A4220 HCPCS - REFILL KIT FOR IMPLANTABLE INFUSION PUMP

Code Information

HCPCS Code: A4220
Sequence Number: 0010
Short Description: Infusion pump refill kit
Long Description: Refill kit for implantable infusion pump
Date Added: 1/1/1994
Action Code: N - No maintenance for this code
Action Effective Date: 3/3/1998
Classification: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
Coding System: HCPCS

Pricing Indicator Code:
- 57 - Other carrier priced
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
- 60-14
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: D - Special coverage instructions apply

Field Name	Field Value
Healthcare Common Procedure Coding System Code	A4220
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Refill kit for implantable infusion pump
HCPCS Short Description	Infusion pump refill kit
HCPCS Pricing Indicator Code 1	57 - Other carrier priced
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Issues Manual Reference Section Number 1	60-14
HCPCS Coverage Code	D - Special coverage instructions apply
HCPCS Processing Note Number	0050
HCPCS Berenson-Eggers Type Of Service Code	D1A - Medical/surgical supplies
HCPCS Type Of Service Code 1	P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/1994
HCPCS Action Effective Date	3/3/1998
HCPCS Action Code	N - No maintenance for this code