List of HCPCS codes for: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental (A-codes) - Group A4



HCPCS Code: A4
Short Description: Dressing for four wounds
Long Description: Dressing for four wounds

HCPCS Code: A4206
Short Description: 1 cc sterile syringe&needle
Long Description: Syringe with needle, sterile, 1 cc or less, each

HCPCS Code: A4207
Short Description: 2 cc sterile syringe&needle
Long Description: Syringe with needle, sterile 2 cc, each

HCPCS Code: A4208
Short Description: 3 cc sterile syringe&needle
Long Description: Syringe with needle, sterile 3 cc, each

HCPCS Code: A4209
Short Description: 5+ cc sterile syringe&needle
Long Description: Syringe with needle, sterile 5 cc or greater, each

HCPCS Code: A4210
Short Description: Nonneedle injection device
Long Description: Needle-free injection device, each

HCPCS Code: A4211
Short Description: Supp for self-adm injections
Long Description: Supplies for self-administered injections

HCPCS Code: A4212
Short Description: Non coring needle or stylet
Long Description: Non-coring needle or stylet with or without catheter

HCPCS Code: A4213
Short Description: 20+ cc syringe only
Long Description: Syringe, sterile, 20 cc or greater, each

HCPCS Code: A4215
Short Description: Sterile needle
Long Description: Needle, sterile, any size, each

HCPCS Code: A4216
Short Description: Sterile water/saline, 10 ml
Long Description: Sterile water, saline and/or dextrose, diluent/flush, 10 ml

HCPCS Code: A4217
Short Description: Sterile water/saline, 500 ml
Long Description: Sterile water/saline, 500 ml

HCPCS Code: A4218
Short Description: Sterile saline or water
Long Description: Sterile saline or water, metered dose dispenser, 10 ml

HCPCS Code: A4220
Short Description: Infusion pump refill kit
Long Description: Refill kit for implantable infusion pump

HCPCS Code: A4221
Short Description: Maint drug infus cath per wk
Long Description: Supplies for maintenance of drug infusion catheter, per week (list drug separately)

HCPCS Code: A4222
Short Description: Infusion supplies with pump
Long Description: Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)

HCPCS Code: A4223
Short Description: Infusion supplies w/o pump
Long Description: Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)

HCPCS Code: A4230
Short Description: Infus insulin pump non needl
Long Description: Infusion set for external insulin pump, non needle cannula type

HCPCS Code: A4231
Short Description: Infusion insulin pump needle
Long Description: Infusion set for external insulin pump, needle type

HCPCS Code: A4232
Short Description: Syringe w/needle insulin 3cc
Long Description: Syringe with needle for external insulin pump, sterile, 3 cc

HCPCS Code: A4233
Short Description: Alkalin batt for glucose mon
Long Description: Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each

HCPCS Code: A4234
Short Description: J-cell batt for glucose mon
Long Description: Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each

HCPCS Code: A4235
Short Description: Lithium batt for glucose mon
Long Description: Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each

HCPCS Code: A4236
Short Description: Silvr oxide batt glucose mon
Long Description: Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each

HCPCS Code: A4244
Short Description: Alcohol or peroxide per pint
Long Description: Alcohol or peroxide, per pint

HCPCS Code: A4245
Short Description: Alcohol wipes per box
Long Description: Alcohol wipes, per box

HCPCS Code: A4246
Short Description: Betadine/phisohex solution
Long Description: Betadine or phisohex solution, per pint

HCPCS Code: A4247
Short Description: Betadine/iodine swabs/wipes
Long Description: Betadine or iodine swabs/wipes, per box

HCPCS Code: A4248
Short Description: Chlorhexidine antisept
Long Description: Chlorhexidine containing antiseptic, 1 ml

HCPCS Code: A4250
Short Description: Urine reagent strips/tablets
Long Description: Urine test or reagent strips or tablets (100 tablets or strips)

HCPCS Code: A4252
Short Description: Blood ketone test or strip
Long Description: Blood ketone test or reagent strip, each

HCPCS Code: A4253
Short Description: Blood glucose/reagent strips
Long Description: Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips

HCPCS Code: A4255
Short Description: Glucose monitor platforms
Long Description: Platforms for home blood glucose monitor, 50 per box

HCPCS Code: A4256
Short Description: Calibrator solution/chips
Long Description: Normal, low and high calibrator solution / chips

HCPCS Code: A4257
Short Description: Replace lensshield cartridge
Long Description: Replacement lens shield cartridge for use with laser skin piercing device, each

HCPCS Code: A4258
Short Description: Lancet device each
Long Description: Spring-powered device for lancet, each

HCPCS Code: A4259
Short Description: Lancets per box
Long Description: Lancets, per box of 100

HCPCS Code: A4261
Short Description: Cervical cap contraceptive
Long Description: Cervical cap for contraceptive use

HCPCS Code: A4262
Short Description: Temporary tear duct plug
Long Description: Temporary, absorbable lacrimal duct implant, each

HCPCS Code: A4263
Short Description: Permanent tear duct plug
Long Description: Permanent, long term, non-dissolvable lacrimal duct implant, each

HCPCS Code: A4264
Short Description: Intratubal occlusion device
Long Description: Permanent implantable contraceptive intratubal occlusion device(s) and delivery system

HCPCS Code: A4265
Short Description: Paraffin
Long Description: Paraffin, per pound

HCPCS Code: A4266
Short Description: Diaphragm
Long Description: Diaphragm for contraceptive use

HCPCS Code: A4267
Short Description: Male condom
Long Description: Contraceptive supply, condom, male, each

HCPCS Code: A4268
Short Description: Female condom
Long Description: Contraceptive supply, condom, female, each

HCPCS Code: A4269
Short Description: Spermicide
Long Description: Contraceptive supply, spermicide (e.g., foam, gel), each

HCPCS Code: A4270
Short Description: Disposable endoscope sheath
Long Description: Disposable endoscope sheath, each

HCPCS Code: A4280
Short Description: Brst prsths adhsv attchmnt
Long Description: Adhesive skin support attachment for use with external breast prosthesis, each

HCPCS Code: A4281
Short Description: Replacement breastpump tube
Long Description: Tubing for breast pump, replacement

HCPCS Code: A4282
Short Description: Replacement breastpump adpt
Long Description: Adapter for breast pump, replacement

HCPCS Code: A4283
Short Description: Replacement breastpump cap
Long Description: Cap for breast pump bottle, replacement

HCPCS Code: A4284
Short Description: Replcmnt breast pump shield
Long Description: Breast shield and splash protector for use with breast pump, replacement

HCPCS Code: A4285
Short Description: Replcmnt breast pump bottle
Long Description: Polycarbonate bottle for use with breast pump, replacement

HCPCS Code: A4286
Short Description: Replcmnt breastpump lok ring
Long Description: Locking ring for breast pump, replacement

HCPCS Code: A4290
Short Description: Sacral nerve stim test lead
Long Description: Sacral nerve stimulation test lead, each

HCPCS Code: A4300
Short Description: Cath impl vasc access portal
Long Description: Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access

HCPCS Code: A4301
Short Description: Implantable access syst perc
Long Description: Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)

HCPCS Code: A4305
Short Description: Drug delivery system >=50 ml
Long Description: Disposable drug delivery system, flow rate of 50 ml or greater per hour

HCPCS Code: A4306
Short Description: Drug delivery system <=50 ml
Long Description: Disposable drug delivery system, flow rate of less than 50 ml per hour

HCPCS Code: A4310
Short Description: Insert tray w/o bag/cath
Long Description: Insertion tray without drainage bag and without catheter (accessories only)

HCPCS Code: A4311
Short Description: Catheter w/o bag 2-way latex
Long Description: Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)

HCPCS Code: A4312
Short Description: Cath w/o bag 2-way silicone
Long Description: Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone

HCPCS Code: A4313
Short Description: Catheter w/bag 3-way
Long Description: Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation

HCPCS Code: A4314
Short Description: Cath w/drainage 2-way latex
Long Description: Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)

HCPCS Code: A4315
Short Description: Cath w/drainage 2-way silcne
Long Description: Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone

HCPCS Code: A4316
Short Description: Cath w/drainage 3-way
Long Description: Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation

HCPCS Code: A4320
Short Description: Irrigation tray
Long Description: Irrigation tray with bulb or piston syringe, any purpose

HCPCS Code: A4321
Short Description: Cath therapeutic irrig agent
Long Description: Therapeutic agent for urinary catheter irrigation

HCPCS Code: A4322
Short Description: Irrigation syringe
Long Description: Irrigation syringe, bulb or piston, each

HCPCS Code: A4326
Short Description: Male external catheter
Long Description: Male external catheter with integral collection chamber, any type, each

HCPCS Code: A4327
Short Description: Fem urinary collect dev cup
Long Description: Female external urinary collection device; meatal cup, each

HCPCS Code: A4328
Short Description: Fem urinary collect pouch
Long Description: Female external urinary collection device; pouch, each

HCPCS Code: A4330
Short Description: Stool collection pouch
Long Description: Perianal fecal collection pouch with adhesive, each

HCPCS Code: A4331
Short Description: Extension drainage tubing
Long Description: Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each

HCPCS Code: A4332
Short Description: Lube sterile packet
Long Description: Lubricant, individual sterile packet, each

HCPCS Code: A4333
Short Description: Urinary cath anchor device
Long Description: Urinary catheter anchoring device, adhesive skin attachment, each

HCPCS Code: A4334
Short Description: Urinary cath leg strap
Long Description: Urinary catheter anchoring device, leg strap, each

HCPCS Code: A4335
Short Description: Incontinence supply
Long Description: Incontinence supply; miscellaneous

HCPCS Code: A4336
Short Description: Urethral insert
Long Description: Incontinence supply, urethral insert, any type, each

HCPCS Code: A4337
Short Description: Incontinent rectal insert
Long Description: Incontinence supply, rectal insert, any type, each

HCPCS Code: A4338
Short Description: Indwelling catheter latex
Long Description: Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each

HCPCS Code: A4340
Short Description: Indwelling catheter special
Long Description: Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each

HCPCS Code: A4344
Short Description: Cath indw foley 2 way silicn
Long Description: Indwelling catheter, foley type, two-way, all silicone, each

HCPCS Code: A4346
Short Description: Cath indw foley 3 way
Long Description: Indwelling catheter; foley type, three way for continuous irrigation, each

HCPCS Code: A4349
Short Description: Disposable male external cat
Long Description: Male external catheter, with or without adhesive, disposable, each

HCPCS Code: A4351
Short Description: Straight tip urine catheter
Long Description: Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each

HCPCS Code: A4352
Short Description: Coude tip urinary catheter
Long Description: Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each

HCPCS Code: A4353
Short Description: Intermittent urinary cath
Long Description: Intermittent urinary catheter, with insertion supplies

HCPCS Code: A4354
Short Description: Cath insertion tray w/bag
Long Description: Insertion tray with drainage bag but without catheter

HCPCS Code: A4355
Short Description: Bladder irrigation tubing
Long Description: Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each

HCPCS Code: A4356
Short Description: Ext ureth clmp or compr dvc
Long Description: External urethral clamp or compression device (not to be used for catheter clamp), each

HCPCS Code: A4357
Short Description: Bedside drainage bag
Long Description: Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each

HCPCS Code: A4358
Short Description: Urinary leg or abdomen bag
Long Description: Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each

HCPCS Code: A4360
Short Description: Disposable ext urethral dev
Long Description: Disposable external urethral clamp or compression device, with pad and/or pouch, each

HCPCS Code: A4361
Short Description: Ostomy face plate
Long Description: Ostomy faceplate, each

HCPCS Code: A4362
Short Description: Solid skin barrier
Long Description: Skin barrier; solid, 4 x 4 or equivalent; each

HCPCS Code: A4363
Short Description: Ostomy clamp, replacement
Long Description: Ostomy clamp, any type, replacement only, each

HCPCS Code: A4364
Short Description: Adhesive, liquid or equal
Long Description: Adhesive, liquid or equal, any type, per oz

HCPCS Code: A4366
Short Description: Ostomy vent
Long Description: Ostomy vent, any type, each

HCPCS Code: A4367
Short Description: Ostomy belt
Long Description: Ostomy belt, each

HCPCS Code: A4368
Short Description: Ostomy filter
Long Description: Ostomy filter, any type, each

HCPCS Code: A4369
Short Description: Skin barrier liquid per oz
Long Description: Ostomy skin barrier, liquid (spray, brush, etc.), per oz

HCPCS Code: A4371
Short Description: Skin barrier powder per oz
Long Description: Ostomy skin barrier, powder, per oz

HCPCS Code: A4372
Short Description: Skin barrier solid 4x4 equiv
Long Description: Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each

HCPCS Code: A4373
Short Description: Skin barrier with flange
Long Description: Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each

HCPCS Code: A4375
Short Description: Drainable plastic pch w fcpl
Long Description: Ostomy pouch, drainable, with faceplate attached, plastic, each

HCPCS Code: A4376
Short Description: Drainable rubber pch w fcplt
Long Description: Ostomy pouch, drainable, with faceplate attached, rubber, each

HCPCS Code: A4377
Short Description: Drainable plstic pch w/o fp
Long Description: Ostomy pouch, drainable, for use on faceplate, plastic, each

HCPCS Code: A4378
Short Description: Drainable rubber pch w/o fp
Long Description: Ostomy pouch, drainable, for use on faceplate, rubber, each

HCPCS Code: A4379
Short Description: Urinary plastic pouch w fcpl
Long Description: Ostomy pouch, urinary, with faceplate attached, plastic, each

HCPCS Code: A4380
Short Description: Urinary rubber pouch w fcplt
Long Description: Ostomy pouch, urinary, with faceplate attached, rubber, each

HCPCS Code: A4381
Short Description: Urinary plastic pouch w/o fp
Long Description: Ostomy pouch, urinary, for use on faceplate, plastic, each

HCPCS Code: A4382
Short Description: Urinary hvy plstc pch w/o fp
Long Description: Ostomy pouch, urinary, for use on faceplate, heavy plastic, each

HCPCS Code: A4383
Short Description: Urinary rubber pouch w/o fp
Long Description: Ostomy pouch, urinary, for use on faceplate, rubber, each

HCPCS Code: A4384
Short Description: Ostomy faceplt/silicone ring
Long Description: Ostomy faceplate equivalent, silicone ring, each

HCPCS Code: A4385
Short Description: Ost skn barrier sld ext wear
Long Description: Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each

HCPCS Code: A4387
Short Description: Ost clsd pouch w att st barr
Long Description: Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each

HCPCS Code: A4388
Short Description: Drainable pch w ex wear barr
Long Description: Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each

HCPCS Code: A4389
Short Description: Drainable pch w st wear barr
Long Description: Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each

HCPCS Code: A4390
Short Description: Drainable pch ex wear convex
Long Description: Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each

HCPCS Code: A4391
Short Description: Urinary pouch w ex wear barr
Long Description: Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each

HCPCS Code: A4392
Short Description: Urinary pouch w st wear barr
Long Description: Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each

HCPCS Code: A4393
Short Description: Urine pch w ex wear bar conv
Long Description: Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each

HCPCS Code: A4394
Short Description: Ostomy pouch liq deodorant
Long Description: Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce

HCPCS Code: A4395
Short Description: Ostomy pouch solid deodorant
Long Description: Ostomy deodorant for use in ostomy pouch, solid, per tablet

HCPCS Code: A4396
Short Description: Peristomal hernia supprt blt
Long Description: Ostomy belt with peristomal hernia support

HCPCS Code: A4397
Short Description: Irrigation supply sleeve
Long Description: Irrigation supply; sleeve, each

HCPCS Code: A4398
Short Description: Ostomy irrigation bag
Long Description: Ostomy irrigation supply; bag, each

HCPCS Code: A4399
Short Description: Ostomy irrig cone/cath w brs
Long Description: Ostomy irrigation supply; cone/catheter, with or without brush

HCPCS Code: A4400
Short Description: Ostomy irrigation set
Long Description: Ostomy irrigation set

HCPCS Code: A4402
Short Description: Lubricant per ounce
Long Description: Lubricant, per ounce

HCPCS Code: A4404
Short Description: Ostomy ring each
Long Description: Ostomy ring, each

HCPCS Code: A4405
Short Description: Nonpectin based ostomy paste
Long Description: Ostomy skin barrier, non-pectin based, paste, per ounce

HCPCS Code: A4406
Short Description: Pectin based ostomy paste
Long Description: Ostomy skin barrier, pectin-based, paste, per ounce

HCPCS Code: A4407
Short Description: Ext wear ost skn barr <=4sq"
Long Description: Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each

HCPCS Code: A4408
Short Description: Ext wear ost skn barr >4sq"
Long Description: Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each

HCPCS Code: A4409
Short Description: Ost skn barr convex <=4 sq i
Long Description: Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each

HCPCS Code: A4410
Short Description: Ost skn barr extnd >4 sq
Long Description: Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each

HCPCS Code: A4411
Short Description: Ost skn barr extnd =4sq
Long Description: Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each

HCPCS Code: A4412
Short Description: Ost pouch drain high output
Long Description: Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each

HCPCS Code: A4413
Short Description: 2 pc drainable ost pouch
Long Description: Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each

HCPCS Code: A4414
Short Description: Ost sknbar w/o conv<=4 sq in
Long Description: Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each

HCPCS Code: A4415
Short Description: Ost skn barr w/o conv >4 sqi
Long Description: Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each

HCPCS Code: A4416
Short Description: Ost pch clsd w barrier/filtr
Long Description: Ostomy pouch, closed, with barrier attached, with filter (1 piece), each

HCPCS Code: A4417
Short Description: Ost pch w bar/bltinconv/fltr
Long Description: Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each

HCPCS Code: A4418
Short Description: Ost pch clsd w/o bar w filtr
Long Description: Ostomy pouch, closed; without barrier attached, with filter (1 piece), each

HCPCS Code: A4419
Short Description: Ost pch for bar w flange/flt
Long Description: Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each

HCPCS Code: A4420
Short Description: Ost pch clsd for bar w lk fl
Long Description: Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each

HCPCS Code: A4421
Short Description: Ostomy supply misc
Long Description: Ostomy supply; miscellaneous

HCPCS Code: A4422
Short Description: Ost pouch absorbent material
Long Description: Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each

HCPCS Code: A4423
Short Description: Ost pch for bar w lk fl/fltr
Long Description: Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each

HCPCS Code: A4424
Short Description: Ost pch drain w bar & filter
Long Description: Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each

HCPCS Code: A4425
Short Description: Ost pch drain for barrier fl
Long Description: Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each

HCPCS Code: A4426
Short Description: Ost pch drain 2 piece system
Long Description: Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each

HCPCS Code: A4427
Short Description: Ost pch drain/barr lk flng/f
Long Description: Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each

HCPCS Code: A4428
Short Description: Urine ost pouch w faucet/tap
Long Description: Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each

HCPCS Code: A4429
Short Description: Urine ost pouch w bltinconv
Long Description: Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each

HCPCS Code: A4430
Short Description: Ost urine pch w b/bltin conv
Long Description: Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each

HCPCS Code: A4431
Short Description: Ost pch urine w barrier/tapv
Long Description: Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each

HCPCS Code: A4432
Short Description: Os pch urine w bar/fange/tap
Long Description: Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each

HCPCS Code: A4433
Short Description: Urine ost pch bar w lock fln
Long Description: Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each

HCPCS Code: A4434
Short Description: Ost pch urine w lock flng/ft
Long Description: Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each

HCPCS Code: A4435
Short Description: 1pc ost pch drain hgh output
Long Description: Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each

HCPCS Code: A4450
Short Description: Non-waterproof tape
Long Description: Tape, non-waterproof, per 18 square inches

HCPCS Code: A4452
Short Description: Waterproof tape
Long Description: Tape, waterproof, per 18 square inches

HCPCS Code: A4455
Short Description: Adhesive remover per ounce
Long Description: Adhesive remover or solvent (for tape, cement or other adhesive), per ounce

HCPCS Code: A4456
Short Description: Adhesive remover, wipes
Long Description: Adhesive remover, wipes, any type, each

HCPCS Code: A4458
Short Description: Reusable enema bag
Long Description: Enema bag with tubing, reusable

HCPCS Code: A4459
Short Description: Manual pump enema, reusable
Long Description: Manual pump-operated enema system, includes balloon, catheter and all accessories, reusable, any type

HCPCS Code: A4461
Short Description: Surgicl dress hold non-reuse
Long Description: Surgical dressing holder, non-reusable, each

HCPCS Code: A4463
Short Description: Surgical dress holder reuse
Long Description: Surgical dressing holder, reusable, each

HCPCS Code: A4465
Short Description: Non-elastic extremity binder
Long Description: Non-elastic binder for extremity

HCPCS Code: A4466
Short Description: Elastic garment/covering
Long Description: Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each

HCPCS Code: A4470
Short Description: Gravlee jet washer
Long Description: Gravlee jet washer

HCPCS Code: A4480
Short Description: Vabra aspirator
Long Description: Vabra aspirator

HCPCS Code: A4481
Short Description: Tracheostoma filter
Long Description: Tracheostoma filter, any type, any size, each

HCPCS Code: A4483
Short Description: Moisture exchanger
Long Description: Moisture exchanger, disposable, for use with invasive mechanical ventilation

HCPCS Code: A4490
Short Description: Above knee surgical stocking
Long Description: Surgical stockings above knee length, each

HCPCS Code: A4495
Short Description: Thigh length surg stocking
Long Description: Surgical stockings thigh length, each

HCPCS Code: A4500
Short Description: Below knee surgical stocking
Long Description: Surgical stockings below knee length, each

HCPCS Code: A4510
Short Description: Full length surg stocking
Long Description: Surgical stockings full length, each

HCPCS Code: A4520
Short Description: Incontinence garment anytype
Long Description: Incontinence garment, any type, (e.g., brief, diaper), each

HCPCS Code: A4550
Short Description: Surgical trays
Long Description: Surgical trays

HCPCS Code: A4554
Short Description: Disposable underpads
Long Description: Disposable underpads, all sizes

HCPCS Code: A4555
Short Description: Ca tx e-stim electr/transduc
Long Description: Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only

HCPCS Code: A4556
Short Description: Electrodes, pair
Long Description: Electrodes, (e.g., apnea monitor), per pair

HCPCS Code: A4557
Short Description: Lead wires, pair
Long Description: Lead wires, (e.g., apnea monitor), per pair

HCPCS Code: A4558
Short Description: Conductive gel or paste
Long Description: Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz

HCPCS Code: A4559
Short Description: Coupling gel or paste
Long Description: Coupling gel or paste, for use with ultrasound device, per oz

HCPCS Code: A4561
Short Description: Pessary rubber, any type
Long Description: Pessary, rubber, any type

HCPCS Code: A4562
Short Description: Pessary, non rubber,any type
Long Description: Pessary, non rubber, any type

HCPCS Code: A4565
Short Description: Slings
Long Description: Slings

HCPCS Code: A4566
Short Description: Should sling/vest/abrestrain
Long Description: Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment

HCPCS Code: A4570
Short Description: Splint
Long Description: Splint

HCPCS Code: A4575
Short Description: Hyperbaric o2 chamber disps
Long Description: Topical hyperbaric oxygen chamber, disposable

HCPCS Code: A4580
Short Description: Cast supplies (plaster)
Long Description: Cast supplies (e.g., plaster)

HCPCS Code: A4590
Short Description: Special casting material
Long Description: Special casting material (e.g., fiberglass)

HCPCS Code: A4595
Short Description: Tens suppl 2 lead per month
Long Description: Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)

HCPCS Code: A4600
Short Description: Sleeve, inter limb comp dev
Long Description: Sleeve for intermittent limb compression device, replacement only, each

HCPCS Code: A4601
Short Description: Lith ion non prosth recharge
Long Description: Lithium ion battery, rechargeable, for non-prosthetic use, replacement

HCPCS Code: A4602
Short Description: Replace lithium battery 1.5v
Long Description: Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each

HCPCS Code: A4604
Short Description: Tubing with heating element
Long Description: Tubing with integrated heating element for use with positive airway pressure device

HCPCS Code: A4605
Short Description: Trach suction cath close sys
Long Description: Tracheal suction catheter, closed system, each

HCPCS Code: A4606
Short Description: Oxygen probe used w oximeter
Long Description: Oxygen probe for use with oximeter device, replacement

HCPCS Code: A4608
Short Description: Transtracheal oxygen cath
Long Description: Transtracheal oxygen catheter, each

HCPCS Code: A4611
Short Description: Heavy duty battery
Long Description: Battery, heavy duty; replacement for patient owned ventilator

HCPCS Code: A4612
Short Description: Battery cables
Long Description: Battery cables; replacement for patient-owned ventilator

HCPCS Code: A4613
Short Description: Battery charger
Long Description: Battery charger; replacement for patient-owned ventilator

HCPCS Code: A4614
Short Description: Hand-held pefr meter
Long Description: Peak expiratory flow rate meter, hand held

HCPCS Code: A4615
Short Description: Cannula nasal
Long Description: Cannula, nasal

HCPCS Code: A4616
Short Description: Tubing (oxygen) per foot
Long Description: Tubing (oxygen), per foot

HCPCS Code: A4617
Short Description: Mouth piece
Long Description: Mouth piece

HCPCS Code: A4618
Short Description: Breathing circuits
Long Description: Breathing circuits

HCPCS Code: A4619
Short Description: Face tent
Long Description: Face tent

HCPCS Code: A4620
Short Description: Variable concentration mask
Long Description: Variable concentration mask

HCPCS Code: A4623
Short Description: Tracheostomy inner cannula
Long Description: Tracheostomy, inner cannula

HCPCS Code: A4624
Short Description: Tracheal suction tube
Long Description: Tracheal suction catheter, any type other than closed system, each

HCPCS Code: A4625
Short Description: Trach care kit for new trach
Long Description: Tracheostomy care kit for new tracheostomy

HCPCS Code: A4626
Short Description: Tracheostomy cleaning brush
Long Description: Tracheostomy cleaning brush, each

HCPCS Code: A4627
Short Description: Spacer bag/reservoir
Long Description: Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler

HCPCS Code: A4628
Short Description: Oropharyngeal suction cath
Long Description: Oropharyngeal suction catheter, each

HCPCS Code: A4629
Short Description: Tracheostomy care kit
Long Description: Tracheostomy care kit for established tracheostomy

HCPCS Code: A4630
Short Description: Repl bat t.e.n.s. own by pt
Long Description: Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient

HCPCS Code: A4633
Short Description: Uvl replacement bulb
Long Description: Replacement bulb/lamp for ultraviolet light therapy system, each

HCPCS Code: A4634
Short Description: Replacement bulb th lightbox
Long Description: Replacement bulb for therapeutic light box, tabletop model

HCPCS Code: A4635
Short Description: Underarm crutch pad
Long Description: Underarm pad, crutch, replacement, each

HCPCS Code: A4636
Short Description: Handgrip for cane etc
Long Description: Replacement, handgrip, cane, crutch, or walker, each

HCPCS Code: A4637
Short Description: Repl tip cane/crutch/walker
Long Description: Replacement, tip, cane, crutch, walker, each.

HCPCS Code: A4638
Short Description: Repl batt pulse gen sys
Long Description: Replacement battery for patient-owned ear pulse generator, each

HCPCS Code: A4639
Short Description: Infrared ht sys replcmnt pad
Long Description: Replacement pad for infrared heating pad system, each

HCPCS Code: A4640
Short Description: Alternating pressure pad
Long Description: Replacement pad for use with medically necessary alternating pressure pad owned by patient

HCPCS Code: A4641
Short Description: Radiopharm dx agent noc
Long Description: Radiopharmaceutical, diagnostic, not otherwise classified

HCPCS Code: A4642
Short Description: In111 satumomab
Long Description: Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries

HCPCS Code: A4648
Short Description: Implantable tissue marker
Long Description: Tissue marker, implantable, any type, each

HCPCS Code: A4649
Short Description: Surgical supplies
Long Description: Surgical supply; miscellaneous

HCPCS Code: A4650
Short Description: Implant radiation dosimeter
Long Description: Implantable radiation dosimeter, each

HCPCS Code: A4651
Short Description: Calibrated microcap tube
Long Description: Calibrated microcapillary tube, each

HCPCS Code: A4652
Short Description: Microcapillary tube sealant
Long Description: Microcapillary tube sealant

HCPCS Code: A4653
Short Description: Pd catheter anchor belt
Long Description: Peritoneal dialysis catheter anchoring device, belt, each

HCPCS Code: A4657
Short Description: Syringe w/wo needle
Long Description: Syringe, with or without needle, each

HCPCS Code: A4660
Short Description: Sphyg/bp app w cuff and stet
Long Description: Sphygmomanometer/blood pressure apparatus with cuff and stethoscope

HCPCS Code: A4663
Short Description: Dialysis blood pressure cuff
Long Description: Blood pressure cuff only

HCPCS Code: A4670
Short Description: Automatic bp monitor, dial
Long Description: Automatic blood pressure monitor

HCPCS Code: A4671
Short Description: Disposable cycler set
Long Description: Disposable cycler set used with cycler dialysis machine, each

HCPCS Code: A4672
Short Description: Drainage ext line, dialysis
Long Description: Drainage extension line, sterile, for dialysis, each

HCPCS Code: A4673
Short Description: Ext line w easy lock connect
Long Description: Extension line with easy lock connectors, used with dialysis

HCPCS Code: A4674
Short Description: Chem/antisept solution, 8oz
Long Description: Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz

HCPCS Code: A4680
Short Description: Activated carbon filter, ea
Long Description: Activated carbon filter for hemodialysis, each

HCPCS Code: A4690
Short Description: Dialyzer, each
Long Description: Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each

HCPCS Code: A4706
Short Description: Bicarbonate conc sol per gal
Long Description: Bicarbonate concentrate, solution, for hemodialysis, per gallon

HCPCS Code: A4707
Short Description: Bicarbonate conc pow per pac
Long Description: Bicarbonate concentrate, powder, for hemodialysis, per packet

HCPCS Code: A4708
Short Description: Acetate conc sol per gallon
Long Description: Acetate concentrate solution, for hemodialysis, per gallon

HCPCS Code: A4709
Short Description: Acid conc sol per gallon
Long Description: Acid concentrate, solution, for hemodialysis, per gallon

HCPCS Code: A4714
Short Description: Treated water per gallon
Long Description: Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon

HCPCS Code: A4719
Short Description: "y set" tubing
Long Description: "y set" tubing for peritoneal dialysis

HCPCS Code: A4720
Short Description: Dialysat sol fld vol > 249cc
Long Description: Dialysate solution, any concentration of dextrose, fluid volume greater than 249cc, but less than or equal to 999 cc, for peritoneal dialysis

HCPCS Code: A4721
Short Description: Dialysat sol fld vol > 999cc
Long Description: Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis

HCPCS Code: A4722
Short Description: Dialys sol fld vol > 1999cc
Long Description: Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis

HCPCS Code: A4723
Short Description: Dialys sol fld vol > 2999cc
Long Description: Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis

HCPCS Code: A4724
Short Description: Dialys sol fld vol > 3999cc
Long Description: Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis

HCPCS Code: A4725
Short Description: Dialys sol fld vol > 4999cc
Long Description: Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis

HCPCS Code: A4726
Short Description: Dialys sol fld vol > 5999cc
Long Description: Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis

HCPCS Code: A4728
Short Description: Dialysate solution, non-dex
Long Description: Dialysate solution, non-dextrose containing, 500 ml

HCPCS Code: A4730
Short Description: Fistula cannulation set, ea
Long Description: Fistula cannulation set for hemodialysis, each

HCPCS Code: A4736
Short Description: Topical anesthetic, per gram
Long Description: Topical anesthetic, for dialysis, per gram

HCPCS Code: A4737
Short Description: Inj anesthetic per 10 ml
Long Description: Injectable anesthetic, for dialysis, per 10 ml

HCPCS Code: A4740
Short Description: Shunt accessory
Long Description: Shunt accessory, for hemodialysis, any type, each

HCPCS Code: A4750
Short Description: Art or venous blood tubing
Long Description: Blood tubing, arterial or venous, for hemodialysis, each

HCPCS Code: A4755
Short Description: Comb art/venous blood tubing
Long Description: Blood tubing, arterial and venous combined, for hemodialysis, each

HCPCS Code: A4760
Short Description: Dialysate sol test kit, each
Long Description: Dialysate solution test kit, for peritoneal dialysis, any type, each

HCPCS Code: A4765
Short Description: Dialysate conc pow per pack
Long Description: Dialysate concentrate, powder, additive for peritoneal dialysis, per packet

HCPCS Code: A4766
Short Description: Dialysate conc sol add 10 ml
Long Description: Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml

HCPCS Code: A4770
Short Description: Blood collection tube/vacuum
Long Description: Blood collection tube, vacuum, for dialysis, per 50

HCPCS Code: A4771
Short Description: Serum clotting time tube
Long Description: Serum clotting time tube, for dialysis, per 50

HCPCS Code: A4772
Short Description: Blood glucose test strips
Long Description: Blood glucose test strips, for dialysis, per 50

HCPCS Code: A4773
Short Description: Occult blood test strips
Long Description: Occult blood test strips, for dialysis, per 50

HCPCS Code: A4774
Short Description: Ammonia test strips
Long Description: Ammonia test strips, for dialysis, per 50

HCPCS Code: A4802
Short Description: Protamine sulfate per 50 mg
Long Description: Protamine sulfate, for hemodialysis, per 50 mg

HCPCS Code: A4860
Short Description: Disposable catheter tips
Long Description: Disposable catheter tips for peritoneal dialysis, per 10

HCPCS Code: A4870
Short Description: Plumb/elec wk hm hemo equip
Long Description: Plumbing and/or electrical work for home hemodialysis equipment

HCPCS Code: A4890
Short Description: Repair/maint cont hemo equip
Long Description: Contracts, repair and maintenance, for hemodialysis equipment

HCPCS Code: A4911
Short Description: Drain bag/bottle
Long Description: Drain bag/bottle, for dialysis, each

HCPCS Code: A4913
Short Description: Misc dialysis supplies noc
Long Description: Miscellaneous dialysis supplies, not otherwise specified

HCPCS Code: A4918
Short Description: Venous pressure clamp
Long Description: Venous pressure clamp, for hemodialysis, each

HCPCS Code: A4927
Short Description: Non-sterile gloves
Long Description: Gloves, non-sterile, per 100

HCPCS Code: A4928
Short Description: Surgical mask
Long Description: Surgical mask, per 20

HCPCS Code: A4929
Short Description: Tourniquet for dialysis, ea
Long Description: Tourniquet for dialysis, each

HCPCS Code: A4930
Short Description: Sterile, gloves per pair
Long Description: Gloves, sterile, per pair

HCPCS Code: A4931
Short Description: Reusable oral thermometer
Long Description: Oral thermometer, reusable, any type, each

HCPCS Code: A4932
Short Description: Reusable rectal thermometer
Long Description: Rectal thermometer, reusable, any type, each