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

HCPCS Code	Short Description	Long Description
A0021	Outside state ambulance serv	Ambulance service, outside state per mile, transport (medicaid only)
A0080	Noninterest escort in non er	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest
A0090	Interest escort in non er	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest
A0100	Nonemergency transport taxi	Non-emergency transportation; taxi
A0110	Nonemergency transport bus	Non-emergency transportation and bus, intra or inter state carrier
A0120	Noner transport mini-bus	Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems
A0130	Noner transport wheelch van	Non-emergency transportation: wheelchair van
A0140	Nonemergency transport air	Non-emergency transportation and air travel (private or commercial) intra or inter state
A0160	Noner transport case worker	Non-emergency transportation: per mile - case worker or social worker
A0170	Transport parking fees/tolls	Transportation ancillary: parking fees, tolls, other
A0180	Noner transport lodgng recip	Non-emergency transportation: ancillary: lodging-recipient
A0190	Noner transport meals recip	Non-emergency transportation: ancillary: meals-recipient
A0200	Noner transport lodgng escrt	Non-emergency transportation: ancillary: lodging escort
A0210	Noner transport meals escort	Non-emergency transportation: ancillary: meals-escort
A0225	Neonatal emergency transport	Ambulance service, neonatal transport, base rate, emergency transport, one way
A0380	Basic life support mileage	Bls mileage (per mile)
A0382	Basic support routine suppls	Bls routine disposable supplies
A0384	Bls defibrillation supplies	Bls specialized service disposable supplies; defibrillation (used by als ambulances and bls ambulances in jurisdictions where defibrillation is permitted in bls ambulances)
A0390	Advanced life support mileag	Als mileage (per mile)
A0392	Als defibrillation supplies	Als specialized service disposable supplies; defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances)
A0394	Als iv drug therapy supplies	Als specialized service disposable supplies; iv drug therapy
A0396	Als esophageal intub suppls	Als specialized service disposable supplies; esophageal intubation
A0398	Als routine disposble suppls	Als routine disposable supplies
A0420	Ambulance waiting 1/2 hr	Ambulance waiting time (als or bls), one half (1/2) hour increments
A0422	Ambulance 02 life sustaining	Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation
A0424	Extra ambulance attendant	Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)
A0425	Ground mileage	Ground mileage, per statute mile
A0426	Als 1	Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)
A0427	Als1-emergency	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)
A0428	Bls	Ambulance service, basic life support, non-emergency transport, (bls)
A0429	Bls-emergency	Ambulance service, basic life support, emergency transport (bls-emergency)
A0430	Fixed wing air transport	Ambulance service, conventional air services, transport, one way (fixed wing)
A0431	Rotary wing air transport	Ambulance service, conventional air services, transport, one way (rotary wing)
A0432	Pi volunteer ambulance co	Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers
A0433	Als 2	Advanced life support, level 2 (als 2)
A0434	Specialty care transport	Specialty care transport (sct)
A0435	Fixed wing air mileage	Fixed wing air mileage, per statute mile
A0436	Rotary wing air mileage	Rotary wing air mileage, per statute mile
A0888	Noncovered ambulance mileage	Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility)
A0998	Ambulance response/treatment	Ambulance response and treatment, no transport
A0999	Unlisted ambulance service	Unlisted ambulance service
A1	Dressing for one wound	Dressing for one wound
A2	Dressing for two wounds	Dressing for two wounds
A2001	Innovamatrix ac, per sq cm	Innovamatrix ac, per square centimeter
A2002	Mirragen adv wnd mat per sq	Mirragen advanced wound matrix, per square centimeter
A2004	Xcellistem, 1 mg	Xcellistem, 1 mg
A2005	Microlyte matrix, per sq cm	Microlyte matrix, per square centimeter
A2006	Novosorb synpath per sq cm	Novosorb synpath dermal matrix, per square centimeter
A2007	Restrata, per sq cm	Restrata, per square centimeter
A2008	Theragenesis, per sq cm	Theragenesis, per square centimeter
A2009	Symphony, per sq cm	Symphony, per square centimeter
A2010	Apis, per square centimeter	Apis, per square centimeter
A2011	Supra sdrm, per sq cm	Supra sdrm, per square centimeter
A2012	Suprathel, per sq cm	Suprathel, per square centimeter
A2013	Innovamatrix fs, per sq cm	Innovamatrix fs, per square centimeter
A2014	Omeza collag per 100 mg	Omeza collagen matrix, per 100 mg
A2015	Phoenix wnd mtrx, per sq cm	Phoenix wound matrix, per square centimeter
A2016	Permeaderm b, per sq cm	Permeaderm b, per square centimeter
A2017	Permeaderm glove, each	Permeaderm glove, each
A2018	Permeaderm c, per sq cm	Permeaderm c, per square centimeter
A2019	Kerecis marigen shld sq cm	Kerecis omega3 marigen shield, per square centimeter
A2020	Ac5 wound system	Ac5 advanced wound system (ac5)
A2021	Neomatrix per sq cm	Neomatrix, per square centimeter
A2022	Innovabrn/innovamatx xl sqcm	Innovaburn or innovamatrix xl, per square centimeter
A2023	Innovamatrix pd, 1 mg	Innovamatrix pd, 1 mg
A2024	Resolve matrix per sq cm	Resolve matrix, per square centimeter
A2025	Miro3d per cubic cm	Miro3d, per cubic centimeter
A2026	Restrata minimatrix, 5 mg	Restrata minimatrix, 5 mg
A3	Dressing for three wounds	Dressing for three wounds
A4	Dressing for four wounds	Dressing for four wounds
A4100	Skin sub fda clrd as dev nos	Skin substitute, fda cleared as a device, not otherwise specified
A4206	1 cc sterile syringe&needle	Syringe with needle, sterile, 1 cc or less, each
A4207	2 cc sterile syringe&needle	Syringe with needle, sterile 2 cc, each
A4208	3 cc sterile syringe&needle	Syringe with needle, sterile 3 cc, each
A4209	5+ cc sterile syringe&needle	Syringe with needle, sterile 5 cc or greater, each
A4210	Nonneedle injection device	Needle-free injection device, each
A4211	Supp for self-adm injections	Supplies for self-administered injections
A4212	Non coring needle or stylet	Non-coring needle or stylet with or without catheter
A4213	20+ cc syringe only	Syringe, sterile, 20 cc or greater, each
A4215	Sterile needle	Needle, sterile, any size, each
A4216	Sterile water/saline, 10 ml	Sterile water, saline and/or dextrose, diluent/flush, 10 ml
A4217	Sterile water/saline, 500 ml	Sterile water/saline, 500 ml
A4218	Sterile saline or water	Sterile saline or water, metered dose dispenser, 10 ml
A4220	Infusion pump refill kit	Refill kit for implantable infusion pump
A4221	Supp non-insulin inf cath/wk	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)
A4222	Infusion supplies with pump	Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)
A4223	Infusion supplies w/o pump	Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
A4224	Supply insulin inf cath/wk	Supplies for maintenance of insulin infusion catheter, per week
A4225	Sup/ext insulin inf pump syr	Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
A4226	Weekly supply maint cgs pump	Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week
A4230	Infus insulin pump non needl	Infusion set for external insulin pump, non needle cannula type
A4231	Infusion insulin pump needle	Infusion set for external insulin pump, needle type
A4232	Syringe w/needle insulin 3cc	Syringe with needle for external insulin pump, sterile, 3 cc
A4233	Alkalin batt for glucose mon	Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each
A4234	J-cell batt for glucose mon	Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each
A4235	Lithium batt for glucose mon	Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each
A4236	Silvr oxide batt glucose mon	Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each
A4238	Adju cgm supply allowance	Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
A4239	Non-adju cgm supply allow	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
A4244	Alcohol or peroxide per pint	Alcohol or peroxide, per pint
A4245	Alcohol wipes per box	Alcohol wipes, per box
A4246	Betadine/phisohex solution	Betadine or phisohex solution, per pint
A4247	Betadine/iodine swabs/wipes	Betadine or iodine swabs/wipes, per box
A4248	Chlorhexidine antisept	Chlorhexidine containing antiseptic, 1 ml
A4250	Urine reagent strips/tablets	Urine test or reagent strips or tablets (100 tablets or strips)
A4252	Blood ketone test or strip	Blood ketone test or reagent strip, each
A4253	Blood glucose/reagent strips	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
A4255	Glucose monitor platforms	Platforms for home blood glucose monitor, 50 per box
A4256	Calibrator solution/chips	Normal, low and high calibrator solution / chips
A4257	Replace lensshield cartridge	Replacement lens shield cartridge for use with laser skin piercing device, each
A4258	Lancet device each	Spring-powered device for lancet, each
A4259	Lancets per box	Lancets, per box of 100
A4261	Cervical cap contraceptive	Cervical cap for contraceptive use
A4262	Temporary tear duct plug	Temporary, absorbable lacrimal duct implant, each
A4263	Permanent tear duct plug	Permanent, long term, non-dissolvable lacrimal duct implant, each
A4264	Intratubal occlusion device	Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
A4265	Paraffin	Paraffin, per pound
A4266	Diaphragm	Diaphragm for contraceptive use
A4267	Male condom	Contraceptive supply, condom, male, each
A4268	Female condom	Contraceptive supply, condom, female, each
A4269	Spermicide	Contraceptive supply, spermicide (e.g., foam, gel), each
A4270	Disposable endoscope sheath	Disposable endoscope sheath, each
A4271	Home lancing/test cartridges	Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per month
A4280	Brst prsths adhsv attchmnt	Adhesive skin support attachment for use with external breast prosthesis, each
A4281	Replacement breastpump tube	Tubing for breast pump, replacement
A4282	Replacement breastpump adpt	Adapter for breast pump, replacement
A4283	Replacement breastpump cap	Cap for breast pump bottle, replacement
A4284	Replcmnt breast pump shield	Breast shield and splash protector for use with breast pump, replacement
A4285	Replcmnt breast pump bottle	Polycarbonate bottle for use with breast pump, replacement
A4286	Replcmnt breastpump lok ring	Locking ring for breast pump, replacement
A4287	Disp col sto bag breast milk	Disposable collection and storage bag for breast milk, any size, any type, each
A4290	Sacral nerve stim test lead	Sacral nerve stimulation test lead, each
A4300	Cath impl vasc access portal	Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access
A4301	Implantable access syst perc	Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)
A4305	Drug delivery system >=50 ml	Disposable drug delivery system, flow rate of 50 ml or greater per hour
A4306	Drug delivery system <=50 ml	Disposable drug delivery system, flow rate of less than 50 ml per hour
A4310	Insert tray w/o bag/cath	Insertion tray without drainage bag and without catheter (accessories only)
A4311	Catheter w/o bag 2-way latex	Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
A4312	Cath w/o bag 2-way silicone	Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone
A4313	Catheter w/bag 3-way	Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
A4314	Cath w/drainage 2-way latex	Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
A4315	Cath w/drainage 2-way silcne	Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone
A4316	Cath w/drainage 3-way	Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
A4320	Irrigation tray	Irrigation tray with bulb or piston syringe, any purpose
A4321	Cath therapeutic irrig agent	Therapeutic agent for urinary catheter irrigation
A4322	Irrigation syringe	Irrigation syringe, bulb or piston, each
A4326	Male external catheter	Male external catheter with integral collection chamber, any type, each
A4327	Fem urinary collect dev cup	Female external urinary collection device; meatal cup, each
A4328	Fem urinary collect pouch	Female external urinary collection device; pouch, each
A4330	Stool collection pouch	Perianal fecal collection pouch with adhesive, each
A4331	Extension drainage tubing	Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each
A4332	Lube sterile packet	Lubricant, individual sterile packet, each
A4333	Urinary cath anchor device	Urinary catheter anchoring device, adhesive skin attachment, each
A4334	Urinary cath leg strap	Urinary catheter anchoring device, leg strap, each
A4335	Incontinence supply	Incontinence supply; miscellaneous
A4336	Urethral insert	Incontinence supply, urethral insert, any type, each
A4337	Incontinent rectal insert	Incontinence supply, rectal insert, any type, each
A4338	Indwelling catheter latex	Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each
A4340	Indwelling catheter special	Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each
A4341	Iduc valve pat inst repl	Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
A4342	Iduc valve sply repl	Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each
A4344	Cath indw foley 2 way silicn	Indwelling catheter, foley type, two-way, all silicone or polyurethane, each
A4346	Cath indw foley 3 way	Indwelling catheter; foley type, three way for continuous irrigation, each
A4349	Disposable male external cat	Male external catheter, with or without adhesive, disposable, each
A4351	Straight tip urine catheter	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each
A4352	Coude tip urinary catheter	Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each
A4353	Intermittent urinary cath	Intermittent urinary catheter, with insertion supplies
A4354	Cath insertion tray w/bag	Insertion tray with drainage bag but without catheter
A4355	Bladder irrigation tubing	Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each
A4356	Ext ureth clmp or compr dvc	External urethral clamp or compression device (not to be used for catheter clamp), each
A4357	Bedside drainage bag	Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each
A4358	Urinary leg or abdomen bag	Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each
A4360	Disposable ext urethral dev	Disposable external urethral clamp or compression device, with pad and/or pouch, each
A4361	Ostomy face plate	Ostomy faceplate, each
A4362	Solid skin barrier	Skin barrier; solid, 4 x 4 or equivalent; each
A4363	Ostomy clamp, replacement	Ostomy clamp, any type, replacement only, each
A4364	Adhesive, liquid or equal	Adhesive, liquid or equal, any type, per oz
A4366	Ostomy vent	Ostomy vent, any type, each
A4367	Ostomy belt	Ostomy belt, each
A4368	Ostomy filter	Ostomy filter, any type, each
A4369	Skin barrier liquid per oz	Ostomy skin barrier, liquid (spray, brush, etc.), per oz
A4371	Skin barrier powder per oz	Ostomy skin barrier, powder, per oz
A4372	Skin barrier solid 4x4 equiv	Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each
A4373	Skin barrier with flange	Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each
A4375	Drainable plastic pch w fcpl	Ostomy pouch, drainable, with faceplate attached, plastic, each
A4376	Drainable rubber pch w fcplt	Ostomy pouch, drainable, with faceplate attached, rubber, each
A4377	Drainable plstic pch w/o fp	Ostomy pouch, drainable, for use on faceplate, plastic, each
A4378	Drainable rubber pch w/o fp	Ostomy pouch, drainable, for use on faceplate, rubber, each
A4379	Urinary plastic pouch w fcpl	Ostomy pouch, urinary, with faceplate attached, plastic, each
A4380	Urinary rubber pouch w fcplt	Ostomy pouch, urinary, with faceplate attached, rubber, each
A4381	Urinary plastic pouch w/o fp	Ostomy pouch, urinary, for use on faceplate, plastic, each
A4382	Urinary hvy plstc pch w/o fp	Ostomy pouch, urinary, for use on faceplate, heavy plastic, each
A4383	Urinary rubber pouch w/o fp	Ostomy pouch, urinary, for use on faceplate, rubber, each
A4384	Ostomy faceplt/silicone ring	Ostomy faceplate equivalent, silicone ring, each
A4385	Ost skn barrier sld ext wear	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each
A4387	Ost clsd pouch w att st barr	Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each
A4388	Drainable pch w ex wear barr	Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each
A4389	Drainable pch w st wear barr	Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each
A4390	Drainable pch ex wear convex	Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each
A4391	Urinary pouch w ex wear barr	Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each
A4392	Urinary pouch w st wear barr	Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each
A4393	Urine pch w ex wear bar conv	Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each
A4394	Ostomy pouch liq deodorant	Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce
A4395	Ostomy pouch solid deodorant	Ostomy deodorant for use in ostomy pouch, solid, per tablet
A4396	Peristomal hernia supprt blt	Ostomy belt with peristomal hernia support
A4397	Irrigation supply sleeve	Irrigation supply; sleeve, each
A4398	Ostomy irrigation bag	Ostomy irrigation supply; bag, each
A4399	Ostomy irrig cone/cath w brs	Ostomy irrigation supply; cone/catheter, with or without brush
A4400	Ostomy irrigation set	Ostomy irrigation set
A4402	Lubricant per ounce	Lubricant, per ounce
A4404	Ostomy ring each	Ostomy ring, each
A4405	Nonpectin based ostomy paste	Ostomy skin barrier, non-pectin based, paste, per ounce
A4406	Pectin based ostomy paste	Ostomy skin barrier, pectin-based, paste, per ounce
A4407	Ext wear ost skn barr <=4sq	Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each
A4408	Ext wear ost skn barr >4sq	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each
A4409	Ost skn barr convex <=4 sq i	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each
A4410	Ost skn barr extnd >4 sq	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each
A4411	Ost skn barr extnd =4sq	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each
A4412	Ost pouch drain high output	Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each
A4413	2 pc drainable ost pouch	Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each
A4414	Ost sknbar w/o conv<=4 sq in	Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each
A4415	Ost skn barr w/o conv >4 sqi	Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each
A4416	Ost pch clsd w barrier/filtr	Ostomy pouch, closed, with barrier attached, with filter (1 piece), each
A4417	Ost pch w bar/bltinconv/fltr	Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each
A4418	Ost pch clsd w/o bar w filtr	Ostomy pouch, closed; without barrier attached, with filter (1 piece), each
A4419	Ost pch for bar w flange/flt	Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each
A4420	Ost pch clsd for bar w lk fl	Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each
A4421	Ostomy supply misc	Ostomy supply; miscellaneous
A4422	Ost pouch absorbent material	Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each
A4423	Ost pch for bar w lk fl/fltr	Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each
A4424	Ost pch drain w bar & filter	Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each
A4425	Ost pch drain for barrier fl	Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each
A4426	Ost pch drain 2 piece system	Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each
A4427	Ost pch drain/barr lk flng/f	Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each
A4428	Urine ost pouch w faucet/tap	Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each
A4429	Urine ost pouch w bltinconv	Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
A4430	Ost urine pch w b/bltin conv	Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
A4431	Ost pch urine w barrier/tapv	Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each
A4432	Os pch urine w bar/fange/tap	Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each
A4433	Urine ost pch bar w lock fln	Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each
A4434	Ost pch urine w lock flng/ft	Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each
A4435	1pc ost pch drain hgh output	Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each
A4436	Irr supply sleev reus per mo	Irrigation supply; sleeve, reusable, per month
A4437	Irr supply sleev disp per mo	Irrigation supply; sleeve, disposable, per month
A4438	Adhesive clip ext ens contr	Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
A4450	Non-waterproof tape	Tape, non-waterproof, per 18 square inches
A4452	Waterproof tape	Tape, waterproof, per 18 square inches
A4453	Rec cath man pump enema repl	Rectal catheter for use with the manual pump-operated enema system, replacement only
A4455	Adhesive remover per ounce	Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
A4456	Adhesive remover, wipes	Adhesive remover, wipes, any type, each
A4457	Enema tube any type repl	Enema tube, with or without adapter, any type, replacement only, each
A4458	Reusable enema bag	Enema bag with tubing, reusable
A4459	Manual pump enema, reusable	Manual pump-operated enema system, includes balloon, catheter and all accessories, reusable, any type
A4461	Surgicl dress hold non-reuse	Surgical dressing holder, non-reusable, each
A4463	Surgical dress holder reuse	Surgical dressing holder, reusable, each
A4465	Non-elastic extremity binder	Non-elastic binder for extremity
A4466	Elastic garment/covering	Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each
A4467	Belt strap sleev grmnt cover	Belt, strap, sleeve, garment, or covering, any type
A4468	Exsuff belt incl all sup acc	Exsufflation belt, includes all supplies and accessories
A4470	Gravlee jet washer	Gravlee jet washer
A4480	Vabra aspirator	Vabra aspirator
A4481	Tracheostoma filter	Tracheostoma filter, any type, any size, each
A4483	Moisture exchanger	Moisture exchanger, disposable, for use with invasive mechanical ventilation
A4490	Above knee surgical stocking	Surgical stockings above knee length, each
A4495	Thigh length surg stocking	Surgical stockings thigh length, each
A4500	Below knee surgical stocking	Surgical stockings below knee length, each
A4510	Full length surg stocking	Surgical stockings full length, each
A4520	Incontinence garment anytype	Incontinence garment, any type, (e.g., brief, diaper), each
A4540	Trans elec nerv periph nerv	Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
A4541	Monthly supp use with e0733	Monthly supplies for use of device coded at e0733
A4542	Supp ext up limb tremor stim	Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
A4550	Surgical trays	Surgical trays
A4553	Nondisp underpads, all sizes	Non-disposable underpads, all sizes
A4554	Disposable underpads	Disposable underpads, all sizes
A4555	Ca tx e-stim electr/transduc	Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only
A4556	Electrodes, pair	Electrodes, (e.g., apnea monitor), per pair
A4557	Lead wires, pair	Lead wires, (e.g., apnea monitor), per pair
A4558	Conductive gel or paste	Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz
A4559	Coupling gel or paste	Coupling gel or paste, for use with ultrasound device, per oz
A4560	Nmes disposable	Neuromuscular electrical stimulator (nmes), disposable, replacement only
A4561	Pessary reusable rub anytype	Pessary, reusable, rubber, any type
A4562	Pessary reusable nonrubber	Pessary, reusable, non rubber, any type
A4563	Vag inser rectal control sys	Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each
A4564	Pessary, disposable any type	Pessary, disposable, any type
A4565	Slings	Slings
A4566	Should sling/vest/abrestrain	Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment
A4570	Splint	Splint
A4575	Hyperbaric o2 chamber disps	Topical hyperbaric oxygen chamber, disposable
A4580	Cast supplies (plaster)	Cast supplies (e.g., plaster)
A4590	Special casting material	Special casting material (e.g., fiberglass)
A4593	Neuromod sti sys adj rehab	Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller
A4594	Neuromod adj rehab mouthpie	Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each
A4595	Tens suppl 2 lead per month	Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)
A4596	Ces system monthly supp	Cranial electrotherapy stimulation (ces) system supplies and accessories, per month
A4600	Sleeve, inter limb comp dev	Sleeve for intermittent limb compression device, replacement only, each
A4601	Lith ion non prosth recharge	Lithium ion battery, rechargeable, for non-prosthetic use, replacement
A4602	Replace lithium battery 1.5v	Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each
A4604	Tubing with heating element	Tubing with integrated heating element for use with positive airway pressure device
A4605	Trach suction cath close sys	Tracheal suction catheter, closed system, each
A4606	Oxygen probe used w oximeter	Oxygen probe for use with oximeter device, replacement
A4608	Transtracheal oxygen cath	Transtracheal oxygen catheter, each
A4611	Heavy duty battery	Battery, heavy duty; replacement for patient owned ventilator
A4612	Battery cables	Battery cables; replacement for patient-owned ventilator
A4613	Battery charger	Battery charger; replacement for patient-owned ventilator
A4614	Hand-held pefr meter	Peak expiratory flow rate meter, hand held
A4615	Cannula nasal	Cannula, nasal
A4616	Tubing (oxygen) per foot	Tubing (oxygen), per foot
A4617	Mouth piece	Mouth piece
A4618	Breathing circuits	Breathing circuits
A4619	Face tent	Face tent
A4620	Variable concentration mask	Variable concentration mask
A4623	Tracheostomy inner cannula	Tracheostomy, inner cannula
A4624	Tracheal suction tube	Tracheal suction catheter, any type other than closed system, each
A4625	Trach care kit for new trach	Tracheostomy care kit for new tracheostomy
A4626	Tracheostomy cleaning brush	Tracheostomy cleaning brush, each
A4627	Spacer bag/reservoir	Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler
A4628	Oropharyngeal suction cath	Oral and/or oropharyngeal suction catheter, each
A4629	Tracheostomy care kit	Tracheostomy care kit for established tracheostomy
A4630	Repl bat t.e.n.s. own by pt	Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient
A4633	Uvl replacement bulb	Replacement bulb/lamp for ultraviolet light therapy system, each
A4634	Replacement bulb th lightbox	Replacement bulb for therapeutic light box, tabletop model
A4635	Underarm crutch pad	Underarm pad, crutch, replacement, each
A4636	Handgrip for cane etc	Replacement, handgrip, cane, crutch, or walker, each
A4637	Repl tip cane/crutch/walker	Replacement, tip, cane, crutch, walker, each.
A4638	Repl batt pulse gen sys	Replacement battery for patient-owned ear pulse generator, each
A4639	Infrared ht sys replcmnt pad	Replacement pad for infrared heating pad system, each
A4640	Alternating pressure pad	Replacement pad for use with medically necessary alternating pressure pad owned by patient
A4641	Radiopharm dx agent noc	Radiopharmaceutical, diagnostic, not otherwise classified
A4642	In111 satumomab	Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
A4648	Implantable tissue marker	Tissue marker, implantable, any type, each
A4649	Surgical supplies	Surgical supply; miscellaneous
A4650	Implant radiation dosimeter	Implantable radiation dosimeter, each
A4651	Calibrated microcap tube	Calibrated microcapillary tube, each
A4652	Microcapillary tube sealant	Microcapillary tube sealant
A4653	Pd catheter anchor belt	Peritoneal dialysis catheter anchoring device, belt, each
A4657	Syringe w/wo needle	Syringe, with or without needle, each
A4660	Sphyg/bp app w cuff and stet	Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
A4663	Dialysis blood pressure cuff	Blood pressure cuff only
A4670	Automatic bp monitor, dial	Automatic blood pressure monitor
A4671	Disposable cycler set	Disposable cycler set used with cycler dialysis machine, each
A4672	Drainage ext line, dialysis	Drainage extension line, sterile, for dialysis, each
A4673	Ext line w easy lock connect	Extension line with easy lock connectors, used with dialysis
A4674	Chem/antisept solution, 8oz	Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz
A4680	Activated carbon filter, ea	Activated carbon filter for hemodialysis, each
A4690	Dialyzer, each	Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each
A4706	Bicarbonate conc sol per gal	Bicarbonate concentrate, solution, for hemodialysis, per gallon
A4707	Bicarbonate conc pow per pac	Bicarbonate concentrate, powder, for hemodialysis, per packet
A4708	Acetate conc sol per gallon	Acetate concentrate solution, for hemodialysis, per gallon
A4709	Acid conc sol per gallon	Acid concentrate, solution, for hemodialysis, per gallon
A4714	Treated water per gallon	Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon
A4719	y set tubing	y set tubing for peritoneal dialysis
A4720	Dialysat sol fld vol > 249cc	Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
A4721	Dialysat sol fld vol > 999cc	Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
A4722	Dialys sol fld vol > 1999cc	Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis
A4723	Dialys sol fld vol > 2999cc	Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis
A4724	Dialys sol fld vol > 3999cc	Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis
A4725	Dialys sol fld vol > 4999cc	Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis
A4726	Dialys sol fld vol > 5999cc	Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis
A4728	Dialysate solution, non-dex	Dialysate solution, non-dextrose containing, 500 ml
A4730	Fistula cannulation set, ea	Fistula cannulation set for hemodialysis, each
A4736	Topical anesthetic, per gram	Topical anesthetic, for dialysis, per gram
A4737	Inj anesthetic per 10 ml	Injectable anesthetic, for dialysis, per 10 ml
A4740	Shunt accessory	Shunt accessory, for hemodialysis, any type, each
A4750	Art or venous blood tubing	Blood tubing, arterial or venous, for hemodialysis, each
A4755	Comb art/venous blood tubing	Blood tubing, arterial and venous combined, for hemodialysis, each
A4760	Dialysate sol test kit, each	Dialysate solution test kit, for peritoneal dialysis, any type, each
A4765	Dialysate conc pow per pack	Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
A4766	Dialysate conc sol add 10 ml	Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml
A4770	Blood collection tube/vacuum	Blood collection tube, vacuum, for dialysis, per 50
A4771	Serum clotting time tube	Serum clotting time tube, for dialysis, per 50
A4772	Blood glucose test strips	Blood glucose test strips, for dialysis, per 50
A4773	Occult blood test strips	Occult blood test strips, for dialysis, per 50
A4774	Ammonia test strips	Ammonia test strips, for dialysis, per 50
A4802	Protamine sulfate per 50 mg	Protamine sulfate, for hemodialysis, per 50 mg
A4860	Disposable catheter tips	Disposable catheter tips for peritoneal dialysis, per 10
A4870	Plumb/elec wk hm hemo equip	Plumbing and/or electrical work for home hemodialysis equipment
A4890	Repair/maint cont hemo equip	Contracts, repair and maintenance, for hemodialysis equipment
A4911	Drain bag/bottle	Drain bag/bottle, for dialysis, each
A4913	Misc dialysis supplies noc	Miscellaneous dialysis supplies, not otherwise specified
A4918	Venous pressure clamp	Venous pressure clamp, for hemodialysis, each
A4927	Non-sterile gloves	Gloves, non-sterile, per 100
A4928	Surgical mask	Surgical mask, per 20
A4929	Tourniquet for dialysis, ea	Tourniquet for dialysis, each
A4930	Sterile, gloves per pair	Gloves, sterile, per pair
A4931	Reusable oral thermometer	Oral thermometer, reusable, any type, each
A4932	Reusable rectal thermometer	Rectal thermometer, reusable, any type, each
A5	Dressing for five wounds	Dressing for five wounds
A5051	Pouch clsd w barr attached	Ostomy pouch, closed; with barrier attached (1 piece), each
A5052	Clsd ostomy pouch w/o barr	Ostomy pouch, closed; without barrier attached (1 piece), each
A5053	Clsd ostomy pouch faceplate	Ostomy pouch, closed; for use on faceplate, each
A5054	Clsd ostomy pouch w/flange	Ostomy pouch, closed; for use on barrier with flange (2 piece), each
A5055	Stoma cap	Stoma cap
A5056	1 pc ost pouch w filter	Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each
A5057	1 pc ost pou w built-in conv	Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
A5061	Pouch drainable w barrier at	Ostomy pouch, drainable; with barrier attached, (1 piece), each
A5062	Drnble ostomy pouch w/o barr	Ostomy pouch, drainable; without barrier attached (1 piece), each
A5063	Drain ostomy pouch w/flange	Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each
A5071	Urinary pouch w/barrier	Ostomy pouch, urinary; with barrier attached (1 piece), each
A5072	Urinary pouch w/o barrier	Ostomy pouch, urinary; without barrier attached (1 piece), each
A5073	Urinary pouch on barr w/flng	Ostomy pouch, urinary; for use on barrier with flange (2 piece), each
A5081	Stoma plug or seal, any type	Stoma plug or seal, any type
A5082	Continent stoma catheter	Continent device; catheter for continent stoma
A5083	Stoma absorptive cover	Continent device, stoma absorptive cover for continent stoma
A5093	Ostomy accessory convex inse	Ostomy accessory; convex insert
A5102	Bedside drain btl w/wo tube	Bedside drainage bottle with or without tubing, rigid or expandable, each
A5105	Urinary suspensory	Urinary suspensory with leg bag, with or without tube, each
A5112	Urinary leg bag	Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each
A5113	Latex leg strap	Leg strap; latex, replacement only, per set
A5114	Foam/fabric leg strap	Leg strap; foam or fabric, replacement only, per set
A5120	Skin barrier, wipe or swab	Skin barrier, wipes or swabs, each
A5121	Solid skin barrier 6x6	Skin barrier; solid, 6 x 6 or equivalent, each
A5122	Solid skin barrier 8x8	Skin barrier; solid, 8 x 8 or equivalent, each
A5126	Disk/foam pad +or- adhesive	Adhesive or non-adhesive; disk or foam pad
A5131	Appliance cleaner	Appliance cleaner, incontinence and ostomy appliances, per 16 oz.
A5200	Percutaneous catheter anchor	Percutaneous catheter/tube anchoring device, adhesive skin attachment
A5500	Diab shoe for density insert	For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe
A5501	Diabetic custom molded shoe	For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe
A5503	Diabetic shoe w/roller/rockr	For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe
A5504	Diabetic shoe with wedge	For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe
A5505	Diab shoe w/metatarsal bar	For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe
A5506	Diabetic shoe w/off set heel	For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe
A5507	Modification diabetic shoe	For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe
A5508	Diabetic deluxe shoe	For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe
A5510	Compression form shoe insert	For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe
A5512	Multi den insert direct form	For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each
A5513	Multi den insert custom mold	For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
A5514	Mult den insert dir carv/cam	For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
A6	Dressing for six wounds	Dressing for six wounds
A6000	Wound warming wound cover	Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card
A6010	Collagen based wound filler	Collagen based wound filler, dry form, sterile, per gram of collagen
A6011	Collagen gel/paste wound fil	Collagen based wound filler, gel/paste, per gram of collagen
A6021	Collagen dressing <=16 sq in	Collagen dressing, sterile, size 16 sq. in. or less, each
A6022	Collagen drsg>16<=48 sq in	Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each
A6023	Collagen dressing >48 sq in	Collagen dressing, sterile, size more than 48 sq. in., each
A6024	Collagen dsg wound filler	Collagen dressing wound filler, sterile, per 6 inches
A6025	Silicone gel sheet, each	Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each
A6154	Wound pouch each	Wound pouch, each
A6196	Alginate dressing <=16 sq in	Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing
A6197	Alginate drsg >16 <=48 sq in	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
A6198	Alginate dressing > 48 sq in	Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing
A6199	Alginate drsg wound filler	Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches
A6203	Composite drsg <= 16 sq in	Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6204	Composite drsg >16<=48 sq in	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
A6205	Composite drsg > 48 sq in	Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6206	Contact layer <= 16 sq in	Contact layer, sterile, 16 sq. in. or less, each dressing
A6207	Contact layer >16<= 48 sq in	Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
A6208	Contact layer > 48 sq in	Contact layer, sterile, more than 48 sq. in., each dressing
A6209	Foam drsg <=16 sq in w/o bdr	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6210	Foam drg >16<=48 sq in w/o b	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
A6211	Foam drg > 48 sq in w/o brdr	Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6212	Foam drg <=16 sq in w/border	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6213	Foam drg >16<=48 sq in w/bdr	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
A6214	Foam drg > 48 sq in w/border	Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6215	Foam dressing wound filler	Foam dressing, wound filler, sterile, per gram
A6216	Non-sterile gauze<=16 sq in	Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6217	Non-sterile gauze>16<=48 sq	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
A6218	Non-sterile gauze > 48 sq in	Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6219	Gauze <= 16 sq in w/border	Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6220	Gauze >16 <=48 sq in w/bordr	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
A6221	Gauze > 48 sq in w/border	Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6222	Gauze <=16 in no w/sal w/o b	Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6223	Gauze >16<=48 no w/sal w/o b	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
A6224	Gauze > 48 in no w/sal w/o b	Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6228	Gauze <= 16 sq in water/sal	Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6229	Gauze >16<=48 sq in watr/sal	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
A6230	Gauze > 48 sq in water/salne	Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6231	Hydrogel dsg<=16 sq in	Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing
A6232	Hydrogel dsg>16<=48 sq in	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
A6233	Hydrogel dressing >48 sq in	Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing
A6234	Hydrocolld drg <=16 w/o bdr	Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6235	Hydrocolld drg >16<=48 w/o b	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
A6236	Hydrocolld drg > 48 in w/o b	Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6237	Hydrocolld drg <=16 in w/bdr	Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6238	Hydrocolld drg >16<=48 w/bdr	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
A6239	Hydrocolld drg > 48 in w/bdr	Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6240	Hydrocolld drg filler paste	Hydrocolloid dressing, wound filler, paste, sterile, per ounce
A6241	Hydrocolloid drg filler dry	Hydrocolloid dressing, wound filler, dry form, sterile, per gram
A6242	Hydrogel drg <=16 in w/o bdr	Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6243	Hydrogel drg >16<=48 w/o bdr	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
A6244	Hydrogel drg >48 in w/o bdr	Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6245	Hydrogel drg <= 16 in w/bdr	Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6246	Hydrogel drg >16<=48 in w/b	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
A6247	Hydrogel drg > 48 sq in w/b	Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6248	Hydrogel drsg gel filler	Hydrogel dressing, wound filler, gel, per fluid ounce
A6250	Skin seal protect moisturizr	Skin sealants, protectants, moisturizers, ointments, any type, any size
A6251	Absorpt drg <=16 sq in w/o b	Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6252	Absorpt drg >16 <=48 w/o bdr	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
A6253	Absorpt drg > 48 sq in w/o b	Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6254	Absorpt drg <=16 sq in w/bdr	Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6255	Absorpt drg >16<=48 in w/bdr	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
A6256	Absorpt drg > 48 sq in w/bdr	Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6257	Transparent film <= 16 sq in	Transparent film, sterile, 16 sq. in. or less, each dressing
A6258	Transparent film >16<=48 in	Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
A6259	Transparent film > 48 sq in	Transparent film, sterile, more than 48 sq. in., each dressing
A6260	Wound cleanser any type/size	Wound cleansers, any type, any size
A6261	Wound filler gel/paste /oz	Wound filler, gel/paste, per fluid ounce, not otherwise specified
A6262	Wound filler dry form / gram	Wound filler, dry form, per gram, not otherwise specified
A6266	Impreg gauze no h20/sal/yard	Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard
A6402	Sterile gauze <= 16 sq in	Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6403	Sterile gauze>16 <= 48 sq in	Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing
A6404	Sterile gauze > 48 sq in	Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
A6407	Packing strips, non-impreg	Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard
A6410	Sterile eye pad	Eye pad, sterile, each
A6411	Non-sterile eye pad	Eye pad, non-sterile, each
A6412	Occlusive eye patch	Eye patch, occlusive, each
A6413	Adhesive bandage, first-aid	Adhesive bandage, first-aid type, any size, each
A6441	Pad band w>=3 <5/yd	Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard
A6442	Conform band n/s w<3/yd	Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard
A6443	Conform band n/s w>=3<5/yd	Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard
A6444	Conform band n/s w>=5/yd	Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard
A6445	Conform band s w <3/yd	Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard
A6446	Conform band s w>=3 <5/yd	Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard
A6447	Conform band s w >=5/yd	Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard
A6448	Lt compres band <3/yd	Light compression bandage, elastic, knitted/woven, width less than three inches, per yard
A6449	Lt compres band >=3 <5/yd	Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard
A6450	Lt compres band >=5/yd	Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard
A6451	Mod compres band w>=3<5/yd	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
A6452	High compres band w>=3<5yd	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
A6453	Self-adher band w <3/yd	Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard
A6454	Self-adher band w>=3 <5/yd	Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard
A6455	Self-adher band >=5/yd	Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard
A6456	Zinc paste band w >=3<5/yd	Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard
A6457	Tubular dressing	Tubular dressing with or without elastic, any width, per linear yard
A6460	Synthetic drsg <= 16 sq in	Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6461	Synthetic drsg >16<=48 sq in	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
A6501	Compres burngarment bodysuit	Compression burn garment, bodysuit (head to foot), custom fabricated
A6502	Compres burngarment chinstrp	Compression burn garment, chin strap, custom fabricated
A6503	Compres burngarment facehood	Compression burn garment, facial hood, custom fabricated
A6504	Cmprsburngarment glove-wrist	Compression burn garment, glove to wrist, custom fabricated
A6505	Cmprsburngarment glove-elbow	Compression burn garment, glove to elbow, custom fabricated
A6506	Cmprsburngrmnt glove-axilla	Compression burn garment, glove to axilla, custom fabricated
A6507	Cmprs burngarment foot-knee	Compression burn garment, foot to knee length, custom fabricated
A6508	Cmprs burngarment foot-thigh	Compression burn garment, foot to thigh length, custom fabricated
A6509	Compres burn garment jacket	Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated
A6510	Compres burn garment leotard	Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated
A6511	Compres burn garment panty	Compression burn garment, lower trunk including leg openings (panty), custom fabricated
A6512	Compres burn garment, noc	Compression burn garment, not otherwise classified
A6513	Compress burn mask face/neck	Compression burn mask, face and/or neck, plastic or equal, custom fabricated
A6520	G com garmnt glove nghttime	Gradient compression garment, glove, padded, for nighttime use, each
A6521	G com garmnt glove nght cust	Gradient compression garment, glove, padded, for nighttime use, custom, each
A6522	G com garment arm nighttime	Gradient compression garment, arm, padded, for nighttime use, each
A6523	G com garment arm nght custm	Gradient compression garment, arm, padded, for nighttime use, custom, each
A6524	G com garmnt lwr leg/ft nght	Gradient compression garment, lower leg and foot, padded, for nighttime use, each
A6525	G com garm lwrleg/ft ngt cus	Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each
A6526	G com garmt full leg/ft nght	Gradient compression garment, full leg and foot, padded, for nighttime use, each
A6527	G garmt full leg/ft nght cus	Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each
A6528	G com garment bra nighttime	Gradient compression garment, bra, for nighttime use, each
A6529	G com garmt bra night custm	Gradient compression garment, bra, for nighttime use, custom, each
A6530	Compression stocking bk18-30	Gradient compression stocking, below knee, 18-30 mmhg, each
A6531	Compress stking bk30-40 surg	Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each
A6532	Compress stking bk40-50 surg	Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each
A6533	Gc stocking thighlngth 18-30	Gradient compression stocking, thigh length, 18-30 mmhg, each
A6534	Gc stocking thighlngth 30-40	Gradient compression stocking, thigh length, 30-40 mmhg, each
A6535	Gc stocking thighlngth 40+	Gradient compression stocking, thigh length, 40 mmhg or greater, each
A6536	Gc stocking full lngth 18-30	Gradient compression stocking, full length/chap style, 18-30 mmhg, each
A6537	Gc stocking full lngth 30-40	Gradient compression stocking, full length/chap style, 30-40 mmhg, each
A6538	Gc stocking full lngth 40+	Gradient compression stocking, full length/chap style, 40 mmhg or greater, each
A6539	Gc stocking waistlngth 18-30	Gradient compression stocking, waist length, 18-30 mmhg, each
A6540	Gc stocking waistlngth 30-40	Gradient compression stocking, waist length, 30-40 mmhg, each
A6541	Gc stocking waistlngth 40+	Gradient compression stocking, waist length, 40 mmhg or greater, each
A6544	Gc stocking garter belt	Gradient compression stocking, garter belt
A6545	Grad com non-elastic bk surg	Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each
A6549	G compression garment	Gradient compression garment, not otherwise specified
A6550	Neg pres wound ther drsg set	Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories
A6552	Grad com stocking bk 30-40	Gradient compression stocking, below knee, 30-40 mmhg, each
A6553	G com stcking bk 30-40 custm	Gradient compression stocking, below knee, 30-40 mmhg, custom, each
A6554	Grad com stocking bk 40+	Gradient compression stocking, below knee, 40 mmhg or greater, each
A6555	G com stcking bk 40+ custm	Gradient compression stocking, below knee, 40 mmhg or greater, custom, each
A6556	G com stcking thgh18-30 cust	Gradient compression stocking, thigh length, 18-30 mmhg, custom, each
A6557	G com stcking thgh30-40 cust	Gradient compression stocking, thigh length, 30-40 mmhg, custom, each
A6558	G com stcking thgh 40+ cust	Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each
A6559	G stckng full/chap18-30 cust	Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each
A6560	G stckng full/chap30-40 cust	Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each
A6561	G stockng full/chap 40+ cust	Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each
A6562	G com stckng waist18-30 cust	Gradient compression stocking, waist length, 18-30 mmhg, custom, each
A6563	G com stckng waist30-40 cust	Gradient compression stocking, waist length, 30-40 mmhg, custom, each
A6564	G com stckng waist 40+ cust	Gradient compression stocking, waist length, 40 mmhg or greater, custom, each
A6565	Grad comp gauntlet custom	Gradient compression gauntlet, custom, each
A6566	Grad com garment neck/head	Gradient compression garment, neck/head, each
A6567	G com garment neck/head cust	Gradient compression garment, neck/head, custom, each
A6568	G com garment torso/shldr	Gradient compression garment, torso and shoulder, each
A6569	G com garmnt torso/shdr cust	Gradient compression garment, torso/shoulder, custom, each
A6570	Grad com garment genital	Gradient compression garment, genital region, each
A6571	G com garment genital custm	Gradient compression garment, genital region, custom, each
A6572	Grad com garment toe caps	Gradient compression garment, toe caps, each
A6573	Grad com garmnt toe cap cust	Gradient compression garment, toe caps, custom, each
A6574	Custom gradient sleev/glov	Gradient compression arm sleeve and glove combination, custom, each
A6575	Gradient comp sleev/glov	Gradient compression arm sleeve and glove combination, each
A6576	Custom grad com sleeve med	Gradient compression arm sleeve, custom, medium weight, each
A6577	Custom grad cm sleeve heavy	Gradient compression arm sleeve, custom, heavy weight, each
A6578	Gradient comp sleeve	Gradient compression arm sleeve, each
A6579	Custom grad com glove med	Gradient compression glove, custom, medium weight, each
A6580	Custom grad com glove heavy	Gradient compression glove, custom, heavy weight, each
A6581	Gradient comp glove	Gradient compression glove, each
A6582	Gradient comp gauntlet	Gradient compression gauntlet, each
A6583	Grad com wrap w straps bk	Gradient compression wrap with adjustable straps, below knee, 30-50 mmhg, each
A6584	Grad com wrap w straps	Gradient compression wrap with adjustable straps, not otherwise specified
A6585	Grad com wrap w straps ak	Gradient pressure wrap with adjustable straps, above knee, each
A6586	Grad com wrap w straps leg	Gradient pressure wrap with adjustable straps, full leg, each
A6587	Grad com wrap w straps foot	Gradient pressure wrap with adjustable straps, foot, each
A6588	Grad com wrap w straps arm	Gradient pressure wrap with adjustable straps, arm, each
A6589	Grad com wrap w straps bra	Gradient pressure wrap with adjustable straps, bra, each
A6590	Urinary cath disp suc pump	External urinary catheters; disposable, with wicking material, for use with suction pump, per month
A6591	Urinary cath suc pump	External urinary catheter; non-disposable, for use with suction pump, per month
A6593	Grad com accessory gmt_wrap	Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified
A6594	G comp bandge liner lwr extr	Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each
A6595	G comp bandge liner upr extr	Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each
A6596	G comp bandge conform gauze	Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each
A6597	G comp bandage long stretch	Gradient compression bandage roll, elastic long stretch, linear yard, any width, each
A6598	G comp bandage med stretch	Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each
A6599	G comp bandage short stretch	Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each
A6600	G com bandge hgh dn foam sht	Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each
A6601	G com bandge hgh dn foam pad	Gradient compression bandaging supply, high density foam pad, any size or shape, each
A6602	G com bandge hgh dn foamroll	Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each
A6603	G com bandge low dn foamchnl	Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each
A6604	G com bandge low dn foam flt	Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each
A6605	G com bandage padded foam	Gradient compression bandaging supply, padded foam, per linear yard, any width, each
A6606	G com bandage padded textile	Gradient compression bandaging supply, padded textile, per linear yard, any width, each
A6607	G com bandage tub protct lyr	Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each
A6608	G com bandage tub protct pad	Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each
A6609	G compression bandaging	Gradient compression bandaging supply, not otherwise specified
A6610	G com stcking bk 18-30 custm	Gradient compression stocking, below knee, 18-30 mmhg, custom, each
A7	Dressing for seven wounds	Dressing for seven wounds
A7000	Disposable canister for pump	Canister, disposable, used with suction pump, each
A7001	Nondisposable pump canister	Canister, non-disposable, used with suction pump, each
A7002	Tubing used w suction pump	Tubing, used with suction pump, each
A7003	Nebulizer administration set	Administration set, with small volume nonfiltered pneumatic nebulizer, disposable
A7004	Disposable nebulizer sml vol	Small volume nonfiltered pneumatic nebulizer, disposable
A7005	Nondisposable nebulizer set	Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable
A7006	Filtered nebulizer admin set	Administration set, with small volume filtered pneumatic nebulizer
A7007	Lg vol nebulizer disposable	Large volume nebulizer, disposable, unfilled, used with aerosol compressor
A7008	Disposable nebulizer prefill	Large volume nebulizer, disposable, prefilled, used with aerosol compressor
A7009	Nebulizer reservoir bottle	Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer
A7010	Disposable corrugated tubing	Corrugated tubing, disposable, used with large volume nebulizer, 100 feet
A7011	Nondispos corrugated tubing	Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet
A7012	Nebulizer water collec devic	Water collection device, used with large volume nebulizer
A7013	Disposable compressor filter	Filter, disposable, used with aerosol compressor or ultrasonic generator
A7014	Compressor nondispos filter	Filter, nondisposable, used with aerosol compressor or ultrasonic generator
A7015	Aerosol mask used w nebulize	Aerosol mask, used with dme nebulizer
A7016	Nebulizer dome & mouthpiece	Dome and mouthpiece, used with small volume ultrasonic nebulizer
A7017	Nebulizer not used w oxygen	Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen
A7018	Water distilled w/nebulizer	Water, distilled, used with large volume nebulizer, 1000 ml
A7020	Interface, cough stim device	Interface for cough stimulating device, includes all components, replacement only
A7023	Mech allergen parti barrier	Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical
A7025	Replace chest compress vest	High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each
A7026	Replace chst cmprss sys hose	High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each
A7027	Combination oral/nasal mask	Combination oral/nasal mask, used with continuous positive airway pressure device, each
A7028	Repl oral cushion combo mask	Oral cushion for combination oral/nasal mask, replacement only, each
A7029	Repl nasal pillow comb mask	Nasal pillows for combination oral/nasal mask, replacement only, pair
A7030	Cpap full face mask	Full face mask used with positive airway pressure device, each
A7031	Replacement facemask interfa	Face mask interface, replacement for full face mask, each
A7032	Replacement nasal cushion	Cushion for use on nasal mask interface, replacement only, each
A7033	Replacement nasal pillows	Pillow for use on nasal cannula type interface, replacement only, pair
A7034	Nasal application device	Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap
A7035	Pos airway press headgear	Headgear used with positive airway pressure device
A7036	Pos airway press chinstrap	Chinstrap used with positive airway pressure device
A7037	Pos airway pressure tubing	Tubing used with positive airway pressure device
A7038	Pos airway pressure filter	Filter, disposable, used with positive airway pressure device
A7039	Filter, non disposable w pap	Filter, non disposable, used with positive airway pressure device
A7040	One way chest drain valve	One way chest drain valve
A7041	Water seal drain container	Water seal drainage container and tubing for use with implanted chest tube
A7042	Implanted pleural catheter	Implanted pleural catheter, each
A7043	Vacuum drainagebottle/tubing	Vacuum drainage bottle and tubing for use with implanted catheter
A7044	Pap oral interface	Oral interface used with positive airway pressure device, each
A7045	Repl exhalation port for pap	Exhalation port with or without swivel used with accessories for positive airway devices, replacement only
A7046	Repl water chamber, pap dev	Water chamber for humidifier, used with positive airway pressure device, replacement, each
A7047	Resp suction oral interface	Oral interface used with respiratory suction pump, each
A7048	Vacuum drain bottle/tube kit	Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each
A7049	Epap nasal valve	Expiratory positive airway pressure intranasal resistance valve
A7501	Tracheostoma valve w diaphra	Tracheostoma valve, including diaphragm, each
A7502	Replacement diaphragm/fplate	Replacement diaphragm/faceplate for tracheostoma valve, each
A7503	Hmes filter holder or cap	Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each
A7504	Tracheostoma hmes filter	Filter for use in a tracheostoma heat and moisture exchange system, each
A7505	Hmes or trach valve housing	Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each
A7506	Hmes/trachvalve adhesivedisk	Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each
A7507	Integrated filter & holder	Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each
A7508	Housing & integrated adhesiv	Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each
A7509	Heat & moisture exchange sys	Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each
A7520	Trach/laryn tube non-cuffed	Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each
A7521	Trach/laryn tube cuffed	Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each
A7522	Trach/laryn tube stainless	Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each
A7523	Tracheostomy shower protect	Tracheostomy shower protector, each
A7524	Tracheostoma stent/stud/bttn	Tracheostoma stent/stud/button, each
A7525	Tracheostomy mask	Tracheostomy mask, each
A7526	Tracheostomy tube collar	Tracheostomy tube collar/holder, each
A7527	Trach/laryn tube plug/stop	Tracheostomy/laryngectomy tube plug/stop, each
A8	Dressing for eight wounds	Dressing for eight wounds
A8000	Soft protect helmet prefab	Helmet, protective, soft, prefabricated, includes all components and accessories
A8001	Hard protect helmet prefab	Helmet, protective, hard, prefabricated, includes all components and accessories
A8002	Soft protect helmet custom	Helmet, protective, soft, custom fabricated, includes all components and accessories
A8003	Hard protect helmet custom	Helmet, protective, hard, custom fabricated, includes all components and accessories
A8004	Repl soft interface, helmet	Soft interface for helmet, replacement only
A9	Dressing for 9 or more wound	Dressing for nine or more wounds
A9150	Misc/exper non-prescript dru	Non-prescription drugs
A9152	Single vitamin nos	Single vitamin/mineral/trace element, oral, per dose, not otherwise specified
A9153	Multi-vitamin nos	Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified
A9155	Artificial saliva	Artificial saliva, 30 ml
A9156	Oral mucoadhesive per 1 ml	Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml
A9180	Lice treatment, topical	Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker
A9268	Programmer orally ingest cap	Programmer for transient, orally ingested capsule
A9269	Programable ingest capsule	Programable, transient, orally ingested capsule, for use with external programmer, per month
A9270	Non-covered item or service	Non-covered item or service
A9272	Disp wound suct, drsg/access	Wound suction, disposable, includes dressing, all accessories and components, any type, each
A9273	Hot/cold botle/cap/col/wrap	Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type
A9274	Ext amb insulin delivery sys	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories
A9275	Disp home glucose monitor	Home glucose disposable monitor, includes test strips
A9276	Disposable sensor, cgm sys	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply
A9277	External transmitter, cgm	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system
A9278	External receiver, cgm sys	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system
A9279	Monitoring feature/devicenoc	Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified
A9280	Alert device, noc	Alert or alarm device, not otherwise classified
A9281	Reaching/grabbing device	Reaching/grabbing device, any type, any length, each
A9282	Wig any type	Wig, any type, each
A9283	Foot press off load supp dev	Foot pressure off loading/supportive device, any type, each
A9284	Non-electronic spirometer	Spirometer, non-electronic, includes all accessories
A9285	Inversion eversion cor devic	Inversion/eversion correction device
A9286	Any hygienic item, device	Hygienic item or device, disposable or non-disposable, any type, each
A9291	Pres dig cog behav thera fda	Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment
A9292	Pres dig visual therapy fda	Prescription digital visual therapy, software-only, fda cleared, per course of treatment
A9293	Fertility cycl tracking soft	Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)
A9300	Exercise equipment	Exercise equipment
A9500	Tc99m sestamibi	Technetium tc-99m sestamibi, diagnostic, per study dose
A9501	Technetium tc-99m teboroxime	Technetium tc-99m teboroxime, diagnostic, per study dose
A9502	Tc99m tetrofosmin	Technetium tc-99m tetrofosmin, diagnostic, per study dose
A9503	Tc99m medronate	Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries
A9504	Tc99m apcitide	Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries
A9505	Tl201 thallium	Thallium tl-201 thallous chloride, diagnostic, per millicurie
A9506	Tc-99m graphite crucible	Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible
A9507	In111 capromab	Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries
A9508	I131 iodobenguate, dx	Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie
A9509	Iodine i-123 sod iodide mil	Iodine i-123 sodium iodide, diagnostic, per millicurie
A9510	Tc99m disofenin	Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries
A9512	Tc99m pertechnetate	Technetium tc-99m pertechnetate, diagnostic, per millicurie
A9513	Lutetium lu 177 dotatat ther	Lutetium lu 177, dotatate, therapeutic, 1 millicurie
A9515	Choline c-11	Choline c-11, diagnostic, per study dose up to 20 millicuries
A9516	Iodine i-123 sod iodide mic	Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries
A9517	I131 iodide cap, rx	Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie
A9520	Tc99 tilmanocept diag 0.5mci	Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries
A9521	Tc99m exametazime	Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
A9524	I131 serum albumin, dx	Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries
A9526	Nitrogen n-13 ammonia	Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries
A9527	Iodine i-125 sodium iodide	Iodine i-125, sodium iodide solution, therapeutic, per millicurie
A9528	Iodine i-131 iodide cap, dx	Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie
A9529	I131 iodide sol, dx	Iodine i-131 sodium iodide solution, diagnostic, per millicurie
A9530	I131 iodide sol, rx	Iodine i-131 sodium iodide solution, therapeutic, per millicurie
A9531	I131 max 100uci	Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)
A9532	I125 serum albumin, dx	Iodine i-125 serum albumin, diagnostic, per 5 microcuries
A9536	Tc99m depreotide	Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries
A9537	Tc99m mebrofenin	Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries
A9538	Tc99m pyrophosphate	Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries
A9539	Tc99m pentetate	Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries
A9540	Tc99m maa	Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries
A9541	Tc99m sulfur colloid	Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries
A9542	In111 ibritumomab, dx	Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries
A9543	Y90 ibritumomab, rx	Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries
A9544	I131 tositumomab, dx	Iodine i-131 tositumomab, diagnostic, per study dose
A9545	I131 tositumomab, rx	Iodine i-131 tositumomab, therapeutic, per treatment dose
A9546	Co57/58	Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie
A9547	In111 oxyquinoline	Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie
A9548	In111 pentetate	Indium in-111 pentetate, diagnostic, per 0.5 millicurie
A9550	Tc99m gluceptate	Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie
A9551	Tc99m succimer	Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries
A9552	F18 fdg	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries
A9553	Cr51 chromate	Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries
A9554	I125 iothalamate, dx	Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries
A9555	Rb82 rubidium	Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries
A9556	Ga67 gallium	Gallium ga-67 citrate, diagnostic, per millicurie
A9557	Tc99m bicisate	Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries
A9558	Xe133 xenon 10mci	Xenon xe-133 gas, diagnostic, per 10 millicuries
A9559	Co57 cyano	Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie
A9560	Tc99m labeled rbc	Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries
A9561	Tc99m oxidronate	Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries
A9562	Tc99m mertiatide	Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries
A9563	P32 na phosphate	Sodium phosphate p-32, therapeutic, per millicurie
A9564	P32 chromic phosphate	Chromic phosphate p-32 suspension, therapeutic, per millicurie
A9566	Tc99m fanolesomab	Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries
A9567	Technetium tc-99m aerosol	Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries
A9568	Technetium tc99m arcitumomab	Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries
A9569	Technetium tc-99m auto wbc	Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
A9570	Indium in-111 auto wbc	Indium in-111 labeled autologous white blood cells, diagnostic, per study dose
A9571	Indium in-111 auto platelet	Indium in-111 labeled autologous platelets, diagnostic, per study dose
A9572	Indium in-111 pentetreotide	Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
A9573	Inj, gadopiclenol, 1 ml	Injection, gadopiclenol, 1 ml
A9575	Inj gadoterate meglumi 0.1ml	Injection, gadoterate meglumine, 0.1 ml
A9576	Inj prohance multipack	Injection, gadoteridol, (prohance multipack), per ml
A9577	Inj multihance	Injection, gadobenate dimeglumine (multihance), per ml
A9578	Inj multihance multipack	Injection, gadobenate dimeglumine (multihance multipack), per ml
A9579	Gad-base mr contrast nos,1ml	Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml
A9580	Sodium fluoride f-18	Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
A9581	Gadoxetate disodium inj	Injection, gadoxetate disodium, 1 ml
A9582	Iodine i-123 iobenguane	Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
A9583	Gadofosveset trisodium inj	Injection, gadofosveset trisodium, 1 ml
A9584	Iodine i-123 ioflupane	Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries
A9585	Gadobutrol injection	Injection, gadobutrol, 0.1 ml
A9586	Florbetapir f18	Florbetapir f18, diagnostic, per study dose, up to 10 millicuries
A9587	Gallium ga-68	Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
A9588	Fluciclovine f-18	Fluciclovine f-18, diagnostic, 1 millicurie
A9589	Insti hexaminolevulinate hcl	Instillation, hexaminolevulinate hydrochloride, 100 mg
A9590	Iodine i-131 iobenguane 1mci	Iodine i-131, iobenguane, 1 millicurie
A9591	Fluoroestradiol f 18	Fluoroestradiol f 18, diagnostic, 1 millicurie
A9592	Copper cu 64 dotatate diag	Copper cu-64, dotatate, diagnostic, 1 millicurie
A9593	Gallium ga-68 psma-11 ucsf	Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie
A9594	Gallium ga-68 psma-11, ucla	Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie
A9595	Piflu f-18, dia 1 millicurie	Piflufolastat f-18, diagnostic, 1 millicurie
A9596	Gallium illuccix 1 millicure	Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
A9597	Pet, dx, for tumor id, noc	Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
A9598	Pet dx for non-tumor id, noc	Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified
A9599	Radioph dx b amyloid pet nos	Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specified
A9600	Sr89 strontium	Strontium sr-89 chloride, therapeutic, per millicurie
A9601	Flortaucipir inj 1 millicuri	Flortaucipir f 18 injection, diagnostic, 1 millicurie
A9602	Fluorodopa f-18 diag per mci	Fluorodopa f-18, diagnostic, per millicurie
A9603	Inj, pafolacianine, 0.1 mg	Injection, pafolacianine, 0.1 mg
A9604	Sm 153 lexidronam	Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
A9606	Radium ra223 dichloride ther	Radium ra-223 dichloride, therapeutic, per microcurie
A9607	Lutetium lu 177 vipivotide	Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie
A9608	Flotufolastat f18 diag 1 mci	Flotufolastat f 18, diagnostic, 1 millicurie
A9609	F18 fdg, 15 millicuries	Fludeoxyglucose f18 up to 15 millicuries
A9697	Inj, magtrace per study dose	Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose
A9698	Non-rad contrast materialnoc	Non-radioactive contrast imaging material, not otherwise classified, per study
A9699	Radiopharm rx agent noc	Radiopharmaceutical, therapeutic, not otherwise classified
A9700	Echocardiography contrast	Supply of injectable contrast material for use in echocardiography, per study
A9800	Gallium locametz 1 millicuri	Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie
A9900	Supply/accessory/service	Miscellaneous dme supply, accessory, and/or service component of another hcpcs code
A9901	Delivery/set up/dispensing	Dme delivery, set up, and/or dispensing service component of another hcpcs code
A9999	Dme supply or accessory, nos	Miscellaneous dme supply or accessory, not otherwise specified
AA	Anesthesia perf by anesgst	Anesthesia services performed personally by anesthesiologist
AB	Aud svs w/o order evry 12mo	Audiology service furnished personally by an audiologist without a physician/npp order for non-acute hearing assessment unrelated to disequilibrium, or hearing aids, or examinations for the purpose of prescribing, fitting, or changing hearing aids; service may be performed once every 12 months, per beneficiary
AD	Md supervision, >4 anes proc	Medical supervision by a physician: more than four concurrent anesthesia procedures
AE	Registered dietician	Registered dietician
AF	Specialty physician	Specialty physician
AG	Primary physician	Primary physician
AH	Clinical psychologist	Clinical psychologist
AI	Principal physician of rec	Principal physician of record
AJ	Clinical social worker	Clinical social worker
AK	Non participating physician	Non participating physician
AM	Physician, team member svc	Physician, team member service
AO	Prov declined alt pmt method	Alternate payment method declined by provider of service
AP	No dtmn of refractive state	Determination of refractive state was not performed in the course of diagnostic ophthalmological examination
AQ	Physician service hpsa area	Physician providing a service in an unlisted health professional shortage area (hpsa)
AR	Physician scarcity area	Physician provider services in a physician scarcity area
AS	Assistant at surgery service	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
AT	Acute treatment	Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)
AU	Uro, ostomy or trach item	Item furnished in conjunction with a urological, ostomy, or tracheostomy supply
AV	Item w prosthetic/orthotic	Item furnished in conjunction with a prosthetic device, prosthetic or orthotic
AW	Item w a surgical dressing	Item furnished in conjunction with a surgical dressing
AX	Item w dialysis services	Item furnished in conjunction with dialysis services
AY	Item/service not for esrd tx	Item or service furnished to an esrd patient that is not for the treatment of esrd
AZ	Physician serv in dent hpsa	Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment