easy lock connectors, used with dialysis A4673
| |
|
Chemicalsantiseptics solution used to cleansterilize dialysis equipment, per 8 oz A4674
| |
|
Ostomy skin barrier, powder, per oz A4371
| |
|
Ostomy pouch, drainable without barrier attached (1 piece), each A5062
| |
|
Needle, sterile, any size, each A4215
| |
|
Gradient compression stocking, full lengthchap style, 40-50 mmhg, each A6538
| |
|
Therapeutic agent for urinary catheter irrigation A4321
| |
|
Replacement pad for use with medically necessary alternating pressure pad owned by patient A4640
| |
|
Large volume nebulizer, disposable, prefilled, used with aerosol compressor A7008
| |
|
For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe A5510
| |
|
Face tent A4619
| |
|
Non-elastic binder for extremity A4465
| |
|
Wound pouch, each A6154
| |
|
Ostomy pouch, drainable for use on barrier with flange (2 piece system), each A5063
| |
|
Activated carbon filter for hemodialysis, each A4680
| |
|
Gradient compression stocking, waist length, 18-30 mmhg, each A6539
| |
|
Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer A7009
| |
|
Irrigation syringe, bulb or piston, each A4322
| |
|
Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each A4372
| |
|
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 14 inch material of shore a 35 durometer or 316 inch material of shore a 40 durometer (or higher), prefabricated, each A5512
| |
|
Belt, strap, sleeve, garment, or covering, any type A4467
| |
|
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq in or less, each dressing A6196
| |
|
Variable concentration mask A4620
| |
|
Sterile water, saline andor dextrose, diluentflush, 10 ml A4216
| |
|
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 316 inch material of shore a 35 durometer or higher), includes arch filler and other shaping material, custom fabricated, each A5513
| |
|
Gravlee jet washer A4470
| |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each A4373
| |
|
Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each A4690
| |
|
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet A7010
| |
|
Gradient compression stocking, waist length, 30-40 mmhg, each A6540
| |
|
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
| |
|
Sterile watersaline, 500 ml A4217
| |
|
Male external catheter with integral collection chamber, any type, each A4326
| |
|
Tracheostomy, inner cannula A4623
| |
|
Ostomy pouch, urinary with barrier attached (1 piece), each A5071
| |
|
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq in, each dressing A6198
| |
|
Water collection device, used with large volume nebulizer A7012
| |
|
Ostomy pouch, drainable, with faceplate attached, plastic, each A4375
| |
|
Sterile saline or water, metered dose dispenser, 10 ml A4218
| |
|
Bicarbonate concentrate, solution, for hemodialysis, per gallon A4706
| |
|
Ostomy pouch, urinary without barrier attached (1 piece), each A5072
| |
|
Female external urinary collection device meatal cup, each A4327
| |
|
Tracheal suction catheter, any type other than closed system, each A4624
| |
|
Gradient compression stocking, waist length, 40-50 mmhg, each A6541
| |
|
Vabra aspirator A4480
| |
|
Female external urinary collection device pouch, each A4328
| |
|
Tracheostomy care kit for new tracheostomy A4625
| |
|
Ostomy pouch, drainable, with faceplate attached, rubber, each A4376
| |
|
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches A6199
| |
|
Refill kit for implantable infusion pump A4220
| |
|
Tracheostoma filter, any type, any size, each A4481
| |
|
Filter, disposable, used with aerosol compressor or ultrasonic generator A7013
| |
|
Gradient compression stocking, garter belt A6544
| |
|
Bicarbonate concentrate, powder, for hemodialysis, per packet A4707
| |
|
Ostomy pouch, urinary for use on barrier with flange (2 piece), each A5073
| |
|
Tracheostomy cleaning brush, each A4626
| |
|
Composite dressing, sterile, pad size 16 sq in or less, with any size adhesive border, each dressing A6203
| |
|
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
| |
|
Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each A6545
| |
|
Moisture exchanger, disposable, for use with invasive mechanical ventilation A4483
| |
|
Filter, nondisposable, used with aerosol compressor or ultrasonic generator A7014
| |
|
Perianal fecal collection pouch with adhesive, each A4330
| |
|
Stoma plug or seal, any type A5081
| |
|
Ostomy pouch, drainable, for use on faceplate, plastic, each A4377
| |
|
Acetate concentrate solution, for hemodialysis, per gallon A4708
| |
|
Extension drainage tubing, any type, any length, with connectoradaptor, for use with urinary leg bag or urostomy pouch, each A4331
| |
|
Surgical stockings above knee length, each A4490
| |
|
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
| |
|
Continent device catheter for continent stoma A5082
| |
|
Aerosol mask, used with dme nebulizer A7015
| |
|
Composite dressing, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing A6204
| |
|
Acid concentrate, solution, for hemodialysis, per gallon A4709
| |
|
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler A4627
| |
|
Ostomy pouch, drainable, for use on faceplate, rubber, each A4378
| |
|
Gradient compression stockingsleeve, not otherwise specified A6549
| |
|
Surgical stockings thigh length, each A4495
| |
|
Oropharyngeal suction catheter, each A4628
| |
|
Ostomy pouch, urinary, with faceplate attached, plastic, each A4379
| |
|
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) A4223
| |
|
Continent device, stoma absorptive cover for continent stoma A5083
| |
|
Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon A4714
| |
|
Composite dressing, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing A6205
| |
|
Lubricant, individual sterile packet, each A4332
| |
|
Dome and mouthpiece, used with small volume ultrasonic nebulizer A7016
| |
|
Tracheostomy care kit for established tracheostomy A4629
| |
|
Supplies for maintenance of insulin infusion catheter, per week A4224
| |
|
Ostomy accessory convex insert A5093
| |
|
Urinary catheter anchoring device, adhesive skin attachment, each A4333
| |
|
Ostomy pouch, urinary, with faceplate attached, rubber, each A4380
| |
|
Contact layer, sterile, 16 sq in or less, each dressing A6206
| |
|
Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen A7017
| |
|
y set tubing for peritoneal dialysis A4719
| |
|
Surgical stockings below knee length, each A4500
| |
|
Ostomy pouch, urinary, for use on faceplate, plastic, each A4381
| |
|
Surgical stockings full length, each A4510
| |
|
Urinary catheter anchoring device, leg strap, each A4334
| |
|
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
| |
|
Contact layer, sterile, more than 16 sq in but less than or equal to 48 sq in, each dressing A6207
| |
|
Water, distilled, used with large volume nebulizer, 1000 ml A7018
| |
|
Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis A4720
| |
|
Ostomy pouch, urinary, for use on faceplate, heavy plastic, each A4382
| |
|
Incontinence supply miscellaneous A4335
| |
|
Contact layer, sterile, more than 48 sq in, each dressing A6208
| |
|
Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis A4721
| |
|
Interface for cough stimulating device, includes all components, replacement only A7020
| |
|
Incontinence garment, any type, (eg, brief, diaper), each A4520
| |
|
Infusion set for external insulin pump, non needle cannula type A4230
| |
|
Infusion set for external insulin pump, needle type A4231
| |
|
Incontinence supply, urethral insert, any type, each A4336
| |
|
Foam dressing, wound cover, sterile, pad size 16 sq in or less, without adhesive border, each dressing A6209
| |
|
High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each A7025
| |
|
Surgical trays A4550
| |
|
Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis A4722
| |
|
Ostomy pouch, urinary, for use on faceplate, rubber, each A4383
| |
|
Ostomy faceplate equivalent, silicone ring, each A4384
| |
|
Syringe with needle for external insulin pump, sterile, 3 cc A4232
| |
|
Incontinence supply, rectal insert, any type, each A4337
| |
|
Non-disposable underpads, all sizes A4553
| |
|
Foam 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 A6210
| |
|
Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis A4723
| |
|
High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each A7026
| |
|
Indwelling catheter foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc), each A4338
| |
|
Disposable underpads, all sizes A4554
| |
|
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each A4233
| |
|
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
| |
|
Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis A4724
| |
|
Combination oralnasal mask, used with continuous positive airway pressure device, each A7027
| |
|
Foam dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing A6211
| |
|
Indwelling catheter specialty type, (eg, coude, mushroom, wing, etc), each A4340
| |
|
Foam dressing, wound cover, sterile, pad size 16 sq in or less, with any size adhesive border, each dressing A6212
| |
|
Oral cushion for combination oralnasal mask, replacement only, each A7028
| |
|
Electrodetransducer for use with electrical stimulation device used for cancer treatment, replacement only A4555
| |
|
Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis A4725
| |
|
Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each A4387
| |
|
Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each A4234
| |
|
Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis A4726
| |
|
Electrodes, (eg, apnea monitor), per pair A4556
| |
|
Nasal pillows for combination oralnasal mask, replacement only, pair A7029
| |
|
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each A4388
| |
|
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each A4235
| |
|
Indwelling catheter, foley type, two-way, all silicone, each A4344
| |
|
Foam 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 A6213
| |
|
Foam dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing A6214
| |
|
Full face mask used with positive airway pressure device, each A7030
| |
|
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each A4389
| |
|
Indwelling catheter foley type, three way for continuous irrigation, each A4346
| |
|
Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each A4236
| |
|
Lead wires, (eg, apnea monitor), per pair A4557
| |
|
Dialysate solution, non-dextrose containing, 500 ml A4728
| |
|
Conductive gel or paste, for use with electrical device (eg, tens, nmes), per oz A4558
| |
|
Face mask interface, replacement for full face mask, each A7031
| |
|
Foam dressing, wound filler, sterile, per gram A6215
| |
|
Male external catheter, with or without adhesive, disposable, each A4349
| |
|
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each A4390
| |
|
Alcohol or peroxide, per pint A4244
| |
|
Fistula cannulation set for hemodialysis, each A4730
| |
|
Alcohol wipes, per box A4245
| |
|
Topical anesthetic, for dialysis, per gram A4736
| |
|
Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each A4391
| |
|
Gauze, non-impregnated, non-sterile, pad size 16 sq in or less, without adhesive border, each dressing A6216
| |
|
Cushion for use on nasal mask interface, replacement only, each A7032
| |
|
Intermittent urinary catheter straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc), each A4351
| |
|
Coupling gel or paste, for use with ultrasound device, per oz A4559
| |
|
Pessary, rubber, any type A4561
| |
|
Injectable anesthetic, for dialysis, per 10 ml A4737
| |
|
Pillow for use on nasal cannula type interface, replacement only, pair A7033
| |
|
Betadine or phisohex solution, per pint A4246
| |
|
Intermittent urinary catheter coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc), each A4352
| |
|
Gauze, non-impregnated, non-sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing A6217
| |
|
Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each A4392
| |
|
Shunt accessory, for hemodialysis, any type, each A4740
| |
|
Intermittent urinary catheter, with insertion supplies A4353
| |
|
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
| |
|
Gauze, non-impregnated, non-sterile, pad size more than 48 sq in, without adhesive border, each dressing A6218
| |
|
Pessary, non rubber, any type A4562
| |
|
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each A4393
| |
|
Betadine or iodine swabswipes, per box A4247
| |
|
Chlorhexidine containing antiseptic, 1 ml A4248
| |
|
Slings A4565
| |
|
Gauze, non-impregnated, sterile, pad size 16 sq in or less, with any size adhesive border, each dressing A6219
| |
|
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
| |
|
Headgear used with positive airway pressure device A7035
| |
|
Insertion tray with drainage bag but without catheter A4354
| |
|
Blood tubing, arterial or venous, for hemodialysis, each A4750
| |
|
Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each A4355
| |
|
Gauze, non-impregnated, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, with any size adhesive border, each dressing A6220
| |
|
Chinstrap used with positive airway pressure device A7036
| |
|
Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment A4566
| |
|
Blood tubing, arterial and venous combined, for hemodialysis, each A4755
| |
|
Urine test or reagent strips or tablets (100 tablets or strips) A4250
| |
|
Ostomy deodorant for use in ostomy pouch, solid, per tablet A4395
| |
|
Gauze, non-impregnated, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing A6221
| |
|
Tubing used with positive airway pressure device A7037
| |
|
Ostomy belt with peristomal hernia support A4396
| |
|
Dialysate solution test kit, for peritoneal dialysis, any type, each A4760
| |
|
Blood ketone test or reagent strip, each A4252
| |
|
Splint A4570
| |
|
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
| |
|
Filter, disposable, used with positive airway pressure device A7038
| |
|
Topical hyperbaric oxygen chamber, disposable A4575
| |
|
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq in or less, without adhesive border, each dressing A6222
| |
|
Irrigation supply sleeve, each A4397
| |
|
Dialysate concentrate, powder, additive for peritoneal dialysis, per packet A4765
| |
|
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq in, but less than or equal to 48 sq in, without adhesive border, each dressing A6223
| |
|
Platforms for home blood glucose monitor, 50 per box A4255
| |
|
Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml A4766
| |
|
Filter, non disposable, used with positive airway pressure device A7039
| |
|
Ostomy irrigation supply bag, each A4398
| |
|
Cast supplies (eg, plaster) A4580
| |
|
Ostomy irrigation supply conecatheter, with or without brush A4399
| |
|
One way chest drain valve A7040
| |
|
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq in, without adhesive border, each dressing A6224
| |
|
Normal, low and high calibrator solution chips A4256
| |
|
Special casting material (eg, fiberglass) A4590
| |
|
Blood collection tube, vacuum, for dialysis, per 50 A4770
| |
|
Water seal drainage container and tubing for use with implanted chest tube A7041
| |
|
Serum clotting time tube, for dialysis, per 50 A4771
| |
|
Ostomy irrigation set A4400
| |
|
Replacement lens shield cartridge for use with laser skin piercing device, each A4257
| |
|
Electrical stimulator supplies, 2 lead, per month, (eg, tens, nmes) A4595
| |
|
Gauze, impregnated, water or normal saline, sterile, pad size 16 sq in or less, without adhesive border, each dressing A6228
| |
|
Sleeve for intermittent limb compression device, replacement only, each A4600
| |
|
Oral interface used with positive airway pressure device, each A7044
| |
|
Spring-powered device for lancet, each A4258
| |
|
Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq in but less than or equal to 48 sq in, without adhesive border, each dressing A6229
| |
|
Blood glucose test strips, for dialysis, per 50 A4772
| |
|
Lubricant, per ounce A4402
| |
|
Occult blood test strips, for dialysis, per 50 A4773
| |
|
Ostomy ring, each A4404
| |
|
Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq in, without adhesive border, each dressing A6230
| |
|
Lancets, per box of 100 A4259
| |
|
Lithium ion battery, rechargeable, for non-prosthetic use, replacement A4601
| |
|
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only A7045
| |
|
Replacement battery for external infusion pump owned by patient, lithium, 15 volt, each A4602
| |
|
Ammonia test strips, for dialysis, per 50 A4774
| |
|
Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046
| |
|
Cervical cap for contraceptive use A4261
| |
|
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq in or less, each dressing A6231
| |
|
Ostomy skin barrier, non-pectin based, paste, per ounce A4405
| |
|
Protamine sulfate, for hemodialysis, per 50 mg A4802
| |
|
Ostomy skin barrier, pectin-based, paste, per ounce A4406
| |
|
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq in, but less than or equal to 48 sq in, each dressing A6232
| |
|
Oral interface used with respiratory suction pump, each A7047
| |
|
Tubing with integrated heating element for use with positive airway pressure device A4604
| |
|
Temporary, absorbable lacrimal duct implant, each A4262
| |
|
Disposable catheter tips for peritoneal dialysis, per 10 A4860
| |
|
Permanent, long term, non-dissolvable lacrimal duct implant, each A4263
| |
|
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407
| |
|
Tracheal suction catheter, closed system, each A4605
| |
|
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq in, each dressing A6233
| |
|
Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each A7048
| |
|
Plumbing andor electrical work for home hemodialysis equipment A4870
| |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each A4408
| |
|
Oxygen probe for use with oximeter device, replacement A4606
| |
|
Tracheostoma valve, including diaphragm, each A7501
| |
|
Permanent implantable contraceptive intratubal occlusion device(s) and delivery system A4264
| |
|
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq in or less, without adhesive border, each dressing A6234
| |
|
Replacement diaphragmfaceplate for tracheostoma valve, each A7502
| |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
| |
|
Hydrocolloid 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 A6235
| |
|
Paraffin, per pound A4265
| |
|
Transtracheal oxygen catheter, each A4608
| |
|
Contracts, repair and maintenance, for hemodialysis equipment A4890
| |
|
Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing A6236
| |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each A4410
| |
|
Diaphragm for contraceptive use A4266
| |
|
Drain bagbottle, for dialysis, each A4911
| |
|
Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each A7503
| |
|
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each A4411
| |
|
Filter for use in a tracheostoma heat and moisture exchange system, each A7504
| |
|
Miscellaneous dialysis supplies, not otherwise specified A4913
| |
|
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq in or less, with any size adhesive border, each dressing A6237
| |
|
Contraceptive supply, condom, male, each A4267
| |
|
Hydrocolloid 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 A6238
| |
|
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each A4412
| |
|
Venous pressure clamp, for hemodialysis, each A4918
| |
|
Housing, reusable without adhesive, for use in a heat and moisture exchange system andor with a tracheostoma valve, each A7505
| |
|
Contraceptive supply, condom, female, each A4268
| |
|
Contraceptive supply, spermicide (eg, foam, gel), each A4269
| |
|
Gloves, non-sterile, per 100 A4927
| |
|
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each A4413
| |
|
Adhesive disc for use in a heat and moisture exchange system andor with tracheostoma valve, any type each A7506
| |
|
Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing A6239
| |
|
Hydrocolloid dressing, wound filler, paste, sterile, per ounce A6240
| |
|
Disposable endoscope sheath, each A4270
| |
|
Surgical mask, per 20 A4928
| |
|
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each A7507
| |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each A4414
| |
|
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system andor with a tracheostoma valve, each A7508
| |
|
Adhesive skin support attachment for use with external breast prosthesis, each A4280
| |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each A4415
| |
|
Hydrocolloid dressing, wound filler, dry form, sterile, per gram A6241
| |
|
Tourniquet for dialysis, each A4929
| |
|
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each A7509
| |
|
Hydrogel dressing, wound cover, sterile, pad size 16 sq in or less, without adhesive border, each dressing A6242
| |
|
Gloves, sterile, per pair A4930
| |
|
Tubing for breast pump, replacement A4281
| |
|
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each A4416
| |
|
Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each A4417
| |
|
Oral thermometer, reusable, any type, each A4931
| |
|
Adapter for breast pump, replacement A4282
| |
|
Hydrogel 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 A6243
| |
|
Rectal thermometer, reusable, any type, each A4932
| |
|
Ostomy pouch, closed without barrier attached, with filter (1 piece), each A4418
| |
|
Cap for breast pump bottle, replacement A4283
| |
|
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing A6244
| |
|
Ostomy pouch, closed for use on barrier with non-locking flange, with filter (2 piece), each A4419
| |
|
Hydrogel dressing, wound cover, sterile, pad size 16 sq in or less, with any size adhesive border, each dressing A6245
| |
|
Breast shield and splash protector for use with breast pump, replacement A4284
| |
|
Hydrogel 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 A6246
| |
|
Polycarbonate bottle for use with breast pump, replacement A4285
| |
|
Ostomy pouch, closed for use on barrier with locking flange (2 piece), each A4420
| |
|
Ostomy supply miscellaneous A4421
| |
|
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing A6247
| |
|
Locking ring for breast pump, replacement A4286
| |
|
Hydrogel dressing, wound filler, gel, per fluid ounce A6248
| |
|
Sacral nerve stimulation test lead, each A4290
| |
|
Ostomy absorbent material (sheetpadcrystal packet) for use in ostomy pouch to thicken liquid stomal output, each A4422
| |
|
Skin sealants, protectants, moisturizers, ointments, any type, any size A6250
| |
|
Ostomy pouch, closed for use on barrier with locking flange, with filter (2 piece), each A4423
| |
|
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each A4424
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq in or less, without adhesive border, each dressing A6251
| |
|
Ostomy pouch, drainable for use on barrier with non-locking flange, with filter (2 piece system), each A4425
| |
|
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
| |
|
Ostomy pouch, drainable for use on barrier with locking flange (2 piece system), each A4426
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq in, without adhesive border, each dressing A6253
| |
|
Ostomy pouch, drainable for use on barrier with locking flange, with filter (2 piece system), each A4427
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq in or less, with any size adhesive border, each dressing A6254
| |
|
Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each A4428
| |
|
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
| |
|
Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each A4429
| |
|
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq in, with any size adhesive border, each dressing A6256
| |
|
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each A4430
| |
|
Transparent film, sterile, 16 sq in or less, each dressing A6257
| |
|
Ostomy pouch, urinary with barrier attached, with faucet-type tap with valve (1 piece), each A4431
| |
|
Transparent film, sterile, more than 16 sq in but less than or equal to 48 sq in, each dressing A6258
| |
|
Transparent film, sterile, more than 48 sq in, each dressing A6259
| |
|
Ostomy pouch, urinary for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each A4432
| |
|
Ostomy pouch, urinary for use on barrier with locking flange (2 piece), each A4433
| |
|
Wound cleansers, any type, any size A6260
| |
|
Ostomy pouch, urinary for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each A4434
| |
|
Wound filler, gelpaste, per fluid ounce, not otherwise specified A6261
| |
|
Wound filler, dry form, per gram, not otherwise specified A6262
| |
|
Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each A4435
| |
|
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard A6266
| |
|
Gauze, non-impregnated, sterile, pad size 16 sq in or less, without adhesive border, each dressing A6402
| |
|
Gauze, non-impregnated, sterile, pad size more than 16 sq in less than or equal to 48 sq in, without adhesive border, each dressing A6403
| |
|
Gauze, non-impregnated, sterile, pad size more than 48 sq in, without adhesive border, each dressing A6404
| |
|
Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard A6407
| |
|
Eye pad, sterile, each A6410
| |
|
Eye pad, non-sterile, each A6411
| |
|
Eye patch, occlusive, each A6412
| |
|
Adhesive bandage, first-aid type, any size, each A6413
| |
|
Padding bandage, non-elastic, non-wovennon-knitted, width greater than or equal to three inches and less than five inches, per yard A6441
| |
|
Conforming bandage, non-elastic, knittedwoven, non-sterile, width less than three inches, per yard A6442
| |
|
Conforming bandage, non-elastic, knittedwoven, non-sterile, width greater than or equal to three inches and less than five inches, per yard A6443
| |
|
Conforming bandage, non-elastic, knittedwoven, non-sterile, width greater than or equal to 5 inches, per yard A6444
| |
|
Conforming bandage, non-elastic, knittedwoven, sterile, width less than three inches, per yard A6445
| |
|
Conforming bandage, non-elastic, knittedwoven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446
| |
|
Conforming bandage, non-elastic, knittedwoven, sterile, width greater than or equal to five inches, per yard A6447
| |
|
Light compression bandage, elastic, knittedwoven, width less than three inches, per yard A6448
| |
|
Light compression bandage, elastic, knittedwoven, width greater than or equal to three inches and less than five inches, per yard A6449
| |
|
Light compression bandage, elastic, knittedwoven, width greater than or equal to five inches, per yard A6450
| |
|
Moderate compression bandage, elastic, knittedwoven, load resistance of 125 to 134 foot pounds at 50 maximum stretch, width greater than or equal to three inches and less than five inches, per yard A6451
| |
|
High compression bandage, elastic, knittedwoven, load resistance greater than or equal to 135 foot pounds at 50 maximum stretch, width greater than or equal to three inches and less than five inches, per yard A6452
| |
|
Self-adherent bandage, elastic, non-knittednon-woven, width less than three inches, per yard A6453
| |
|
Self-adherent bandage, elastic, non-knittednon-woven, width greater than or equal to three inches and less than five inches, per yard A6454
| |
|
Self-adherent bandage, elastic, non-knittednon-woven, width greater than or equal to five inches, per yard A6455
| |
|
Zinc paste impregnated bandage, non-elastic, knittedwoven, width greater than or equal to three inches and less than five inches, per yard A6456
| |
|
Tubular dressing with or without elastic, any width, per linear yard A6457
| |
|
Compression burn garment, bodysuit (head to foot), custom fabricated A6501
| |
|
Compression burn garment, chin strap, custom fabricated A6502
| |
|
Compression burn garment, facial hood, custom fabricated A6503
| |
|
Compression burn garment, glove to wrist, custom fabricated A6504
| |
|
Compression burn garment, glove to elbow, custom fabricated A6505
| |
|
Compression burn garment, glove to axilla, custom fabricated A6506
| |
|
Compression burn garment, foot to knee length, custom fabricated A6507
| |
|
Compression burn garment, foot to thigh length, custom fabricated A6508
| |
|
Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated A6509
| |
|
Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated A6510
| |
|
Compression burn garment, lower trunk including leg openings (panty), custom fabricated A6511
| |
|
Compression burn garment, not otherwise classified A6512
| |
|
Compression burn mask, face andor neck, plastic or equal, custom fabricated A6513
| |
|
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories A6550
| |
|
Medroxyprogesterone,acetate J105 |
|
|
Melphalan,HCl J9245
| |
|
Melphalan,oral J8600
| |
|
Methylnaltrexone, J2212
| |
|
Meperidine, J2175
| |
|
Meperidine,and,promethazine J2180
| |
|
Mepivacaine,HCl J0670
| |
|
Mepolizumab, J2182
| |
|
Meropenem, J2185
| |
|
Mesna, J9209
| |
|
Metacarpophalangeal,joint,prosthetic,implant L8630, L8631 |
|
|
Metaproterenol,sulfate,inhalation,solution,concentrated J7667, J7668 |
|
|
Metaproterenol,sulfate,inhalation,solution,unit,dose J7669, J7670 |
|
|
Metaraminol,bitartrate J0380
| |
|
Metatarsal,joint,prosthetic,implant L8641
| |
|
Meter,bath,conductivity,dialysis E1550
| |
|
Methacholine,chloride J7674
| |
|
Methadone,HCl J1230
| |
|
Methocarbamol, J2800
| |
|
Methotrexate,oral J8610
| |
|
Methotrexate,sodium J9250, J9260 |
|
|
Methyldopate,HCl J0210
| |
|
Methylene,blue Q9968
| |
|
acetate, J1020 - J1040 |
|
|
Injection, methylprednisolone acetate, 20 mg J1020
| |
|
Injection, methylprednisolone acetate, 40 mg J1030
| |
|
Injection, methylprednisolone acetate, 80 mg J1040
| |
|
oral, J7509
| |
|
sodium,succinate J2920, J2930 |
|
|
Metoclopramide,HCl J2765
| |
|
Micafungin,sodium J2248
| |
|
Microbiology,test P7001
| |
|
Midazolam,HCl J2250
| |
|
Mileage,ambulance A0380, A0390 |
|
|
Milrinone,lactate J2260
| |
|
Mini-bus,nonemergency,transportation A0120
| |
|
Minocycline,hydrochloride J2265
| |
|
Mitomycin J7315, J9280 |
|
|
Mitoxantrone,HCl J9293
| |
|
Modalities,with,office,visit M0005 - M0008 |
|
|
Moisture,exchanger,for,use,with,invasive,mechanical,ventilation A4483
| |
|
Moisturizer,skin A6250
| |
|
blood,glucose E0607
| |
|
blood,pressure A4670
| |
|
pacemaker E0610, E0615 |
|
|
Monitoring,featuredevice A9279
| |
|
Monoclonal,antibodies J7505
| |
|
Morphine,sulfate J2270
| |
|
epidural,or,intrathecal,use J2274
| |
|
Mouthpiece,(for,respiratory,equipment) A4617
| |
|
Moxifloxacin, J2280
| |
|
Mucoprotein,blood P2038
| |
|
Multiaxial,ankle L5986
| |
|
Multidisciplinary,services H2000 - H2001 , T1023 - T1028 |
|
|
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter T1023
| |
|
Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter T1024
| |
|
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem T1025
| |
|
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, medical and psychosocial impairments, per hour T1026
| |
|
Family training and counseling for child development, per 15 minutes T1027
| |
|
Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs T1028
| |
|
Comprehensive multidisciplinary evaluation H2000
| |
|
Rehabilitation program, per 12 day H2001
| |
|
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter T1023
| |
|
Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter T1024
| |
|
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem T1025
| |
|
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, medical and psychosocial impairments, per hour T1026
| |
|
Family training and counseling for child development, per 15 minutes T1027
| |
|
Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs T1028
| |
|
Multiple,post,collar,cervical L0180 - L0200 |
|
|
Cervical, multiple post collar, occipitalmandibular supports, adjustable L0180
| |
|
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars (somi, guilford, taylor types) L0190
| |
|
Cervical, multiple post collar, occipitalmandibular supports, adjustable cervical bars, and thoracic extension L0200
| |
|
Multi-Podus,type,AFO L4396
| |
|
Muromonab-CD3, J7505
| |
|
Mycophenolate,mofetil J7517
| |
|
Mycophenolic,acid J7518
| |
