HCPCS Service Codes - Other medical items or services

HCPCS Codes for Other medical items or services

• A4226

  Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week

• A4238

  Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

• A4239

  Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

• A4250

  Urine test or reagent strips or tablets (100 tablets or strips)

• A4261

  Cervical cap for contraceptive use

• A4262

  Temporary, absorbable lacrimal duct implant, each

• A4263

  Permanent, long term, non-dissolvable lacrimal duct implant, each

• A4264

  Permanent implantable contraceptive intratubal occlusion device(s) and delivery system

• A4265

  Paraffin, per pound

• A4266

  Diaphragm for contraceptive use

• A4267

  Contraceptive supply, condom, male, each

• A4268

  Contraceptive supply, condom, female, each

• A4269

  Contraceptive supply, spermicide (e.g., foam, gel), each

• A4270

  Disposable endoscope sheath, each

• A4281

  Tubing for breast pump, replacement

• A4282

  Adapter for breast pump, replacement

• A4283

  Cap for breast pump bottle, replacement

• A4284

  Breast shield and splash protector for use with breast pump, replacement

• A4285

  Polycarbonate bottle for use with breast pump, replacement

• A4286

  Locking ring for breast pump, replacement

• A4287

  Disposable collection and storage bag for breast milk, any size, any type, each

• A4288

  Valve for breast pump, replacement

• A4290

  Sacral nerve stimulation test lead, each

• A4305

  Disposable drug delivery system, flow rate of 50 ml or greater per hour

• A4306

  Disposable drug delivery system, flow rate of less than 50 ml per hour

• A4360

  Disposable external urethral clamp or compression device, with pad and/or pouch, each

• A4457

  Enema tube, with or without adapter, any type, replacement only, each

• A4458

  Enema bag with tubing, reusable

• A4465

  Non-elastic binder for extremity

• A4466

  Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each

• A4467

  Belt, strap, sleeve, garment, or covering, any type

• A4468

  Exsufflation belt, includes all supplies and accessories

• A4520

  Incontinence garment, any type, (e.g., brief, diaper), each

• A4540

  Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm

• A4543

  Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month

• A4550

  Surgical trays

• A4553

  Non-disposable underpads, all sizes

• A4554

  Disposable underpads, all sizes

• A4560

  Neuromuscular electrical stimulator (nmes), disposable, replacement only

• A4566

  Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment

• A4575

  Topical hyperbaric oxygen chamber, disposable

• A4580

  Cast supplies (e.g., plaster)

• A4590

  Special casting material (e.g., fiberglass)

• A4606

  Oxygen probe for use with oximeter device, replacement

• A4614

  Peak expiratory flow rate meter, hand held

• A4627

  Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler

• A4634

  Replacement bulb for therapeutic light box, tabletop model

• A4648

  Tissue marker, implantable, any type, each

• A4649

  Surgical supply; miscellaneous

• A4650

  Implantable radiation dosimeter, each