Procedure Code |
Description |
Effective Date |
End Date |
A2001 |
Innovamatrix ac, per square centimeter |
01/01/2022 |
Open |
A2002 |
Mirragen advanced wound matrix, per square centimeter |
01/01/2022 |
Open |
A2003 |
Bio-connekt wound matrix, per square centimeter |
01/01/2022 |
01/01/2022 |
A2004 |
Xcellistem, 1 mg |
01/01/2022 |
Open |
A2005 |
Microlyte matrix, per square centimeter |
01/01/2022 |
Open |
A2006 |
Novosorb synpath dermal matrix, per square centimeter |
01/01/2022 |
Open |
A2007 |
Restrata, per square centimeter |
01/01/2022 |
Open |
A2008 |
Theragenesis, per square centimeter |
01/01/2022 |
Open |
A2009 |
Symphony, per square centimeter |
01/01/2022 |
Open |
A2010 |
Apis, per square centimeter |
01/01/2022 |
Open |
A2011 |
Supra sdrm, per square centimeter |
04/01/2022 |
Open |
A2012 |
Suprathel, per square centimeter |
04/01/2022 |
Open |
A2013 |
Innovamatrix fs, per square centimeter |
04/01/2022 |
Open |
A2014 |
Omeza collagen matrix, per 100 mg |
10/01/2022 |
Open |
A2015 |
Phoenix wound matrix, per square centimeter |
10/01/2022 |
Open |
A2016 |
Permeaderm b, per square centimeter |
10/01/2022 |
Open |
A2017 |
Permeaderm glove, each |
10/01/2022 |
Open |
A2018 |
Permeaderm c, per square centimeter |
10/01/2022 |
Open |
A2022 |
Innovaburn or innovamatrix xl, per square centimeter |
10/01/2023 |
Open |
A2023 |
Innovamatrix pd, 1 mg |
10/01/2023 |
Open |
A2024 |
Resolve matrix, per square centimeter |
10/01/2023 |
Open |
A2025 |
Miro3d, per cubic centimeter |
10/01/2023 |
Open |
A4100 |
Skin substitute, fda cleared as a device, not otherwise specified |
04/01/2022 |
Open |
A4206 |
Syringe with needle, sterile, 1 cc or less, each |
01/01/2000 |
Open |
A4207 |
Syringe with needle, sterile 2 cc, each |
01/01/2000 |
Open |
A4208 |
Syringe with needle, sterile 3 cc, each |
01/01/2000 |
Open |
A4209 |
Syringe with needle, sterile 5 cc or greater, each |
01/01/2000 |
Open |
A4210 |
Needle-free injection device, each |
01/01/2000 |
Open |
A4211 |
Supplies for self-administered injections |
01/01/2000 |
Open |
A4212 |
Non-coring needle or stylet with or without catheter |
01/01/2000 |
Open |
A4213 |
Syringe, sterile, 20 cc or greater, each |
01/01/2000 |
Open |
A4215 |
Needle, sterile, any size, each |
01/01/2000 |
Open |
A4217 |
Sterile water/saline, 500 ml |
01/01/2004 |
Open |
A4220 |
Refill kit for implantable infusion pump |
01/01/2000 |
Open |
A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
01/01/2000 |
Open |
A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
01/01/2000 |
Open |
A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
01/01/2005 |
Open |
A4226 |
Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week |
01/01/2020 |
Open |
A4230 |
Infusion set for external insulin pump, non needle cannula type |
01/01/2000 |
Open |
A4231 |
Infusion set for external insulin pump, needle type |
01/01/2000 |
Open |
A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
01/01/2000 |
Open |
A4233 |
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each |
01/01/2006 |
Open |
A4234 |
Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each |
01/01/2006 |
Open |
A4235 |
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each |
01/01/2006 |
Open |
A4236 |
Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each |
01/01/2006 |
Open |
A4244 |
Alcohol or peroxide, per pint |
01/01/2000 |
Open |
A4245 |
Alcohol wipes, per box |
01/01/2000 |
Open |
A4246 |
Betadine or phisohex solution, per pint |
01/01/2000 |
Open |
A4247 |
Betadine or iodine swabs/wipes, per box |
01/01/2000 |
Open |
A4248 |
Chlorhexidine containing antiseptic, 1 ml |
01/01/2004 |
Open |
A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
01/01/2000 |
Open |
A4252 |
Blood ketone test or reagent strip, each |
01/01/2000 |
Open |
A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
01/01/2000 |
Open |
A4255 |
Platforms for home blood glucose monitor, 50 per box |
01/01/2000 |
Open |
A4256 |
Normal, low and high calibrator solution / chips |
01/01/2000 |
Open |
A4257 |
Replacement lens shield cartridge for use with laser skin piercing device, each |
01/01/2002 |
Open |
A4258 |
Spring-powered device for lancet, each |
01/01/2000 |
Open |
A4259 |
Lancets, per box of 100 |
01/01/2000 |
Open |
A4265 |
Paraffin, per pound |
01/01/2000 |
Open |
A4267 |
Contraceptive supply, condom, male, each |
01/01/2003 |
Open |
A4268 |
Contraceptive supply, condom, female, each |
01/01/2003 |
Open |
A4269 |
Contraceptive supply, spermicide (e.g., foam, gel), each |
01/01/2003 |
Open |
A4280 |
Adhesive skin support attachment for use with external breast prosthesis, each |
01/01/2000 |
Open |
A4281 |
Tubing for breast pump, replacement |
01/01/2003 |
Open |
A4282 |
Adapter for breast pump, replacement |
01/01/2003 |
Open |
A4283 |
Cap for breast pump bottle, replacement |
01/01/2003 |
Open |
A4284 |
Breast shield and splash protector for use with breast pump, replacement |
01/01/2003 |
Open |
A4285 |
Polycarbonate bottle for use with breast pump, replacement |
01/01/2003 |
Open |
A4286 |
Locking ring for breast pump, replacement |
01/01/2003 |
Open |
A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
01/01/2000 |
Open |
A4306 |
Disposable drug delivery system, flow rate of less than 50 ml per hour |
01/01/2000 |
Open |
A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
01/01/2000 |
Open |
A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
01/01/2000 |
Open |
A4312 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone |
01/01/2000 |
Open |
A4313 |
Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation |
01/01/2000 |
Open |
A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
01/01/2000 |
Open |
A4315 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone |
01/01/2000 |
Open |
A4316 |
Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation |
01/01/2000 |
Open |
A4319 |
STERILE WATER IRRIGATION SOLUTION, 1000 ML |
01/01/2002 |
12/31/2003 |
A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
01/01/2000 |
Open |
A4321 |
Therapeutic agent for urinary catheter irrigation |
01/01/2000 |
Open |
A4322 |
Irrigation syringe, bulb or piston, each |
01/01/2000 |
Open |
A4324 |
MALE EXTERNAL CATHETER, WITH ADHESIVE COATING, EACH |
01/01/2001 |
12/31/2004 |
A4325 |
MALE EXTERNAL CATHETER, WITH ADHESIVE STRIP, EACH |
01/01/2001 |
12/31/2004 |
A4326 |
Male external catheter with integral collection chamber, any type, each |
01/01/2000 |
Open |
A4327 |
Female external urinary collection device; meatal cup, each |
01/01/2000 |
Open |
A4328 |
Female external urinary collection device; pouch, each |
01/01/2000 |
Open |
A4330 |
Perianal fecal collection pouch with adhesive, each |
01/01/2000 |
Open |
A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
01/01/2001 |
Open |
A4332 |
Lubricant, individual sterile packet, each |
01/01/2005 |
Open |
A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
01/01/2001 |
Open |
A4334 |
Urinary catheter anchoring device, leg strap, each |
01/01/2001 |
Open |
A4335 |
Incontinence supply; miscellaneous |
01/01/2000 |
Open |
A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
01/01/2000 |
Open |
A4340 |
Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each |
01/01/2000 |
Open |
A4341 |
Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each |
04/01/2023 |
Open |
A4342 |
Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each |
04/01/2023 |
Open |
A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
01/01/2000 |
Open |
A4346 |
Indwelling catheter; foley type, three way for continuous irrigation, each |
01/01/2000 |
Open |
A4349 |
Male external catheter, with or without adhesive, disposable, each |
01/01/2000 |
Open |
A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
01/01/2000 |
Open |
A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each |
01/01/2000 |
Open |
A4353 |
Intermittent urinary catheter, with insertion supplies |
01/01/2000 |
Open |
A4354 |
Insertion tray with drainage bag but without catheter |
01/01/2000 |
Open |
A4355 |
Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each |
01/01/2000 |
Open |
A4356 |
External urethral clamp or compression device (not to be used for catheter clamp), each |
01/01/2000 |
Open |
A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
01/01/2000 |
Open |
A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
01/01/2000 |
Open |
A4360 |
Disposable external urethral clamp or compression device, with pad and/or pouch, each |
01/01/2010 |
Open |
A4361 |
Ostomy faceplate, each |
01/01/2000 |
Open |
A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
01/01/2000 |
Open |
A4363 |
Ostomy clamp, any type, replacement only, each |
01/01/2000 |
Open |
A4364 |
Adhesive, liquid or equal, any type, per oz |
01/01/2000 |
Open |
A4365 |
ADHESIVE REMOVER WIPES, ANY TYPE, PER 50 |
01/01/2000 |
12/31/2009 |
A4366 |
Ostomy vent, any type, each |
01/01/2000 |
Open |
A4367 |
Ostomy belt, each |
01/01/2000 |
Open |
A4368 |
Ostomy filter, any type, each |
01/01/2000 |
Open |
A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
01/01/2000 |
Open |
A4371 |
Ostomy skin barrier, powder, per oz |
01/01/2000 |
Open |
A4372 |
Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each |
01/01/2000 |
Open |
A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
01/01/2000 |
Open |
A4375 |
Ostomy pouch, drainable, with faceplate attached, plastic, each |
01/01/2000 |
Open |
A4376 |
Ostomy pouch, drainable, with faceplate attached, rubber, each |
01/01/2000 |
Open |
A4377 |
Ostomy pouch, drainable, for use on faceplate, plastic, each |
01/01/2000 |
Open |
A4378 |
Ostomy pouch, drainable, for use on faceplate, rubber, each |
01/01/2000 |
Open |
A4379 |
Ostomy pouch, urinary, with faceplate attached, plastic, each |
01/01/2000 |
Open |
A4380 |
Ostomy pouch, urinary, with faceplate attached, rubber, each |
01/01/2000 |
Open |
A4381 |
Ostomy pouch, urinary, for use on faceplate, plastic, each |
01/01/2000 |
Open |
A4382 |
Ostomy pouch, urinary, for use on faceplate, heavy plastic, each |
01/01/2000 |
Open |
A4383 |
Ostomy pouch, urinary, for use on faceplate, rubber, each |
01/01/2000 |
Open |
A4384 |
Ostomy faceplate equivalent, silicone ring, each |
01/01/2000 |
Open |
A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
01/01/2000 |
Open |
A4387 |
Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each |
01/01/2000 |
Open |
A4388 |
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each |
01/01/2000 |
Open |
A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
01/01/2000 |
Open |
A4390 |
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each |
01/01/2000 |
Open |
A4391 |
Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each |
01/01/2000 |
Open |
A4392 |
Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each |
01/01/2000 |
Open |
A4393 |
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each |
01/01/2000 |
Open |
A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
01/01/2000 |
Open |
A4395 |
Ostomy deodorant for use in ostomy pouch, solid, per tablet |
01/01/2000 |
Open |
A4396 |
Ostomy belt with peristomal hernia support |
01/01/2001 |
Open |
A4397 |
Irrigation supply; sleeve, each |
01/01/2000 |
12/31/2021 |
A4398 |
Ostomy irrigation supply; bag, each |
01/01/2000 |
Open |
A4399 |
Ostomy irrigation supply; cone/catheter, with or without brush |
01/01/2000 |
Open |
A4400 |
Ostomy irrigation set |
01/01/2000 |
Open |
A4402 |
Lubricant, per ounce |
01/01/2000 |
Open |
A4404 |
Ostomy ring, each |
01/01/2000 |
Open |
A4405 |
Ostomy skin barrier, non-pectin based, paste, per ounce |
01/01/2003 |
Open |
A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
01/01/2003 |
Open |
A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
01/01/2003 |
Open |
A4408 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each |
01/01/2003 |
Open |
A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
01/01/2003 |
Open |
A4410 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each |
01/01/2003 |
Open |
A4412 |
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each |
01/01/2006 |
Open |
A4413 |
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each |
01/01/2003 |
Open |
A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
01/01/2003 |
Open |
A4415 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each |
01/01/2003 |
Open |
A4416 |
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each |
01/01/2004 |
Open |
A4417 |
Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each |
01/01/2004 |
Open |
A4418 |
Ostomy pouch, closed; without barrier attached, with filter (1 piece), each |
01/01/2004 |
Open |
A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
01/01/2004 |
Open |
A4420 |
Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each |
01/01/2004 |
Open |
A4421 |
Ostomy supply; miscellaneous |
01/01/2000 |
Open |
A4422 |
Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each |
01/01/2003 |
Open |
A4423 |
Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each |
01/01/2004 |
Open |
A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
01/01/2004 |
Open |
A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
01/01/2004 |
Open |
A4426 |
Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each |
01/01/2004 |
Open |
A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
01/01/2004 |
Open |
A4428 |
Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each |
01/01/2004 |
Open |
A4429 |
Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each |
01/01/2004 |
Open |
A4431 |
Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each |
01/01/2004 |
Open |
A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
01/01/2004 |
Open |
A4433 |
Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each |
01/01/2004 |
Open |
A4434 |
Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each |
01/01/2004 |
Open |
A4435 |
Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each |
01/01/2013 |
Open |
A4436 |
Irrigation supply; sleeve, reusable, per month |
01/01/2022 |
Open |
A4437 |
Irrigation supply; sleeve, disposable, per month |
01/01/2022 |
Open |
A4450 |
Tape, non-waterproof, per 18 square inches |
01/01/2000 |
Open |
A4452 |
Tape, waterproof, per 18 square inches |
01/01/2003 |
Open |
A4453 |
Rectal catheter for use with the manual pump-operated enema system, replacement only |
10/01/2021 |
Open |
A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
01/01/2000 |
Open |
A4456 |
Adhesive remover, wipes, any type, each |
01/01/2010 |
Open |
A4457 |
Enema tube, with or without adapter, any type, replacement only, each |
01/01/2024 |
Open |
A4458 |
Enema bag with tubing, reusable |
01/01/2003 |
Open |
A4461 |
Surgical dressing holder, non-reusable, each |
01/01/2007 |
Open |
A4463 |
Surgical dressing holder, reusable, each |
01/01/2007 |
Open |
A4464 |
JOINT SUPPORTIVE DEVICE/GARMENT, ELASTIC OR EQUAL, EACH |
01/01/2001 |
12/31/2003 |
A4467 |
Belt, strap, sleeve, garment, or covering, any type |
01/01/2017 |
Open |
A4481 |
Tracheostoma filter, any type, any size, each |
01/01/2000 |
Open |
A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
01/01/2000 |
Open |
A4490 |
Surgical stockings above knee length, each |
01/01/2000 |
Open |
A4495 |
Surgical stockings thigh length, each |
01/01/2000 |
Open |
A4500 |
Surgical stockings below knee length, each |
01/01/2000 |
Open |
A4510 |
Surgical stockings full length, each |
01/01/2000 |
Open |
A4550 |
Surgical trays |
01/01/2000 |
07/31/2012 |
A4555 |
Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only |
01/01/2000 |
Open |
A4556 |
Electrodes, (e.g., apnea monitor), per pair |
01/01/2000 |
Open |
A4557 |
Lead wires, (e.g., apnea monitor), per pair |
01/01/2000 |
Open |
A4558 |
Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz |
01/01/2000 |
Open |
A4561 |
Pessary, reusable, rubber, any type |
01/01/2001 |
Open |
A4562 |
Pessary, reusable, non rubber, any type |
01/01/2001 |
Open |
A4565 |
Slings |
01/01/2000 |
Open |
A4570 |
Splint |
01/01/2000 |
Open |
A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
01/01/2003 |
Open |
A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
01/01/2006 |
Open |
A4605 |
Tracheal suction catheter, closed system, each |
01/01/2005 |
Open |
A4606 |
Oxygen probe for use with oximeter device, replacement |
01/01/2003 |
Open |
A4608 |
Transtracheal oxygen catheter, each |
01/01/2001 |
Open |
A4611 |
Battery, heavy duty; replacement for patient owned ventilator |
01/01/2000 |
Open |
A4612 |
Battery cables; replacement for patient-owned ventilator |
01/01/2000 |
Open |
A4613 |
Battery charger; replacement for patient-owned ventilator |
01/01/2000 |
Open |
A4614 |
Peak expiratory flow rate meter, hand held |
01/01/2000 |
Open |
A4615 |
Cannula, nasal |
01/01/2000 |
Open |
A4616 |
Tubing (oxygen), per foot |
01/01/2000 |
Open |
A4617 |
Mouth piece |
01/01/2000 |
Open |
A4618 |
Breathing circuits |
01/01/2000 |
Open |
A4619 |
Face tent |
01/01/2000 |
Open |
A4620 |
Variable concentration mask |
01/01/2000 |
Open |
A4623 |
Tracheostomy, inner cannula |
01/01/2000 |
Open |
A4624 |
Tracheal suction catheter, any type other than closed system, each |
01/01/2000 |
Open |
A4625 |
Tracheostomy care kit for new tracheostomy |
01/01/2000 |
Open |
A4626 |
Tracheostomy cleaning brush, each |
01/01/2000 |
Open |
A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
01/01/2000 |
Open |
A4628 |
Oral and/or oropharyngeal suction catheter, each |
01/01/2000 |
Open |
A4629 |
Tracheostomy care kit for established tracheostomy |
01/01/2000 |
Open |
A4630 |
Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient |
01/01/1900 |
Open |
A4631 |
REPLACEMENT, BATTERIES FOR MEDICALLY NECESSARY ELECTRONIC WHEEL CHAIR OWNED BY PATIENT |
01/01/1900 |
12/31/2003 |
A4633 |
Replacement bulb/lamp for ultraviolet light therapy system, each |
01/01/2003 |
Open |
A4634 |
Replacement bulb for therapeutic light box, tabletop model |
01/01/2003 |
Open |
A4635 |
Underarm pad, crutch, replacement, each |
01/01/2000 |
Open |
A4636 |
Replacement, handgrip, cane, crutch, or walker, each |
01/01/2000 |
Open |
A4637 |
Replacement, tip, cane, crutch, walker, each. |
01/01/2000 |
Open |
A4638 |
Replacement battery for patient-owned ear pulse generator, each |
01/01/2004 |
Open |
A4639 |
Replacement pad for infrared heating pad system, each |
01/01/2003 |
Open |
A4640 |
Replacement pad for use with medically necessary alternating pressure pad owned by patient |
01/01/2000 |
Open |
A4641 |
Radiopharmaceutical, diagnostic, not otherwise classified |
01/01/2000 |
Open |
A4648 |
Tissue marker, implantable, any type, each |
01/01/2000 |
Open |
A4653 |
Peritoneal dialysis catheter anchoring device, belt, each |
01/01/2003 |
12/31/2022 |
A4657 |
Syringe, with or without needle, each |
01/01/2002 |
Open |
A4660 |
Sphygmomanometer/blood pressure apparatus with cuff and stethoscope |
01/01/1900 |
Open |
A4663 |
Blood pressure cuff only |
01/01/1900 |
Open |
A4670 |
Automatic blood pressure monitor |
01/01/1900 |
Open |
A4671 |
Disposable cycler set used with cycler dialysis machine, each |
01/01/2004 |
Open |
A4672 |
Drainage extension line, sterile, for dialysis, each |
01/01/2004 |
Open |
A4673 |
Extension line with easy lock connectors, used with dialysis |
01/01/2004 |
Open |
A4674 |
Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz |
01/01/2004 |
Open |
A4712 |
WATER, STERILE, FOR INJECTION, PER 10 ML |
01/01/2003 |
12/31/2003 |
A4714 |
Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon |
10/01/2003 |
12/31/2022 |
A4728 |
Dialysate solution, non-dextrose containing, 500 ml |
01/01/2004 |
Open |
A4927 |
Gloves, non-sterile, per 100 |
01/01/1900 |
Open |
A4928 |
Surgical mask, per 20 |
01/01/2002 |
Open |
A4930 |
Gloves, sterile, per pair |
01/01/2003 |
Open |
A5051 |
Ostomy pouch, closed; with barrier attached (1 piece), each |
01/01/2000 |
Open |
A5052 |
Ostomy pouch, closed; without barrier attached (1 piece), each |
01/01/2000 |
Open |
A5053 |
Ostomy pouch, closed; for use on faceplate, each |
01/01/2000 |
Open |
A5054 |
Ostomy pouch, closed; for use on barrier with flange (2 piece), each |
01/01/2000 |
Open |
A5055 |
Stoma cap |
01/01/2000 |
Open |
A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
01/01/2012 |
Open |
A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
01/01/2012 |
Open |
A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
01/01/2000 |
Open |
A5062 |
Ostomy pouch, drainable; without barrier attached (1 piece), each |
01/01/2000 |
Open |
A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
01/01/2000 |
Open |
A5071 |
Ostomy pouch, urinary; with barrier attached (1 piece), each |
01/01/2000 |
Open |
A5072 |
Ostomy pouch, urinary; without barrier attached (1 piece), each |
01/01/2000 |
Open |
A5073 |
Ostomy pouch, urinary; for use on barrier with flange (2 piece), each |
01/01/2000 |
Open |
A5081 |
Stoma plug or seal, any type |
01/01/2000 |
Open |
A5082 |
Continent device; catheter for continent stoma |
01/01/2000 |
Open |
A5093 |
Ostomy accessory; convex insert |
01/01/2000 |
Open |
A5102 |
Bedside drainage bottle with or without tubing, rigid or expandable, each |
01/01/2000 |
Open |
A5105 |
Urinary suspensory with leg bag, with or without tube, each |
01/01/2000 |
Open |
A5112 |
Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each |
01/01/2000 |
Open |
A5113 |
Leg strap; latex, replacement only, per set |
01/01/2000 |
Open |
A5114 |
Leg strap; foam or fabric, replacement only, per set |
01/01/2000 |
Open |
A5120 |
Skin barrier, wipes or swabs, each |
01/01/2006 |
Open |
A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
01/01/2000 |
Open |
A5122 |
Skin barrier; solid, 8 x 8 or equivalent, each |
01/01/2000 |
Open |
A5126 |
Adhesive or non-adhesive; disk or foam pad |
01/01/2000 |
Open |
A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
01/01/2000 |
Open |
A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
01/01/2000 |
Open |
A6000 |
Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card |
01/01/2002 |
Open |
A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
01/01/2002 |
Open |
A6011 |
Collagen based wound filler, gel/paste, per gram of collagen |
01/01/2003 |
Open |
A6020 |
COLLAGEN BASED WOUND DRESSING, EACH DRESSING |
01/01/2000 |
12/31/2000 |
A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
01/01/2001 |
Open |
A6022 |
Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each |
01/01/2001 |
Open |
A6023 |
Collagen dressing, sterile, size more than 48 sq. in., each |
01/01/2001 |
Open |
A6024 |
Collagen dressing wound filler, sterile, per 6 inches |
01/01/2001 |
Open |
A6025 |
Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each |
01/01/2000 |
Open |
A6154 |
Wound pouch, each |
01/01/2000 |
Open |
A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
01/01/2000 |
Open |
A6197 |
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 |
01/01/2000 |
Open |
A6198 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing |
01/01/2000 |
Open |
A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
01/01/2000 |
Open |
A6200 |
COMPOSITE DRESSING, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING |
01/01/2000 |
12/31/2009 |
A6201 |
COMPOSITE DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING |
01/01/2000 |
12/31/2009 |
A6202 |
COMPOSITE DRESSING, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING |
01/01/2000 |
12/31/2009 |
A6203 |
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6204 |
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 |
01/01/2000 |
Open |
A6205 |
Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6206 |
Contact layer, sterile, 16 sq. in. or less, each dressing |
01/01/2000 |
Open |
A6207 |
Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
01/01/2000 |
Open |
A6208 |
Contact layer, sterile, more than 48 sq. in., each dressing |
01/01/2000 |
Open |
A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2000 |
Open |
A6210 |
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 |
01/01/2000 |
Open |
A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6213 |
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 |
01/01/2000 |
Open |
A6214 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6215 |
Foam dressing, wound filler, sterile, per gram |
01/01/2000 |
Open |
A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2000 |
Open |
A6217 |
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 |
01/01/2000 |
Open |
A6218 |
Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6220 |
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 |
01/01/2000 |
Open |
A6221 |
Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2000 |
Open |
A6223 |
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 |
01/01/2000 |
Open |
A6224 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6228 |
Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2000 |
Open |
A6229 |
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 |
01/01/2000 |
Open |
A6230 |
Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6231 |
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing |
01/01/2001 |
Open |
A6232 |
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 |
01/01/2001 |
Open |
A6233 |
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing |
01/01/2001 |
Open |
A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2000 |
Open |
A6235 |
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 |
01/01/2000 |
Open |
A6236 |
Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6237 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6238 |
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 |
01/01/2000 |
Open |
A6239 |
Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
01/01/2000 |
Open |
A6241 |
Hydrocolloid dressing, wound filler, dry form, sterile, per gram |
01/01/2000 |
Open |
A6242 |
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2000 |
Open |
A6243 |
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 |
01/01/2000 |
Open |
A6244 |
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6245 |
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6246 |
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 |
01/01/2000 |
Open |
A6247 |
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
01/01/2000 |
Open |
A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
01/01/2000 |
Open |
A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2000 |
Open |
A6252 |
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 |
01/01/2000 |
Open |
A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6254 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6255 |
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 |
01/01/2000 |
Open |
A6256 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
01/01/2000 |
Open |
A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
01/01/2000 |
Open |
A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
01/01/2000 |
Open |
A6259 |
Transparent film, sterile, more than 48 sq. in., each dressing |
01/01/2000 |
Open |
A6260 |
Wound cleansers, any type, any size |
01/01/2000 |
Open |
A6261 |
Wound filler, gel/paste, per fluid ounce, not otherwise specified |
01/01/2000 |
Open |
A6262 |
Wound filler, dry form, per gram, not otherwise specified |
01/01/2000 |
Open |
A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
01/01/2000 |
Open |
A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2000 |
Open |
A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6404 |
Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
01/01/2000 |
Open |
A6407 |
Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard |
01/01/2004 |
Open |
A6410 |
Eye pad, sterile, each |
01/01/2003 |
Open |
A6411 |
Eye pad, non-sterile, each |
01/01/2003 |
Open |
A6412 |
Eye patch, occlusive, each |
01/01/2003 |
Open |
A6441 |
Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard |
01/01/2004 |
Open |
A6442 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard |
01/01/2004 |
Open |
A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
01/01/2004 |
Open |
A6444 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard |
01/01/2004 |
Open |
A6445 |
Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard |
01/01/2004 |
Open |
A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
01/01/2004 |
Open |
A6447 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard |
01/01/2004 |
Open |
A6448 |
Light compression bandage, elastic, knitted/woven, width less than three inches, per yard |
01/01/2004 |
Open |
A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
01/01/2004 |
Open |
A6450 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard |
01/01/2004 |
Open |
A6451 |
Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard |
01/01/2004 |
Open |
A6452 |
High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard |
01/01/2004 |
Open |
A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
01/01/2004 |
Open |
A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
01/01/2004 |
Open |
A6455 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard |
01/01/2004 |
Open |
A6456 |
Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
01/01/2004 |
Open |
A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
01/01/2006 |
Open |
A6460 |
Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
01/01/2019 |
Open |
A6461 |
Synthetic resorbable wound dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
01/01/2019 |
Open |
A6520 |
Gradient compression garment, glove, padded, for nighttime use, each |
01/01/2024 |
Open |
A6521 |
Gradient compression garment, glove, padded, for nighttime use, custom, each |
01/01/2024 |
Open |
A6522 |
Gradient compression garment, arm, padded, for nighttime use, each |
01/01/2024 |
Open |
A6523 |
Gradient compression garment, arm, padded, for nighttime use, custom, each |
01/01/2024 |
Open |
A6524 |
Gradient compression garment, lower leg and foot, padded, for nighttime use, each |
01/01/2024 |
Open |
A6525 |
Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each |
01/01/2024 |
Open |
A6526 |
Gradient compression garment, full leg and foot, padded, for nighttime use, each |
01/01/2024 |
Open |
A6527 |
Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each |
01/01/2024 |
Open |
A6528 |
Gradient compression garment, bra, for nighttime use, each |
01/01/2024 |
Open |
A6529 |
Gradient compression garment, bra, for nighttime use, custom, each |
01/01/2024 |
Open |
A6552 |
Gradient compression stocking, below knee, 30-40 mmhg, each |
01/01/2024 |
Open |
A6553 |
Gradient compression stocking, below knee, 30-40 mmhg, custom, each |
01/01/2024 |
Open |
A6554 |
Gradient compression stocking, below knee, 40 mmhg or greater, each |
01/01/2024 |
Open |
A6555 |
Gradient compression stocking, below knee, 40 mmhg or greater, custom, each |
01/01/2024 |
Open |
A6556 |
Gradient compression stocking, thigh length, 18-30 mmhg, custom, each |
01/01/2024 |
Open |
A6557 |
Gradient compression stocking, thigh length, 30-40 mmhg, custom, each |
01/01/2024 |
Open |
A6558 |
Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each |
01/01/2024 |
Open |
A6559 |
Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each |
01/01/2024 |
Open |
A6560 |
Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each |
01/01/2024 |
Open |
A6561 |
Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each |
01/01/2024 |
Open |
A6562 |
Gradient compression stocking, waist length, 18-30 mmhg, custom, each |
01/01/2024 |
Open |
A6563 |
Gradient compression stocking, waist length, 30-40 mmhg, custom, each |
01/01/2024 |
Open |
A6564 |
Gradient compression stocking, waist length, 40 mmhg or greater, custom, each |
01/01/2024 |
Open |
A6565 |
Gradient compression gauntlet, custom, each |
01/01/2024 |
Open |
A6566 |
Gradient compression garment, neck/head, each |
01/01/2024 |
Open |
A6567 |
Gradient compression garment, neck/head, custom, each |
01/01/2024 |
Open |
A6568 |
Gradient compression garment, torso and shoulder, each |
01/01/2024 |
Open |
A6569 |
Gradient compression garment, torso/shoulder, custom, each |
01/01/2024 |
Open |
A6570 |
Gradient compression garment, genital region, each |
01/01/2024 |
Open |
A6571 |
Gradient compression garment, genital region, custom, each |
01/01/2024 |
Open |
A6572 |
Gradient compression garment, toe caps, each |
01/01/2024 |
Open |
A6573 |
Gradient compression garment, toe caps, custom, each |
01/01/2024 |
Open |
A6574 |
Gradient compression arm sleeve and glove combination, custom, each |
01/01/2024 |
Open |
A6575 |
Gradient compression arm sleeve and glove combination, each |
01/01/2024 |
Open |
A6576 |
Gradient compression arm sleeve, custom, medium weight, each |
01/01/2024 |
Open |
A6577 |
Gradient compression arm sleeve, custom, heavy weight, each |
01/01/2024 |
Open |
A6578 |
Gradient compression arm sleeve, each |
01/01/2024 |
Open |
A6579 |
Gradient compression glove, custom, medium weight, each |
01/01/2024 |
Open |
A6580 |
Gradient compression glove, custom, heavy weight, each |
01/01/2024 |
Open |
A6581 |
Gradient compression glove, each |
01/01/2024 |
Open |
A6582 |
Gradient compression gauntlet, each |
01/01/2024 |
Open |
A6583 |
Gradient compression wrap with adjustable straps, below knee, 30-50 mmhg, each |
01/01/2024 |
Open |
A6584 |
Gradient compression wrap with adjustable straps, not otherwise specified |
01/01/2024 |
Open |
A6585 |
Gradient pressure wrap with adjustable straps, above knee, each |
01/01/2024 |
Open |
A6586 |
Gradient pressure wrap with adjustable straps, full leg, each |
01/01/2024 |
Open |
A6587 |
Gradient pressure wrap with adjustable straps, foot, each |
01/01/2024 |
Open |
A6588 |
Gradient pressure wrap with adjustable straps, arm, each |
01/01/2024 |
Open |
A6589 |
Gradient pressure wrap with adjustable straps, bra, each |
01/01/2024 |
Open |
A6590 |
External urinary catheters; disposable, with wicking material, for use with suction pump, per month |
04/01/2023 |
Open |
A6591 |
External urinary catheter; non-disposable, for use with suction pump, per month |
04/01/2023 |
Open |
A6593 |
Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified |
01/01/2024 |
Open |
A6594 |
Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each |
01/01/2024 |
Open |
A6595 |
Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each |
01/01/2024 |
Open |
A6596 |
Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each |
01/01/2024 |
Open |
A6597 |
Gradient compression bandage roll, elastic long stretch, linear yard, any width, each |
01/01/2024 |
Open |
A6598 |
Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each |
01/01/2024 |
Open |
A6599 |
Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each |
01/01/2024 |
Open |
A6600 |
Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each |
01/01/2024 |
Open |
A6601 |
Gradient compression bandaging supply, high density foam pad, any size or shape, each |
01/01/2024 |
Open |
A6602 |
Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each |
01/01/2024 |
Open |
A6603 |
Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each |
01/01/2024 |
Open |
A6604 |
Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each |
01/01/2024 |
Open |
A6605 |
Gradient compression bandaging supply, padded foam, per linear yard, any width, each |
01/01/2024 |
Open |
A6606 |
Gradient compression bandaging supply, padded textile, per linear yard, any width, each |
01/01/2024 |
Open |
A6607 |
Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each |
01/01/2024 |
Open |
A6608 |
Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each |
01/01/2024 |
Open |
A6609 |
Gradient compression bandaging supply, not otherwise specified |
01/01/2024 |
Open |
A6610 |
Gradient compression stocking, below knee, 18-30 mmhg, custom, each |
01/01/2024 |
Open |
A7000 |
Canister, disposable, used with suction pump, each |
01/01/2000 |
Open |
A7001 |
Canister, non-disposable, used with suction pump, each |
01/01/2000 |
Open |
A7002 |
Tubing, used with suction pump, each |
01/01/2000 |
Open |
A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
01/01/2000 |
Open |
A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
01/01/2000 |
Open |
A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
01/01/2000 |
Open |
A7006 |
Administration set, with small volume filtered pneumatic nebulizer |
01/01/2000 |
Open |
A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
01/01/2000 |
Open |
A7008 |
Large volume nebulizer, disposable, prefilled, used with aerosol compressor |
01/01/2000 |
Open |
A7009 |
Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer |
01/01/2000 |
Open |
A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
01/01/2000 |
Open |
A7011 |
Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet |
01/01/2000 |
12/31/2015 |
A7012 |
Water collection device, used with large volume nebulizer |
01/01/2000 |
Open |
A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
01/01/2000 |
Open |
A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
01/01/2000 |
Open |
A7015 |
Aerosol mask, used with dme nebulizer |
01/01/2000 |
Open |
A7016 |
Dome and mouthpiece, used with small volume ultrasonic nebulizer |
01/01/2000 |
Open |
A7017 |
Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen |
01/01/2000 |
Open |
A7018 |
Water, distilled, used with large volume nebulizer, 1000 ml |
10/01/2003 |
Open |
A7020 |
Interface for cough stimulating device, includes all components, replacement only |
01/01/2011 |
Open |
A7025 |
High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each |
01/01/2003 |
Open |
A7026 |
High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each |
01/01/2003 |
Open |
A7030 |
Full face mask used with positive airway pressure device, each |
01/01/2003 |
Open |
A7031 |
Face mask interface, replacement for full face mask, each |
01/01/2003 |
Open |
A7032 |
Cushion for use on nasal mask interface, replacement only, each |
01/01/2003 |
Open |
A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
01/01/2003 |
Open |
A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
01/01/2003 |
Open |
A7035 |
Headgear used with positive airway pressure device |
01/01/2003 |
Open |
A7036 |
Chinstrap used with positive airway pressure device |
01/01/2003 |
Open |
A7037 |
Tubing used with positive airway pressure device |
01/01/2003 |
Open |
A7038 |
Filter, disposable, used with positive airway pressure device |
01/01/2003 |
Open |
A7039 |
Filter, non disposable, used with positive airway pressure device |
01/01/2003 |
Open |
A7040 |
One way chest drain valve |
01/01/2005 |
Open |
A7041 |
Water seal drainage container and tubing for use with implanted chest tube |
01/01/2005 |
Open |
A7043 |
Vacuum drainage bottle and tubing for use with implanted catheter |
01/01/2003 |
12/31/2014 |
A7044 |
Oral interface used with positive airway pressure device, each |
01/01/2003 |
Open |
A7045 |
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
01/01/2005 |
Open |
A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
01/01/2004 |
Open |
A7047 |
Oral interface used with respiratory suction pump, each |
01/01/2014 |
Open |
A7501 |
Tracheostoma valve, including diaphragm, each |
01/01/2001 |
Open |
A7502 |
Replacement diaphragm/faceplate for tracheostoma valve, each |
01/01/2001 |
Open |
A7503 |
Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each |
01/01/2001 |
Open |
A7504 |
Filter for use in a tracheostoma heat and moisture exchange system, each |
01/01/2001 |
Open |
A7505 |
Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each |
01/01/2001 |
Open |
A7506 |
Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each |
01/01/2001 |
Open |
A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
01/01/2001 |
Open |
A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
01/01/2001 |
Open |
A7509 |
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each |
01/01/2001 |
Open |
A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
01/01/2004 |
Open |
A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
01/01/2004 |
Open |
A7522 |
Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each |
01/01/2004 |
Open |
A7523 |
Tracheostomy shower protector, each |
01/01/2004 |
Open |
A7524 |
Tracheostoma stent/stud/button, each |
01/01/2004 |
Open |
A7525 |
Tracheostomy mask, each |
01/01/2004 |
Open |
A7526 |
Tracheostomy tube collar/holder, each |
01/01/2004 |
Open |
A7527 |
Tracheostomy/laryngectomy tube plug/stop, each |
01/01/2005 |
Open |
A9273 |
Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type |
01/01/2011 |
Open |
A9286 |
Hygienic item or device, disposable or non-disposable, any type, each |
01/01/2017 |
Open |
B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
01/01/2000 |
Open |
B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
01/01/2000 |
Open |
B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
01/01/2000 |
Open |
B4081 |
Nasogastric tubing with stylet |
01/01/2000 |
Open |
B4082 |
Nasogastric tubing without stylet |
01/01/2000 |
Open |
B4083 |
Stomach tube - levine type |
01/01/2000 |
Open |
B4100 |
Food thickener, administered orally, per ounce |
06/12/2003 |
Open |
B4102 |
Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
01/01/2005 |
Open |
B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
01/01/2005 |
Open |
B4148 |
Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
10/01/2023 |
Open |
B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2005 |
Open |
B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2000 |
Open |
B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2000 |
Open |
B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2000 |
Open |
B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2000 |
Open |
B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2000 |
Open |
B4157 |
Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2005 |
Open |
B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2005 |
Open |
B4159 |
Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2005 |
Open |
B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2005 |
Open |
B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2005 |
Open |
B4162 |
Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
01/01/2005 |
Open |
B4220 |
Parenteral nutrition supply kit; premix, per day |
01/01/2000 |
Open |
B4222 |
Parenteral nutrition supply kit; home mix, per day |
01/01/2000 |
Open |
B4224 |
Parenteral nutrition administration kit, per day |
01/01/2000 |
Open |
B9000 |
Enteral nutrition infusion pump - without alarm |
01/01/2000 |
12/31/2016 |
B9002 |
Enteral nutrition infusion pump, any type |
01/01/2000 |
Open |
B9004 |
Parenteral nutrition infusion pump, portable |
01/01/2000 |
Open |
B9006 |
Parenteral nutrition infusion pump, stationary |
01/01/2000 |
Open |
B9998 |
Noc for enteral supplies |
01/01/2000 |
Open |
B9999 |
Noc for parenteral supplies |
01/01/2000 |
Open |
E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
01/01/2000 |
Open |
E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
01/01/2000 |
Open |
E0110 |
Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips |
01/01/2000 |
Open |
E0111 |
Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips |
01/01/2000 |
Open |
E0112 |
Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips |
01/01/2000 |
Open |
E0113 |
Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip |
01/01/2000 |
Open |
E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
01/01/2000 |
Open |
E0116 |
Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each |
01/01/2000 |
Open |
E0117 |
Crutch, underarm, articulating, spring assisted, each |
01/01/2003 |
Open |
E0130 |
Walker, rigid (pickup), adjustable or fixed height |
01/01/2000 |
Open |
E0135 |
Walker, folding (pickup), adjustable or fixed height |
01/01/2000 |
Open |
E0140 |
Walker, with trunk support, adjustable or fixed height, any type |
01/01/2000 |
Open |
E0141 |
Walker, rigid, wheeled, adjustable or fixed height |
01/01/2000 |
Open |
E0143 |
Walker, folding, wheeled, adjustable or fixed height |
01/01/2000 |
Open |
E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
01/01/2000 |
Open |
E0147 |
Walker, heavy duty, multiple braking system, variable wheel resistance |
01/01/2000 |
Open |
E0148 |
Walker, heavy duty, without wheels, rigid or folding, any type, each |
01/01/2001 |
Open |
E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
01/01/2004 |
Open |
E0153 |
Platform attachment, forearm crutch, each |
01/01/2000 |
Open |
E0154 |
Platform attachment, walker, each |
01/01/2000 |
Open |
E0155 |
Wheel attachment, rigid pick-up walker, per pair |
01/01/2000 |
Open |
E0156 |
Seat attachment, walker |
01/01/2000 |
Open |
E0157 |
Crutch attachment, walker, each |
01/01/2000 |
Open |
E0158 |
Leg extensions for walker, per set of four (4) |
01/01/2000 |
Open |
E0159 |
Brake attachment for wheeled walker, replacement, each |
01/01/1997 |
Open |
E0160 |
Sitz type bath or equipment, portable, used with or without commode |
01/01/2000 |
Open |
E0161 |
Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s |
01/01/2000 |
Open |
E0162 |
Sitz bath chair |
01/01/2000 |
Open |
E0163 |
Commode chair, mobile or stationary, with fixed arms |
01/01/2000 |
Open |
E0165 |
Commode chair, mobile or stationary, with detachable arms |
01/01/2000 |
Open |
E0167 |
Pail or pan for use with commode chair, replacement only |
01/01/2000 |
Open |
E0168 |
Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each |
01/01/2001 |
Open |
E0170 |
Commode chair with integrated seat lift mechanism, electric, any type |
01/01/2006 |
Open |
E0171 |
Commode chair with integrated seat lift mechanism, non-electric, any type |
01/01/2006 |
Open |
E0172 |
Seat lift mechanism placed over or on top of toilet, any type |
01/01/2006 |
Open |
E0175 |
Foot rest, for use with commode chair, each |
01/01/2000 |
Open |
E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
01/01/2000 |
Open |
E0182 |
Pump for alternating pressure pad, for replacement only |
01/01/2000 |
Open |
E0183 |
Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty |
10/01/2022 |
Open |
E0184 |
Dry pressure mattress |
01/01/2000 |
Open |
E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
01/01/2000 |
Open |
E0186 |
Air pressure mattress |
01/01/2000 |
Open |
E0187 |
Water pressure mattress |
01/01/2000 |
Open |
E0188 |
Synthetic sheepskin pad |
01/01/2000 |
Open |
E0189 |
Lambswool sheepskin pad, any size |
01/01/2000 |
Open |
E0191 |
Heel or elbow protector, each |
01/01/2000 |
Open |
E0192 |
LOW PRESSURE AND POSITIONING EQUALIZATION PAD, FOR WHEELCHAIR |
01/01/1900 |
12/31/2004 |
E0193 |
Powered air flotation bed (low air loss therapy) |
01/01/1900 |
Open |
E0196 |
Gel pressure mattress |
01/01/2000 |
Open |
E0197 |
Air pressure pad for mattress, standard mattress length and width |
01/01/2000 |
Open |
E0198 |
Water pressure pad for mattress, standard mattress length and width |
01/01/2000 |
Open |
E0199 |
Dry pressure pad for mattress, standard mattress length and width |
01/01/2000 |
Open |
E0200 |
Heat lamp, without stand (table model), includes bulb, or infrared element |
01/01/2000 |
Open |
E0202 |
Phototherapy (bilirubin) light with photometer |
01/01/2000 |
Open |
E0203 |
Therapeutic lightbox, minimum 10,000 lux, table top model |
01/01/2003 |
Open |
E0205 |
Heat lamp, with stand, includes bulb, or infrared element |
01/01/2000 |
Open |
E0210 |
Electric heat pad, standard |
01/01/2000 |
Open |
E0215 |
Electric heat pad, moist |
01/01/2000 |
Open |
E0217 |
Water circulating heat pad with pump |
01/01/2000 |
Open |
E0218 |
Fluid circulating cold pad with pump, any type |
01/01/2000 |
Open |
E0220 |
HOT WATER BOTTLE |
01/01/2000 |
12/31/2010 |
E0221 |
Infrared heating pad system |
01/01/2002 |
Open |
E0225 |
Hydrocollator unit, includes pads |
01/01/2000 |
Open |
E0230 |
ICE CAP OR COLLAR |
01/01/2000 |
12/31/2010 |
E0231 |
Non-contact wound warming device (temperature control unit, ac adapter and power cord) for use with warming card and wound cover |
01/01/2002 |
Open |
E0232 |
Warming card for use with the non contact wound warming device and non contact wound warming wound cover |
01/01/2002 |
Open |
E0235 |
Paraffin bath unit, portable (see medical supply code a4265 for paraffin) |
01/01/2000 |
Open |
E0236 |
Pump for water circulating pad |
01/01/2000 |
Open |
E0238 |
NON-ELECTRIC HEAT PAD, MOIST |
01/01/2000 |
12/31/2010 |
E0239 |
Hydrocollator unit, portable |
01/01/2000 |
Open |
E0240 |
Bath/shower chair, with or without wheels, any size |
01/01/2004 |
Open |
E0241 |
Bath tub wall rail, each |
01/01/2000 |
Open |
E0242 |
Bath tub rail, floor base |
01/01/2000 |
Open |
E0243 |
Toilet rail, each |
01/01/2000 |
Open |
E0244 |
Raised toilet seat |
01/01/2000 |
Open |
E0245 |
Tub stool or bench |
01/01/2000 |
Open |
E0246 |
Transfer tub rail attachment |
01/01/2000 |
Open |
E0247 |
Transfer bench for tub or toilet with or without commode opening |
01/01/2004 |
Open |
E0248 |
Transfer bench, heavy duty, for tub or toilet with or without commode opening |
01/01/2004 |
Open |
E0249 |
Pad for water circulating heat unit, for replacement only |
01/01/2000 |
Open |
E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
01/01/2000 |
Open |
E0251 |
Hospital bed, fixed height, with any type side rails, without mattress |
01/01/2000 |
Open |
E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
01/01/2000 |
Open |
E0256 |
Hospital bed, variable height, hi-lo, with any type side rails, without mattress |
01/01/2000 |
Open |
E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
01/01/2000 |
Open |
E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
01/01/2000 |
Open |
E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
01/01/2000 |
Open |
E0266 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress |
01/01/2000 |
Open |
E0270 |
Hospital bed, institutional type includes: oscillating, circulating and stryker frame, with mattress |
01/01/2000 |
Open |
E0271 |
Mattress, innerspring |
01/01/2000 |
Open |
E0272 |
Mattress, foam rubber |
01/01/2000 |
Open |
E0273 |
Bed board |
01/01/2000 |
Open |
E0274 |
Over-bed table |
01/01/2000 |
Open |
E0275 |
Bed pan, standard, metal or plastic |
01/01/2000 |
Open |
E0276 |
Bed pan, fracture, metal or plastic |
01/01/2000 |
Open |
E0277 |
Powered pressure-reducing air mattress |
01/01/1900 |
Open |
E0280 |
Bed cradle, any type |
01/01/2000 |
Open |
E0290 |
Hospital bed, fixed height, without side rails, with mattress |
01/01/2000 |
Open |
E0291 |
Hospital bed, fixed height, without side rails, without mattress |
01/01/2000 |
Open |
E0292 |
Hospital bed, variable height, hi-lo, without side rails, with mattress |
01/01/2000 |
Open |
E0293 |
Hospital bed, variable height, hi-lo, without side rails, without mattress |
01/01/2000 |
Open |
E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
01/01/2000 |
Open |
E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
01/01/2000 |
Open |
E0296 |
Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress |
01/01/2000 |
Open |
E0297 |
Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress |
01/01/2000 |
Open |
E0300 |
Pediatric crib, hospital grade, fully enclosed, with or without top enclosure |
01/01/2004 |
Open |
E0301 |
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 |
01/01/2004 |
Open |
E0302 |
Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress |
01/01/2004 |
Open |
E0303 |
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 |
01/01/2004 |
Open |
E0304 |
Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress |
01/01/2004 |
Open |
E0305 |
Bed side rails, half length |
01/01/2000 |
Open |
E0310 |
Bed side rails, full length |
01/01/2000 |
Open |
E0315 |
Bed accessory: board, table, or support device, any type |
01/01/2000 |
Open |
E0316 |
Safety enclosure frame/canopy for use with hospital bed, any type |
01/01/2002 |
Open |
E0325 |
Urinal; male, jug-type, any material |
01/01/2000 |
Open |
E0326 |
Urinal; female, jug-type, any material |
01/01/2000 |
Open |
E0350 |
Control unit for electronic bowel irrigation/evacuation system |
01/01/2000 |
Open |
E0352 |
Disposable pack (water reservoir bag, speculum, valving mechanism and collection bag/box) for use with the electronic bowel irrigation/evacuation system |
01/01/2000 |
Open |
E0370 |
Air pressure elevator for heel |
01/01/2000 |
Open |
E0371 |
Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width |
01/01/2000 |
Open |
E0372 |
Powered air overlay for mattress, standard mattress length and width |
01/01/1998 |
Open |
E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
01/01/2000 |
Open |
E0425 |
Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
01/01/2000 |
Open |
E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
01/01/2000 |
Open |
E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
01/01/2000 |
Open |
E0433 |
Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge |
01/01/2010 |
Open |
E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
01/01/2000 |
Open |
E0435 |
Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor |
01/01/2000 |
Open |
E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
01/01/2000 |
Open |
E0440 |
Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
01/01/2000 |
Open |
E0441 |
Stationary oxygen contents, gaseous, 1 month's supply = 1 unit |
01/01/2000 |
Open |
E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
01/01/2000 |
Open |
E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
01/01/2000 |
Open |
E0444 |
Portable oxygen contents, liquid, 1 month's supply = 1 unit |
01/01/2000 |
Open |
E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
01/01/2003 |
Open |
E0450 |
Volume control ventilator, without pressure support mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube) |
01/01/2000 |
12/31/2015 |
E0453 |
THERAPEUTIC VENTILATOR; SUITABLE FOR USE 12 HOURS OR LESS PER DAY |
01/01/2000 |
01/01/2000 |
E0455 |
Oxygen tent, excluding croup or pediatric tents |
01/01/2000 |
Open |
E0457 |
Chest shell (cuirass) |
01/01/2000 |
Open |
E0459 |
Chest wrap |
01/01/2000 |
Open |
E0460 |
Negative pressure ventilator; portable or stationary |
01/01/2000 |
12/31/2015 |
E0461 |
Volume control ventilator, without pressure support mode, may include pressure control mode, used with non-invasive interface (e.g., mask) |
01/01/2000 |
12/31/2015 |
E0462 |
Rocking bed with or without side rails |
01/01/2000 |
Open |
E0463 |
Pressure support ventilator with volume control mode, may include pressure control mode, used with invasive interface (e.g., tracheostomy tube) |
01/01/2005 |
12/31/2015 |
E0464 |
Pressure support ventilator with volume control mode, may include pressure control mode, used with non-invasive interface (e.g., mask) |
01/01/2005 |
12/31/2015 |
E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
01/01/2004 |
Open |
E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
01/01/2004 |
Open |
E0472 |
Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device) |
01/01/2004 |
Open |
E0480 |
Percussor, electric or pneumatic, home model |
01/01/2000 |
Open |
E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
01/01/2002 |
Open |
E0483 |
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each |
01/01/2003 |
Open |
E0484 |
Oscillatory positive expiratory pressure device, non-electric, any type, each |
01/01/2003 |
Open |
E0485 |
Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment |
01/01/2006 |
Open |
E0486 |
Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment |
01/01/2006 |
Open |
E0500 |
Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source |
01/01/2000 |
Open |
E0550 |
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery |
01/01/2000 |
Open |
E0555 |
Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter |
01/01/2000 |
Open |
E0560 |
Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery |
01/01/2000 |
Open |
E0561 |
Humidifier, non-heated, used with positive airway pressure device |
01/01/2004 |
Open |
E0562 |
Humidifier, heated, used with positive airway pressure device |
01/01/2004 |
Open |
E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
01/01/2000 |
Open |
E0570 |
Nebulizer, with compressor |
01/01/2000 |
Open |
E0571 |
Aerosol compressor, battery powered, for use with small volume nebulizer |
01/01/2001 |
12/31/2011 |
E0572 |
Aerosol compressor, adjustable pressure, light duty for intermittent use |
01/01/2001 |
Open |
E0574 |
Ultrasonic/electronic aerosol generator with small volume nebulizer |
01/01/2003 |
Open |
E0575 |
Nebulizer, ultrasonic, large volume |
01/01/2000 |
Open |
E0580 |
Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter |
01/01/2000 |
Open |
E0585 |
Nebulizer, with compressor and heater |
01/01/2000 |
Open |
E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
01/01/2000 |
Open |
E0601 |
Continuous positive airway pressure (cpap) device |
01/01/2000 |
Open |
E0602 |
Breast pump, manual, any type |
01/01/2000 |
Open |
E0603 |
Breast pump, electric (ac and/or dc), any type |
03/26/2003 |
Open |
E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
01/01/2002 |
Open |
E0605 |
Vaporizer, room type |
01/01/2000 |
Open |
E0606 |
Postural drainage board |
01/01/2000 |
Open |
E0607 |
Home blood glucose monitor |
01/01/2000 |
Open |
E0610 |
Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems) |
01/01/2000 |
Open |
E0615 |
Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems |
01/01/2000 |
Open |
E0618 |
Apnea monitor, without recording feature |
01/01/2003 |
Open |
E0619 |
Apnea monitor, with recording feature |
01/01/2003 |
Open |
E0620 |
Skin piercing device for collection of capillary blood, laser, each |
01/01/2000 |
Open |
E0621 |
Sling or seat, patient lift, canvas or nylon |
01/01/2000 |
Open |
E0625 |
Patient lift, bathroom or toilet, not otherwise classified |
01/01/2000 |
Open |
E0627 |
Seat lift mechanism, electric, any type |
01/01/1900 |
Open |
E0628 |
Separate seat lift mechanism for use with patient owned furniture-electric |
01/01/1900 |
12/31/2016 |
E0629 |
Seat lift mechanism, non-electric, any type |
01/01/1900 |
Open |
E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
01/01/2000 |
Open |
E0635 |
Patient lift, electric with seat or sling |
01/01/2000 |
Open |
E0636 |
Multipositional patient support system, with integrated lift, patient accessible controls |
01/01/2003 |
Open |
E0637 |
Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels |
01/01/2004 |
Open |
E0638 |
Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels |
01/01/2004 |
Open |
E0639 |
Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories |
01/01/2005 |
Open |
E0640 |
Patient lift, fixed system, includes all components/accessories |
01/01/2005 |
Open |
E0641 |
Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels |
01/01/2006 |
Open |
E0650 |
Pneumatic compressor, non-segmental home model |
01/01/2000 |
Open |
E0651 |
Pneumatic compressor, segmental home model without calibrated gradient pressure |
01/01/2000 |
Open |
E0652 |
Pneumatic compressor, segmental home model with calibrated gradient pressure |
01/01/2000 |
Open |
E0655 |
Non-segmental pneumatic appliance for use with pneumatic compressor, half arm |
01/01/2000 |
Open |
E0656 |
Segmental pneumatic appliance for use with pneumatic compressor, trunk |
01/01/2009 |
Open |
E0657 |
Segmental pneumatic appliance for use with pneumatic compressor, chest |
01/01/2009 |
Open |
E0660 |
Non-segmental pneumatic appliance for use with pneumatic compressor, full leg |
01/01/2000 |
Open |
E0665 |
Non-segmental pneumatic appliance for use with pneumatic compressor, full arm |
01/01/2000 |
Open |
E0666 |
Non-segmental pneumatic appliance for use with pneumatic compressor, half leg |
01/01/2000 |
Open |
E0667 |
Segmental pneumatic appliance for use with pneumatic compressor, full leg |
01/01/2000 |
Open |
E0668 |
Segmental pneumatic appliance for use with pneumatic compressor, full arm |
01/01/2000 |
Open |
E0669 |
Segmental pneumatic appliance for use with pneumatic compressor, half leg |
01/01/2000 |
Open |
E0670 |
Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk |
01/01/2013 |
Open |
E0671 |
Segmental gradient pressure pneumatic appliance, full leg |
01/01/2000 |
Open |
E0672 |
Segmental gradient pressure pneumatic appliance, full arm |
01/01/2000 |
Open |
E0673 |
Segmental gradient pressure pneumatic appliance, half leg |
01/01/2000 |
Open |
E0675 |
Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system) |
01/01/2004 |
Open |
E0677 |
Non-pneumatic sequential compression garment, trunk |
04/01/2023 |
Open |
E0678 |
Non-pneumatic sequential compression garment, full leg |
01/01/2024 |
Open |
E0679 |
Non-pneumatic sequential compression garment, half leg |
01/01/2024 |
Open |
E0680 |
Non-pneumatic compression controller with sequential calibrated gradient pressure |
01/01/2024 |
Open |
E0681 |
Non-pneumatic compression controller without calibrated gradient pressure |
01/01/2024 |
Open |
E0682 |
Non-pneumatic sequential compression garment, full arm |
01/01/2024 |
Open |
E0691 |
Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less |
01/01/2003 |
Open |
E0692 |
Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel |
01/01/2003 |
Open |
E0693 |
Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel |
01/01/2003 |
Open |
E0694 |
Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection |
01/01/2003 |
Open |
E0700 |
Safety equipment, device or accessory, any type |
01/01/2000 |
Open |
E0705 |
Transfer device, any type, each |
01/01/2006 |
Open |
E0710 |
Restraints, any type (body, chest, wrist or ankle) |
01/01/2000 |
Open |
E0776 |
Iv pole |
01/01/2000 |
Open |
E0779 |
Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater |
01/01/2000 |
Open |
E0780 |
Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours |
01/01/2000 |
Open |
E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
01/01/2000 |
Open |
E0784 |
External ambulatory infusion pump, insulin |
01/01/2000 |
Open |
E0787 |
External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing |
01/01/2020 |
Open |
E0791 |
Parenteral infusion pump, stationary, single or multi-channel |
01/01/2000 |
Open |
E0830 |
Ambulatory traction device, all types, each |
01/01/2001 |
Open |
E0840 |
Traction frame, attached to headboard, cervical traction |
01/01/2000 |
Open |
E0849 |
Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible |
01/01/2005 |
Open |
E0850 |
Traction stand, free standing, cervical traction |
01/01/2000 |
Open |
E0855 |
Cervical traction equipment not requiring additional stand or frame |
01/01/2000 |
Open |
E0860 |
Traction equipment, overdoor, cervical |
01/01/2000 |
Open |
E0870 |
Traction frame, attached to footboard, extremity traction, (e.g., buck's) |
01/01/2000 |
Open |
E0880 |
Traction stand, free standing, extremity traction |
01/01/2000 |
Open |
E0890 |
Traction frame, attached to footboard, pelvic traction |
01/01/2000 |
Open |
E0900 |
Traction stand, free standing, pelvic traction, (e.g., buck's) |
01/01/2000 |
Open |
E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
01/01/2000 |
Open |
E0920 |
Fracture frame, attached to bed, includes weights |
01/01/2000 |
Open |
E0930 |
Fracture frame, free standing, includes weights |
01/01/2000 |
Open |
E0935 |
Continuous passive motion exercise device for use on knee only |
01/01/2000 |
Open |
E0940 |
Trapeze bar, free standing, complete with grab bar |
01/01/2000 |
Open |
E0941 |
Gravity assisted traction device, any type |
01/01/2000 |
Open |
E0942 |
Cervical head harness/halter |
01/01/2000 |
Open |
E0944 |
Pelvic belt/harness/boot |
01/01/2000 |
Open |
E0945 |
Extremity belt/harness |
01/01/2000 |
Open |
E0946 |
Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster) |
01/01/2000 |
Open |
E0947 |
Fracture frame, attachments for complex pelvic traction |
01/01/2000 |
Open |
E0948 |
Fracture frame, attachments for complex cervical traction |
01/01/2000 |
Open |
E0950 |
Wheelchair accessory, tray, each |
01/01/2000 |
Open |
E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
01/01/1900 |
Open |
E0952 |
Toe loop/holder, any type, each |
01/01/1900 |
Open |
E0953 |
Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each |
01/01/2018 |
Open |
E0954 |
Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot |
01/01/2018 |
Open |
E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
01/01/2004 |
Open |
E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
01/01/2004 |
Open |
E0957 |
Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each |
01/01/2004 |
Open |
E0958 |
Manual wheelchair accessory, one-arm drive attachment, each |
01/01/1900 |
Open |
E0959 |
Manual wheelchair accessory, adapter for amputee, each |
01/01/1900 |
Open |
E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
01/01/2004 |
Open |
E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
01/01/1900 |
Open |
E0962 |
1" CUSHION, FOR WHEELCHAIR |
01/01/1900 |
12/31/2004 |
E0964 |
3" CUSHION, FOR WHEELCHAIR |
01/01/1900 |
12/31/2004 |
E0965 |
4" CUSHION, FOR WHEELCHAIR |
01/01/1900 |
12/31/2004 |
E0966 |
Manual wheelchair accessory, headrest extension, each |
01/01/1900 |
Open |
E0967 |
Manual wheelchair accessory, hand rim with projections, any type, replacement only, each |
01/01/1900 |
Open |
E0968 |
Commode seat, wheelchair |
01/01/2000 |
Open |
E0969 |
Narrowing device, wheelchair |
01/01/1900 |
Open |
E0970 |
No. 2 footplates, except for elevating leg rest |
01/01/1900 |
Open |
E0971 |
Manual wheelchair accessory, anti-tipping device, each |
01/01/1900 |
Open |
E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
01/01/1900 |
Open |
E0974 |
Manual wheelchair accessory, anti-rollback device, each |
01/01/1900 |
Open |
E0975 |
REINFORCED SEAT UPHOLSTERY, WHEELCHAIR |
01/01/1900 |
12/31/2003 |
E0976 |
REINFORCED BACK, WHEELCHAIR, UPHOLSTERY OR OTHER MATERIAL |
01/01/1900 |
12/31/2003 |
E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
01/01/1900 |
Open |
E0979 |
BELT, SAFETY WITH VELCRO CLOSURE, WHEELCHAIR |
01/01/1900 |
Open |
E0980 |
Safety vest, wheelchair |
01/01/2000 |
Open |
E0981 |
Wheelchair accessory, seat upholstery, replacement only, each |
01/01/1900 |
Open |
E0982 |
Wheelchair accessory, back upholstery, replacement only, each |
01/01/2004 |
Open |
E0983 |
Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control |
01/01/2004 |
Open |
E0984 |
Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control |
01/01/2004 |
Open |
E0985 |
Wheelchair accessory, seat lift mechanism |
01/01/2004 |
Open |
E0986 |
Manual wheelchair accessory, push-rim activated power assist system |
01/01/2004 |
Open |
E0988 |
Manual wheelchair accessory, lever-activated, wheel drive, pair |
01/01/2012 |
Open |
E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
01/01/1900 |
Open |
E0991 |
UPHOLSTERY SEAT |
01/01/1900 |
12/31/2003 |
E0992 |
Manual wheelchair accessory, solid seat insert |
01/01/1900 |
Open |
E0993 |
BACK, UPHOLSTERY |
01/01/1900 |
12/31/2003 |
E0994 |
Arm rest, each |
01/01/1900 |
Open |
E0995 |
Wheelchair accessory, calf rest/pad, replacement only, each |
01/01/1900 |
Open |
E1011 |
Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair) |
01/01/2003 |
Open |
E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
08/25/2017 |
Open |
E1014 |
Reclining back, addition to pediatric size wheelchair |
01/01/2003 |
Open |
E1015 |
Shock absorber for manual wheelchair, each |
01/01/2003 |
Open |
E1016 |
Shock absorber for power wheelchair, each |
01/01/2003 |
Open |
E1017 |
Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each |
01/01/2003 |
Open |
E1018 |
Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each |
01/01/2003 |
Open |
E1020 |
Residual limb support system for wheelchair, any type |
01/01/2003 |
Open |
E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory |
01/01/2004 |
Open |
E1029 |
Wheelchair accessory, ventilator tray, fixed |
01/01/2004 |
Open |
E1030 |
Wheelchair accessory, ventilator tray, gimbaled |
01/01/2000 |
Open |
E1031 |
Rollabout chair, any and all types with casters 5" or greater |
01/01/2000 |
Open |
E1035 |
Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs |
01/01/2000 |
Open |
E1036 |
Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs |
01/01/2000 |
Open |
E1037 |
Transport chair, pediatric size |
01/01/2003 |
Open |
E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
01/01/2003 |
Open |
E1039 |
Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds |
01/01/2005 |
Open |
E1130 |
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests |
01/01/2000 |
Open |
E1140 |
Wheelchair, detachable arms, desk or full length, swing away detachable footrests |
01/01/2000 |
Open |
E1150 |
Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests |
01/01/2000 |
Open |
E1160 |
Wheelchair, fixed full length arms, swing away detachable elevating legrests |
01/01/2000 |
Open |
E1225 |
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
09/01/2008 |
Open |
E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
09/01/2008 |
Open |
E1227 |
Special height arms for wheelchair |
09/01/2008 |
Open |
E1228 |
Special back height for wheelchair |
09/01/2008 |
Open |
E1229 |
Wheelchair, pediatric size, not otherwise specified |
01/01/2005 |
Open |
E1231 |
Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system |
01/01/2003 |
Open |
E1232 |
Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system |
01/01/2003 |
Open |
E1233 |
Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system |
01/01/2003 |
Open |
E1234 |
Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system |
01/01/2003 |
Open |
E1235 |
Wheelchair, pediatric size, rigid, adjustable, with seating system |
01/01/2003 |
Open |
E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
01/01/2003 |
Open |
E1237 |
Wheelchair, pediatric size, rigid, adjustable, without seating system |
01/01/2003 |
Open |
E1238 |
Wheelchair, pediatric size, folding, adjustable, without seating system |
01/01/2003 |
Open |
E1239 |
Power wheelchair, pediatric size, not otherwise specified |
01/01/2005 |
08/31/2008 |
E1310 |
Whirlpool, non-portable (built-in type) |
01/01/2000 |
Open |
E1352 |
Oxygen accessory, flow regulator capable of positive inspiratory pressure |
01/01/2000 |
12/31/2013 |
E1352 |
Oxygen accessory, flow regulator capable of positive inspiratory pressure |
08/25/2017 |
Open |
E1353 |
Regulator |
01/01/2000 |
Open |
E1354 |
Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each |
01/01/2000 |
Open |
E1355 |
Stand/rack |
01/01/2000 |
Open |
E1356 |
Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each |
01/01/2000 |
Open |
E1357 |
Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each |
01/01/2009 |
Open |
E1358 |
Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each |
01/01/2009 |
Open |
E1372 |
Immersion external heater for nebulizer |
01/01/2000 |
Open |
E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
01/01/2000 |
Open |
E1391 |
Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each |
01/01/2000 |
Open |
E1392 |
Portable oxygen concentrator, rental |
01/01/2000 |
Open |
E1400 |
OXYGEN CONCENTRATOR, MANUFACTURER SPECIFIED MAXIMUM FLOW RATE DOES NOT EXCEED 2 LITERS PER MINUTE, AT 85 PERCENT OR GREATER CONCENTRATION. |
01/01/2000 |
01/01/2000 |
E1401 |
OXYGEN CONCENTRATOR, MANUFACTURER SPECIFIED MAXIMUM FLOW RATE GREATER THAN 2 LITERS PER MINUTE, DOES NOT EXCEED 3 LITERS PER MINUTE, AT 85 PERCENT OR GREATER CONCENTRATION |
01/01/2000 |
01/01/2000 |
E1402 |
OXYGEN CONCENTRATOR, MANUFACTURER SPECIFIED MAXIMUM FLOW RATE GREATER THAN 3 LITERS PER MINUTE, DOES NOT EXCEED 4 LITERS PER MINUTE, AT 85 PERCENT OR GREATER CONCENTRATION |
01/01/2000 |
01/01/2000 |
E1403 |
OXYGEN CONCENTRATOR, MANUFACTURER SPECIFIED MAXIMUM FLOW RATE GREATER THAN 4 LITERS PER MINUTE, DOES NOT EXCEED 5 LITERS PER MINUTE, AT 85 PERCENT OR GREATER CONCENTRATION |
01/01/2000 |
01/01/2000 |
E1404 |
OXYGEN CONCENTRATOR, MANUFACTURER SPECIFIED MAXIMUM FLOW RATE GREATER THAN 5 LITERS PER MINUTE, AT 85 PERCENT OR GREATER CONCENTRATION |
01/01/2000 |
01/01/2000 |
E1405 |
Oxygen and water vapor enriching system with heated delivery |
01/01/2000 |
Open |
E1406 |
Oxygen and water vapor enriching system without heated delivery |
01/01/2000 |
Open |
E1610 |
Reverse osmosis water purification system, for hemodialysis |
10/01/2003 |
12/31/2022 |
E1615 |
Deionizer water purification system, for hemodialysis |
10/01/2003 |
12/31/2022 |
E1625 |
Water softening system, for hemodialysis |
10/01/2003 |
12/31/2022 |
E1629 |
Tablo hemodialysis system for the billable dialysis service |
01/01/2022 |
12/31/2022 |
E1634 |
Peritoneal dialysis clamps, each |
01/01/2004 |
12/31/2022 |
E1700 |
Jaw motion rehabilitation system |
01/01/2000 |
Open |
E1701 |
Replacement cushions for jaw motion rehabilitation system, pkg. of 6 |
01/01/2000 |
Open |
E1702 |
Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200 |
01/01/2000 |
Open |
E1802 |
Dynamic adjustable forearm pronation/supination device, includes soft interface material |
01/01/2003 |
Open |
E2100 |
Blood glucose monitor with integrated voice synthesizer |
01/01/2002 |
Open |
E2101 |
Blood glucose monitor with integrated lancing/blood sample |
01/01/2002 |
Open |
E2102 |
Adjunctive, non-implanted continuous glucose monitor or receiver |
04/01/2022 |
Open |
E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
01/01/2023 |
Open |
E2202 |
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches |
09/01/2008 |
Open |
E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
09/01/2008 |
Open |
E2204 |
Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches |
09/01/2008 |
Open |
E2205 |
Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each |
01/01/2005 |
Open |
E2206 |
Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each |
09/01/2008 |
Open |
E2209 |
Accessory, arm trough, with or without hand support, each |
01/01/2006 |
Open |
E2210 |
Wheelchair accessory, bearings, any type, replacement only, each |
09/01/2008 |
Open |
E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
01/01/2006 |
Open |
E2212 |
Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each |
09/01/2008 |
Open |
E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
01/01/2006 |
Open |
E2214 |
Manual wheelchair accessory, pneumatic caster tire, any size, each |
01/01/2006 |
Open |
E2215 |
Manual wheelchair accessory, tube for pneumatic caster tire, any size, each |
09/01/2008 |
Open |
E2216 |
Manual wheelchair accessory, foam filled propulsion tire, any size, each |
09/01/2008 |
Open |
E2217 |
Manual wheelchair accessory, foam filled caster tire, any size, each |
09/01/2008 |
Open |
E2218 |
Manual wheelchair accessory, foam propulsion tire, any size, each |
09/01/2008 |
Open |
E2219 |
Manual wheelchair accessory, foam caster tire, any size, each |
01/01/2006 |
Open |
E2220 |
Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each |
01/01/2006 |
Open |
E2221 |
Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each |
09/01/2008 |
Open |
E2222 |
Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
09/01/2008 |
Open |
E2223 |
MANUAL WHEELCHAIR ACCESSORY, VALVE, ANY TYPE, REPLACEMENT ONLY, EACH |
09/01/2008 |
12/31/2009 |
E2224 |
Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each |
01/01/2006 |
Open |
E2225 |
Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
09/01/2008 |
Open |
E2226 |
Manual wheelchair accessory, caster fork, any size, replacement only, each |
09/01/2008 |
Open |
E2228 |
Manual wheelchair accessory, wheel braking system and lock, complete, each |
01/01/2017 |
Open |
E2230 |
Manual wheelchair accessory, manual standing system |
01/01/2009 |
Open |
E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
01/01/2009 |
Open |
E2291 |
Back, planar, for pediatric size wheelchair including fixed attaching hardware |
09/01/2008 |
Open |
E2292 |
Seat, planar, for pediatric size wheelchair including fixed attaching hardware |
09/01/2008 |
Open |
E2293 |
Back, contoured, for pediatric size wheelchair including fixed attaching hardware |
09/01/2008 |
Open |
E2294 |
Seat, contoured, for pediatric size wheelchair including fixed attaching hardware |
09/01/2008 |
Open |
E2295 |
Manual wheelchair accessory, for pediatric size wheelchair, dynamic seating frame, allows coordinated movement of multiple positioning features |
01/01/2009 |
Open |
E2398 |
Wheelchair accessory, dynamic positioning hardware for back |
01/01/2020 |
Open |
E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
01/01/2005 |
Open |
E2602 |
General use wheelchair seat cushion, width 22 inches or greater, any depth |
01/01/2005 |
Open |
E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
09/01/2008 |
Open |
E2604 |
Skin protection wheelchair seat cushion, width 22 inches or greater, any depth |
09/01/2008 |
Open |
E2605 |
Positioning wheelchair seat cushion, width less than 22 inches, any depth |
09/01/2008 |
Open |
E2606 |
Positioning wheelchair seat cushion, width 22 inches or greater, any depth |
09/01/2008 |
Open |
E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
09/01/2008 |
Open |
E2608 |
Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth |
09/01/2008 |
Open |
E2609 |
Custom fabricated wheelchair seat cushion, any size |
09/01/2008 |
05/13/2010 |
E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
01/01/2005 |
Open |
E2612 |
General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware |
01/01/2005 |
Open |
E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
09/01/2008 |
Open |
E2614 |
Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware |
09/01/2008 |
Open |
E2615 |
Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware |
09/01/2008 |
Open |
E2616 |
Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware |
09/01/2008 |
Open |
E2618 |
WHEELCHAIR ACCESSORY, SOLID SEAT SUPPORT BASE (REPLACES SLING SEAT), FOR USE WITH MANUAL WHEELCHAIR OR LIGHTWEIGHT POWER WHEELCHAIR, INCLUDES ANY TYPE MOUNTING HARDWARE |
09/01/2008 |
Open |
E2619 |
Replacement cover for wheelchair seat cushion or back cushion, each |
09/01/2008 |
Open |
E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
09/01/2008 |
Open |
E2621 |
Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware |
09/01/2008 |
Open |
E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
01/01/2011 |
Open |
E2623 |
Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth |
01/01/2011 |
Open |
E2624 |
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
01/01/2011 |
Open |
E2625 |
Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth |
01/01/2011 |
Open |
K0001 |
Standard wheelchair |
11/01/2023 |
Open |
K0009 |
Other manual wheelchair/base |
11/01/2023 |
Open |
K0015 |
Detachable, non-adjustable height armrest, replacement only, each |
01/01/2017 |
Open |
K0017 |
Detachable, adjustable height armrest, base, replacement only, each |
11/01/2023 |
Open |
K0018 |
Detachable, adjustable height armrest, upper portion, replacement only, each |
11/01/2023 |
Open |
K0019 |
Arm pad, replacement only, each |
01/01/2017 |
Open |
K0020 |
Fixed, adjustable height armrest, pair |
11/01/2023 |
Open |
K0037 |
High mount flip-up footrest, each |
01/01/2017 |
Open |
K0038 |
Leg strap, each |
11/01/2023 |
Open |
K0039 |
Leg strap, h style, each |
11/01/2023 |
Open |
K0040 |
Adjustable angle footplate, each |
01/01/2004 |
Open |
K0041 |
Large size footplate, each |
11/01/2023 |
Open |
K0042 |
Standard size footplate, replacement only, each |
01/01/2017 |
Open |
K0043 |
Footrest, lower extension tube, replacement only, each |
01/01/2004 |
Open |
K0044 |
Footrest, upper hanger bracket, replacement only, each |
01/01/2004 |
Open |
K0045 |
Footrest, complete assembly, replacement only, each |
01/01/2004 |
Open |
K0046 |
Elevating legrest, lower extension tube, replacement only, each |
01/01/2017 |
Open |
K0047 |
Elevating legrest, upper hanger bracket, replacement only, each |
01/01/2017 |
Open |
K0050 |
Ratchet assembly, replacement only |
01/01/2017 |
Open |
K0051 |
Cam release assembly, footrest or legrest, replacement only, each |
01/01/2017 |
Open |
K0052 |
Swingaway, detachable footrests, replacement only, each |
01/01/2017 |
Open |
K0053 |
Elevating footrests, articulating (telescoping), each |
11/01/2023 |
Open |
K0056 |
Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair |
11/01/2023 |
Open |
K0065 |
Spoke protectors, each |
11/01/2023 |
Open |
K0069 |
Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each |
01/01/2017 |
Open |
K0070 |
Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each |
11/01/2023 |
Open |
K0071 |
Front caster assembly, complete, with pneumatic tire, replacement only, each |
11/01/2023 |
Open |
K0072 |
Front caster assembly, complete, with semi-pneumatic tire, replacement only, each |
11/01/2023 |
Open |
K0073 |
Caster pin lock, each |
11/01/2023 |
Open |
K0077 |
Front caster assembly, complete, with solid tire, replacement only, each |
01/01/2017 |
Open |
K0105 |
Iv hanger, each |
11/01/2023 |
Open |
K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
11/01/2023 |
Open |
K0268 |
HUMIDIFIER, NON-HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE |
01/01/1900 |
12/31/2003 |
K0407 |
URINARY CATHETER ANCHORING DEVICE, ADHESIVE SKIN ATTACHMENT |
01/01/1996 |
12/31/2000 |
K0408 |
URINARY CATHETER ANCHORING DEVICE, LEG STRAP |
01/01/1996 |
12/31/2000 |
K0409 |
STERILE WATER IRRIGATION SOLUTION, 1000 ML |
01/01/1996 |
12/31/2000 |
K0410 |
MALE EXTERNAL CATHETER, WITH ADHESIVE COATING, EACH |
01/01/1996 |
12/31/2000 |
K0411 |
MALE EXTERNAL CATHETER, WITH ADHESIVE STRIP, EACH |
01/01/1996 |
12/31/2000 |
K0531 |
HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE |
05/19/2000 |
12/31/2003 |
K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
01/01/2004 |
Open |
K0601 |
Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each |
11/11/2005 |
Open |
K0602 |
Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each |
11/11/2005 |
Open |
K0603 |
Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each |
11/11/2005 |
Open |
K0604 |
Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each |
11/11/2005 |
Open |
K0608 |
Replacement garment for use with automated external defibrillator, each |
01/01/2004 |
Open |
K0733 |
Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
07/01/2006 |
Open |
K0734 |
SKIN PROTECTION WHEELCHAIR SEAT CUSHION, ADJUSTABLE, WIDTH LESS THAN 22 INCHES, ANY DEPTH |
07/01/2006 |
12/31/2010 |
K0735 |
SKIN PROTECTION WHEELCHAIR SEAT CUSHION, ADJUSTABLE, WIDTH 22 INCHES OR GREATER, ANY DEPTH |
07/01/2006 |
12/31/2010 |
K0736 |
SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, ADJUSTABLE, WIDTH LESS THAN 22 INCHES, ANY DEPTH |
07/01/2006 |
12/31/2010 |
K0737 |
SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, ADJUSTABLE, WIDTH 22 INCHES OR GREATER, ANY DEPTH |
07/01/2006 |
12/31/2010 |
K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10/01/2006 |
Open |
K0800 |
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0801 |
Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0802 |
Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds |
10/01/2006 |
08/31/2008 |
K0806 |
Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds |
10/01/2006 |
08/31/2008 |
K0807 |
Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds |
10/01/2006 |
08/31/2008 |
K0808 |
Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds |
10/01/2006 |
08/31/2008 |
K0812 |
Power operated vehicle, not otherwise classified |
10/01/2006 |
08/31/2008 |
K0813 |
Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0814 |
Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0815 |
Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0816 |
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0820 |
Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0822 |
Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0824 |
Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0826 |
Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
10/01/2006 |
Open |
K0827 |
Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds |
10/01/2006 |
Open |
K0828 |
Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more |
10/01/2006 |
Open |
K0829 |
Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more |
10/01/2006 |
Open |
K0830 |
Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
08/31/2008 |
K0831 |
Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
08/31/2008 |
K0835 |
Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0836 |
Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0837 |
Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0838 |
Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0839 |
Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
10/01/2006 |
Open |
K0840 |
Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more |
10/01/2006 |
Open |
K0841 |
Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0842 |
Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0843 |
Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0848 |
Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0849 |
Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0850 |
Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0851 |
Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0852 |
Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
10/01/2006 |
Open |
K0853 |
Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds |
10/01/2006 |
Open |
K0854 |
Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more |
10/01/2006 |
Open |
K0855 |
Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more |
10/01/2006 |
Open |
K0856 |
Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0857 |
Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0858 |
Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds |
10/01/2006 |
Open |
K0859 |
Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0860 |
Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
10/01/2006 |
Open |
K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0862 |
Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0863 |
Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
10/01/2006 |
Open |
K0864 |
Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more |
10/01/2006 |
Open |
K0868 |
Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0869 |
Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0870 |
Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0871 |
Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
10/01/2006 |
Open |
K0877 |
Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0878 |
Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0879 |
Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0880 |
Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds |
10/01/2006 |
Open |
K0884 |
Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0885 |
Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds |
10/01/2006 |
Open |
K0886 |
Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
10/01/2006 |
Open |
K0890 |
Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds |
10/01/2006 |
Open |
K0891 |
Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds |
10/01/2006 |
Open |
K0898 |
Power wheelchair, not otherwise classified |
10/01/2006 |
Open |
K0899 |
Power mobility device, not coded by dme pdac or does not meet criteria |
10/01/2006 |
08/31/2008 |
K1024 |
Non-pneumatic compression controller with sequential calibrated gradient pressure |
10/01/2021 |
12/31/2023 |
K1025 |
Non-pneumatic sequential compression garment, full arm |
10/01/2021 |
12/31/2023 |
K1027 |
Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment |
10/01/2021 |
Open |
K1031 |
Non-pneumatic compression controller without calibrated gradient pressure |
04/01/2022 |
12/31/2023 |
K1032 |
Non-pneumatic sequential compression garment, full leg |
04/01/2022 |
12/31/2023 |
K1033 |
Non-pneumatic sequential compression garment, half leg |
04/01/2022 |
12/31/2023 |
S1030 |
Continuous noninvasive glucose monitoring device, purchase (for physician interpretation of data, use cpt code) |
01/01/2002 |
Open |
S1031 |
Continuous noninvasive glucose monitoring device, rental, including sensor, sensor replacement, and download to monitor (for physician interpretation of data, use cpt code) |
01/01/2002 |
Open |
S5165 |
Home modifications; per service |
01/01/2004 |
Open |
S8100 |
Holding chamber or spacer for use with an inhaler or nebulizer; without mask |
01/01/2002 |
Open |
S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
01/01/2002 |
Open |
S8105 |
OXIMETER FOR MEASURING BLOOD OXYGEN LEVELS NONINVASIVELY |
01/01/2001 |
12/31/2002 |
S8120 |
Oxygen contents, gaseous, 1 unit equals 1 cubic foot |
01/01/2004 |
Open |
S8121 |
Oxygen contents, liquid, 1 unit equals 1 pound |
01/01/2004 |
Open |
S8180 |
TRACHEOSTOMY SHOWER PROTECTOR |
01/01/2002 |
12/31/2002 |
S8181 |
TRACHEOSTOMY TUBE HOLDER |
01/01/2002 |
12/31/2002 |
S8182 |
HUMIDIFIER, HEATED, USED WITH VENTILATOR, NON-SERVO-CONTROLLED |
01/01/2002 |
12/31/2002 |
S8183 |
HUMIDIFIER, HEATED, USED WITH VENTILATOR, DUAL SERVO-CONTROLLED WITH TEMPERATURE MONITORING |
01/01/2002 |
12/31/2002 |
S8185 |
Flutter device |
01/01/2002 |
Open |
S8186 |
Swivel adapter |
01/01/2002 |
Open |
S8189 |
Tracheostomy supply, not otherwise classified |
01/01/2002 |
Open |
S8190 |
ELECTRONIC SPIROMETER (OR MICROSPIROMETER) |
01/01/2002 |
03/31/2009 |
S8421 |
Gradient pressure aid (sleeve and glove combination), ready made |
01/01/2002 |
Open |
S8424 |
Gradient pressure aid (sleeve), ready made |
01/01/2002 |
Open |
S8427 |
Gradient pressure aid (glove), ready made |
01/01/2002 |
Open |
S8428 |
Gradient pressure aid (gauntlet), ready made |
01/01/2002 |
Open |
S8429 |
Gradient pressure exterior wrap |
01/01/2002 |
Open |
S8430 |
Padding for compression bandage, roll |
01/01/2002 |
Open |
S8431 |
Compression bandage, roll |
01/01/2002 |
Open |
S8490 |
Insulin syringes (100 syringes, any size) |
01/01/2002 |
Open |
T2029 |
Specialized medical equipment, not otherwise specified, waiver |
01/01/2004 |
Open |
T2039 |
Vehicle modifications, waiver; per service |
01/01/2004 |
Open |
T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
01/01/2005 |
Open |
T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
01/01/2005 |
Open |
T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
01/01/2005 |
Open |
T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
01/01/2005 |
Open |
T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
01/01/2005 |
Open |
T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
01/01/2005 |
Open |
T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
01/01/2005 |
Open |
T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
01/01/2005 |
Open |
T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
01/01/2005 |
Open |
T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
01/01/2005 |
Open |
T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
01/01/2005 |
Open |
T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
01/01/2005 |
Open |
T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
01/01/2005 |
Open |
T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
01/01/2005 |
Open |
T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
01/01/2005 |
Open |
T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
01/01/2005 |
Open |
T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
01/01/2005 |
Open |
T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
01/01/2005 |
Open |
T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
01/01/2005 |
Open |
T4541 |
Incontinence product, disposable underpad, large, each |
01/01/2005 |
Open |
T4542 |
Incontinence product, disposable underpad, small size, each |
01/01/2005 |
Open |
T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
02/01/2008 |
Open |
T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
01/01/2014 |
Open |