A-Codes
A4000–A4999: Transportation, Medical & Surgical Supplies
A4000–A4999
- A4100Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)
- A4206Syringe with needle, sterile, 1 cc or less, each
- A4207Syringe with needle, sterile 2 cc, each
- A4208Syringe with needle, sterile 3 cc, each
- A4209Syringe with needle, sterile 5 cc or greater, each
- A4210Needle-free injection device, each
- A4211Supplies for self-administered injections
- A4212Non-coring needle or stylet with or without catheter
- A4213Syringe, sterile, 20 cc or greater, each
- A4215Needle, sterile, any size, each
- A4216Sterile water, saline and/or dextrose, diluent/flush, 10 ml
- A4217Sterile water/saline, 500 ml
- A4218Sterile saline or water, metered dose dispenser, 10 ml
- A4220Refill kit for implantable infusion pump
- A4221Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)
- A4222Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)
- A4223Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
- A4224Supplies for maintenance of insulin infusion catheter, per week
- A4225Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
- A4226Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week
- A4228Supplies for maintenance of non-insulin, device-drug combination infusion catheter, per week
- A4230Infusion set for external insulin pump, non needle cannula type
- A4231Infusion set for external insulin pump, needle type
- A4232Syringe with needle for external insulin pump, sterile, 3 cc
- A4233Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each
- A4234Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each
- A4235Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each
- A4236Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each
- A4238Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
- A4239Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
- A4244Alcohol or peroxide, per pint
- A4245Alcohol wipes, per box
- A4246Betadine or phisohex solution, per pint
- A4247Betadine or iodine swabs/wipes, per box
- A4248Chlorhexidine containing antiseptic, 1 ml
- A4250Urine test or reagent strips or tablets (100 tablets or strips)
- A4252Blood ketone test or reagent strip, each
- A4253Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
- A4255Platforms for home blood glucose monitor, 50 per box
- A4256Normal, low and high calibrator solution / chips
- A4257Replacement lens shield cartridge for use with laser skin piercing device, each
- A4258Spring-powered device for lancet, each
- A4259Lancets, per box of 100
- A4261Cervical cap for contraceptive use
- A4262Temporary, absorbable lacrimal duct implant, each
- A4263Permanent, long term, non-dissolvable lacrimal duct implant, each
- A4264Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
- A4265Paraffin, per pound
- A4266Diaphragm for contraceptive use
- A4267Contraceptive supply, condom, male, each
- A4268Contraceptive supply, condom, female, each
- A4269Contraceptive supply, spermicide (e.g., foam, gel), each
- A4270Disposable endoscope sheath, each
- A4271Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests
- A4280Adhesive skin support attachment for use with external breast prosthesis, each
- A4281Tubing for breast pump, replacement
- A4282Adapter for breast pump, replacement
- A4283Cap for breast pump bottle, replacement
- A4284Breast shield and splash protector for use with breast pump, replacement
- A4285Polycarbonate bottle for use with breast pump, replacement
- A4286Locking ring for breast pump, replacement
- A4287Disposable collection and storage bag for breast milk, any size, any type, each
- A4288Valve for breast pump, replacement
- A4290Sacral nerve stimulation test lead, each
- A4295Intermittent urinary catheter; straight tip, hydrophilic coating, each
- A4296Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each
- A4297Intermittent urinary catheter; hydrophilic coating, with insertion supplies
- A4300Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access
- A4301Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)
- A4305Disposable drug delivery system, flow rate of 50 ml or greater per hour
- A4306Disposable drug delivery system, flow rate of less than 50 ml per hour
- A4310Insertion tray without drainage bag and without catheter (accessories only)
- A4311Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
- A4312Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone
- A4313Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
- A4314Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
- A4315Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone
- A4316Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
- A4318Female external urinary collection cup, with or without ring attachment, per day
- A4320Irrigation tray with bulb or piston syringe, any purpose
- A4321Therapeutic agent for urinary catheter irrigation
- A4322Irrigation syringe, bulb or piston, each
- A4326Male external catheter with integral collection chamber, any type, each
- A4327Female external urinary collection device; meatal cup, each
- A4328Female external urinary collection device; pouch, each
- A4330Perianal fecal collection pouch with adhesive, each
- A4331Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each
- A4332Lubricant, individual sterile packet, each
- A4333Urinary catheter anchoring device, adhesive skin attachment, each
- A4334Urinary catheter anchoring device, leg strap, each
- A4335Incontinence supply; miscellaneous
- A4336Incontinence supply, urethral insert, any type, each
- A4337Incontinence supply, rectal insert, any type, each
- A4338Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each
- A4340Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each
- A4341Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
- A4342Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each
- A4344Indwelling catheter, foley type, two-way, all silicone or polyurethane, each
- A4346Indwelling catheter; foley type, three way for continuous irrigation, each
- A4349Male external catheter, with or without adhesive, disposable, each
- A4351Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each
- A4352Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each
- A4353Intermittent urinary catheter, with insertion supplies
- A4354Insertion tray with drainage bag but without catheter
- A4355Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each
- A4356External urethral clamp or compression device (not to be used for catheter clamp), each
- A4357Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each
- A4358Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each
- A4360Disposable external urethral clamp or compression device, with pad and/or pouch, each
- A4361Ostomy faceplate, each
- A4362Skin barrier; solid, 4 x 4 or equivalent; each
- A4363Ostomy clamp, any type, replacement only, each
- A4364Adhesive, liquid or equal, any type, per oz
- A4366Ostomy vent, any type, each
- A4367Ostomy belt, each
- A4368Ostomy filter, any type, each
- A4369Ostomy skin barrier, liquid (spray, brush, etc.), per oz
- A4371Ostomy skin barrier, powder, per oz
- A4372Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each
- A4373Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each
- A4375Ostomy pouch, drainable, with faceplate attached, plastic, each
- A4376Ostomy pouch, drainable, with faceplate attached, rubber, each
- A4377Ostomy pouch, drainable, for use on faceplate, plastic, each
- A4378Ostomy pouch, drainable, for use on faceplate, rubber, each
- A4379Ostomy pouch, urinary, with faceplate attached, plastic, each
- A4380Ostomy pouch, urinary, with faceplate attached, rubber, each
- A4381Ostomy pouch, urinary, for use on faceplate, plastic, each
- A4382Ostomy pouch, urinary, for use on faceplate, heavy plastic, each
- A4383Ostomy pouch, urinary, for use on faceplate, rubber, each
- A4384Ostomy faceplate equivalent, silicone ring, each
- A4385Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each
- A4387Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each
- A4388Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each
- A4389Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each
- A4390Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each
- A4391Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each
- A4392Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each
- A4393Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each
- A4394Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce
- A4395Ostomy deodorant for use in ostomy pouch, solid, per tablet
- A4396Ostomy belt with peristomal hernia support
- A4397Irrigation supply; sleeve, each
- A4398Ostomy irrigation supply; bag, each
- A4399Ostomy irrigation supply; cone/catheter, with or without brush
- A4400Ostomy irrigation set
- A4402Lubricant, per ounce
- A4404Ostomy ring, each
- A4405Ostomy skin barrier, non-pectin based, paste, per ounce
- A4406Ostomy skin barrier, pectin-based, paste, per ounce
- A4407Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each
- A4408Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each
- A4409Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each
- A4410Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each
- A4411Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each
- A4412Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each
- A4413Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each
- A4414Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each
- A4415Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each
- A4416Ostomy pouch, closed, with barrier attached, with filter (1 piece), each
- A4417Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each
- A4418Ostomy pouch, closed; without barrier attached, with filter (1 piece), each
- A4419Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each
- A4420Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each
- A4421Ostomy supply; miscellaneous
- A4422Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each
- A4423Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each
- A4424Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each
- A4425Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each
- A4426Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each
- A4427Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each
- A4428Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each
- A4429Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
- A4430Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
- A4431Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each
- A4432Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each
- A4433Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each
- A4434Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each
- A4435Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each
- A4436Irrigation supply; sleeve, reusable, per month
- A4437Irrigation supply; sleeve, disposable, per month
- A4438Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
- A4450Tape, non-waterproof, per 18 square inches
- A4452Tape, waterproof, per 18 square inches
- A4453Rectal catheter with or without balloon, for use with any type transanal irrigation system, each
- A4455Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
- A4456Adhesive remover, wipes, any type, each
- A4457Enema tube, with or without adapter, any type, replacement only, each
- A4458Enema bag with tubing, reusable
- A4459Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type
- A4461Surgical dressing holder, non-reusable, each
- A4463Surgical dressing holder, reusable, each
- A4465Non-elastic binder for extremity
- A4466Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each
- A4467Belt, strap, sleeve, garment, or covering, any type
- A4468Exsufflation belt, includes all supplies and accessories
- A4470Gravlee jet washer
- A4479Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type
- A4480Vabra aspirator
- A4481Tracheostoma filter, any type, any size, each
- A4483Moisture exchanger, disposable, for use with invasive mechanical ventilation
- A4490Surgical stockings above knee length, each
- A4495Surgical stockings thigh length, each
- A4500Surgical stockings below knee length, each
- A4510Surgical stockings full length, each
- A4520Incontinence garment, any type, (e.g., brief, diaper), each
- A4540Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
- A4541Monthly supplies for use of device coded at e0733
- A4542Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
- A4543Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month
- A4544Electrode for external lower extremity nerve stimulator for restless legs syndrome
- A4545Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month
- A4550Surgical trays
- A4553Non-disposable underpads, all sizes
- A4554Disposable underpads, all sizes
- A4555Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only
- A4556Electrodes, (e.g., apnea monitor), per pair
- A4557Lead wires, (e.g., apnea monitor), per pair
- A4558Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz
- A4559Coupling gel or paste, for use with ultrasound device, per oz
- A4560Neuromuscular electrical stimulator (nmes), disposable, replacement only
- A4561Pessary, reusable, rubber, any type
- A4562Pessary, reusable, non rubber, any type
- A4563Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each
- A4564Pessary, disposable, any type
- A4565Slings
- A4566Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment
- A4570Splint
- A4575Topical hyperbaric oxygen chamber, disposable
- A4580Cast supplies (e.g., plaster)
- A4590Special casting material (e.g., fiberglass)
- A4593Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller
- A4594Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each
- A4595Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)
- A4596Cranial electrotherapy stimulation (ces) system supplies and accessories, per month
- A4600Sleeve for intermittent limb compression device, replacement only, each
- A4601Lithium ion battery, rechargeable, for non-prosthetic use, replacement
- A4602Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each
- A4604Tubing with integrated heating element for use with positive airway pressure device
- A4605Tracheal suction catheter, closed system, each
- A4606Oxygen probe for use with oximeter device, replacement
- A4608Transtracheal oxygen catheter, each
- A4611Battery, heavy duty; replacement for patient owned ventilator
- A4612Battery cables; replacement for patient-owned ventilator
- A4613Battery charger; replacement for patient-owned ventilator
- A4614Peak expiratory flow rate meter, hand held
- A4615Cannula, nasal
- A4616Tubing (oxygen), per foot
- A4617Mouth piece
- A4618Breathing circuits
- A4619Face tent
- A4620Variable concentration mask
- A4623Tracheostomy, inner cannula
- A4624Tracheal suction catheter, any type other than closed system, each
- A4625Tracheostomy care kit for new tracheostomy
- A4626Tracheostomy cleaning brush, each
- A4627Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler
- A4628Oral and/or oropharyngeal suction catheter, each
- A4629Tracheostomy care kit for established tracheostomy
- A4630Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient
- A4633Replacement bulb/lamp for ultraviolet light therapy system, each
- A4634Replacement bulb for therapeutic light box, tabletop model
- A4635Underarm pad, crutch, replacement, each
- A4636Replacement, handgrip, cane, crutch, or walker, each
- A4637Replacement, tip, cane, crutch, walker, each.
- A4638Replacement battery for patient-owned ear pulse generator, each
- A4639Replacement pad for infrared heating pad system, each
- A4640Replacement pad for use with medically necessary alternating pressure pad owned by patient
- A4641Radiopharmaceutical, diagnostic, not otherwise classified
- A4642Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
- A4648Tissue marker, implantable, any type, each
- A4649Surgical supply; miscellaneous
- A4650Implantable radiation dosimeter, each
- A4651Calibrated microcapillary tube, each
- A4652Microcapillary tube sealant
- A4653Peritoneal dialysis catheter anchoring device, belt, each
- A4657Syringe, with or without needle, each
- A4660Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
- A4663Blood pressure cuff only
- A4670Automatic blood pressure monitor
- A4671Disposable cycler set used with cycler dialysis machine, each
- A4672Drainage extension line, sterile, for dialysis, each
- A4673Extension line with easy lock connectors, used with dialysis
- A4674Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz
- A4680Activated carbon filter for hemodialysis, each
- A4690Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each
- A4706Bicarbonate concentrate, solution, for hemodialysis, per gallon
- A4707Bicarbonate concentrate, powder, for hemodialysis, per packet
- A4708Acetate concentrate solution, for hemodialysis, per gallon
- A4709Acid concentrate, solution, for hemodialysis, per gallon
- A4714Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon
- A4719"y set" tubing for peritoneal dialysis
- A4720Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
- A4721Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
- A4722Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis
- A4723Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis
- A4724Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis
- A4725Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis
- A4726Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis
- A4728Dialysate solution, non-dextrose containing, 500 ml
- A4730Fistula cannulation set for hemodialysis, each
- A4736Topical anesthetic, for dialysis, per gram
- A4737Injectable anesthetic, for dialysis, per 10 ml
- A4740Shunt accessory, for hemodialysis, any type, each
- A4750Blood tubing, arterial or venous, for hemodialysis, each
- A4755Blood tubing, arterial and venous combined, for hemodialysis, each
- A4760Dialysate solution test kit, for peritoneal dialysis, any type, each
- A4765Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
- A4766Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml
- A4770Blood collection tube, vacuum, for dialysis, per 50
- A4771Serum clotting time tube, for dialysis, per 50
- A4772Blood glucose test strips, for dialysis, per 50
- A4773Occult blood test strips, for dialysis, per 50
- A4774Ammonia test strips, for dialysis, per 50
- A4802Protamine sulfate, for hemodialysis, per 50 mg
- A4860Disposable catheter tips for peritoneal dialysis, per 10
- A4870Plumbing and/or electrical work for home hemodialysis equipment
- A4890Contracts, repair and maintenance, for hemodialysis equipment
- A4911Drain bag/bottle, for dialysis, each
- A4913Miscellaneous dialysis supplies, not otherwise specified
- A4918Venous pressure clamp, for hemodialysis, each
- A4927Gloves, non-sterile, per 100
- A4928Surgical mask, per 20
- A4929Tourniquet for dialysis, each
- A4930Gloves, sterile, per pair
- A4931Oral thermometer, reusable, any type, each
- A4932Rectal thermometer, reusable, any type, each