HCPCS Level II 1986 code changes

Added effective January 1, 1986 (525)

• A4253 — Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
• A4265 — Paraffin, per pound
• A4300 — Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access
• A4354 — Insertion tray with drainage bag but without catheter
• A4470 — Gravlee jet washer
• A4480 — Vabra aspirator
• A4490 — Surgical stockings above knee length, each
• A4495 — Surgical stockings thigh length, each
• A4500 — Surgical stockings below knee length, each
• A4510 — Surgical stockings full length, each
• A4554 — Disposable underpads, all sizes
• A4660 — Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
• A4663 — Blood pressure cuff only
• A4670 — Automatic blood pressure monitor
• A4680 — Activated carbon filter for hemodialysis, each
• A4690 — Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each
• A4714 — Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon
• A4730 — Fistula cannulation set for hemodialysis, each
• A4740 — Shunt accessory, for hemodialysis, any type, each
• A4750 — Blood tubing, arterial or venous, for hemodialysis, each
• A4755 — Blood tubing, arterial and venous combined, for hemodialysis, each
• A4760 — Dialysate solution test kit, for peritoneal dialysis, any type, each
• A4765 — Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
• A4770 — Blood collection tube, vacuum, for dialysis, per 50
• A4771 — Serum clotting time tube, for dialysis, per 50
• A4772 — Blood glucose test strips, for dialysis, per 50
• A4773 — Occult blood test strips, for dialysis, per 50
• A4774 — Ammonia test strips, for dialysis, per 50
• A4860 — Disposable catheter tips for peritoneal dialysis, per 10
• A4870 — Plumbing and/or electrical work for home hemodialysis equipment
• A4890 — Contracts, repair and maintenance, for hemodialysis equipment
• A4913 — Miscellaneous dialysis supplies, not otherwise specified
• A4918 — Venous pressure clamp, for hemodialysis, each
• A4927 — Gloves, non-sterile, per 100
• A9150 — Non-prescription drugs
• A9270 — Non-covered item or service
• B4034 — Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
• B4035 — Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
• B4036 — Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
• B4081 — Nasogastric tubing with stylet
• B4082 — Nasogastric tubing without stylet
• B4083 — Stomach tube - levine type
• B4150 — Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
• B4153 — Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
• B4155 — Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit
• B4164 — Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix
• B4176 — Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix
• B4180 — Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix
• B4222 — Parenteral nutrition supply kit; home mix, per day
• B4224 — Parenteral nutrition administration kit, per day
• E0100 — Cane, includes canes of all materials, adjustable or fixed, with tip
• E0105 — Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips
• E0110 — Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips
• E0111 — Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips
• E0112 — Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips
• E0113 — Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip
• E0114 — Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips
• E0116 — Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each
• E0130 — Walker, rigid (pickup), adjustable or fixed height
• E0135 — Walker, folding (pickup), adjustable or fixed height
• E0141 — Walker, rigid, wheeled, adjustable or fixed height
• E0143 — Walker, folding, wheeled, adjustable or fixed height
• E0147 — Walker, heavy duty, multiple braking system, variable wheel resistance
• E0153 — Platform attachment, forearm crutch, each
• E0154 — Platform attachment, walker, each
• E0155 — Wheel attachment, rigid pick-up walker, per pair
• E0156 — Seat attachment, walker
• E0157 — Crutch attachment, walker, each
• E0158 — Leg extensions for walker, per set of four (4)
• E0160 — Sitz type bath or equipment, portable, used with or without commode
• E0161 — Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s
• E0162 — Sitz bath chair
• E0163 — Commode chair, mobile or stationary, with fixed arms
• E0165 — Commode chair, mobile or stationary, with detachable arms
• E0167 — Pail or pan for use with commode chair, replacement only
• E0175 — Foot rest, for use with commode chair, each
• E0181 — Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty
• E0182 — Pump for alternating pressure pad, for replacement only
• E0184 — Dry pressure mattress
• E0185 — Gel or gel-like pressure pad for mattress, standard mattress length and width
• E0186 — Air pressure mattress
• E0187 — Water pressure mattress
• E0188 — Synthetic sheepskin pad
• E0189 — Lambswool sheepskin pad, any size
• E0191 — Heel or elbow protector, each
• E0200 — Heat lamp, without stand (table model), includes bulb, or infrared element
• E0205 — Heat lamp, with stand, includes bulb, or infrared element
• E0210 — Electric heat pad, standard
• E0215 — Electric heat pad, moist
• E0225 — Hydrocollator unit, includes pads
• E0235 — Paraffin bath unit, portable (see medical supply code a4265 for paraffin)
• E0236 — Pump for water circulating pad
• E0239 — Hydrocollator unit, portable
• E0241 — Bath tub wall rail, each
• E0242 — Bath tub rail, floor base
• E0243 — Toilet rail, each
• E0244 — Raised toilet seat
• E0245 — Tub stool or bench
• E0246 — Transfer tub rail attachment
• E0249 — Pad for water circulating heat unit, for replacement only
• E0250 — Hospital bed, fixed height, with any type side rails, with mattress
• E0251 — Hospital bed, fixed height, with any type side rails, without mattress
• E0255 — Hospital bed, variable height, hi-lo, with any type side rails, with mattress
• E0260 — Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
• E0265 — Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress
• E0266 — Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress
• E0270 — Hospital bed, institutional type includes: oscillating, circulating and stryker frame, with mattress
• E0271 — Mattress, innerspring
• E0272 — Mattress, foam rubber
• E0273 — Bed board
• E0274 — Over-bed table
• E0275 — Bed pan, standard, metal or plastic
• E0276 — Bed pan, fracture, metal or plastic
• E0280 — Bed cradle, any type
• E0305 — Bed side rails, half length
• E0310 — Bed side rails, full length
• E0315 — Bed accessory: board, table, or support device, any type
• E0325 — Urinal; male, jug-type, any material
• E0326 — Urinal; female, jug-type, any material
• E0425 — Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
• E0430 — Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing
• E0435 — Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor
• E0440 — Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
• E0455 — Oxygen tent, excluding croup or pediatric tents
• E0480 — Percussor, electric or pneumatic, home model
• E0500 — Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source
• E0550 — Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery
• E0555 — Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter
• E0560 — Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery
• E0570 — Nebulizer, with compressor
• E0575 — Nebulizer, ultrasonic, large volume
• E0580 — Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter
• E0585 — Nebulizer, with compressor and heater
• E0600 — Respiratory suction pump, home model, portable or stationary, electric
• E0605 — Vaporizer, room type
• E0606 — Postural drainage board
• E0607 — Home blood glucose monitor
• E0610 — Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)
• E0615 — Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems
• E0621 — Sling or seat, patient lift, canvas or nylon
• E0625 — Patient lift, bathroom or toilet, not otherwise classified
• E0630 — Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)
• E0635 — Patient lift, electric with seat or sling
• E0650 — Pneumatic compressor, non-segmental home model
• E0655 — Non-segmental pneumatic appliance for use with pneumatic compressor, half arm
• E0660 — Non-segmental pneumatic appliance for use with pneumatic compressor, full leg
• E0665 — Non-segmental pneumatic appliance for use with pneumatic compressor, full arm
• E0666 — Non-segmental pneumatic appliance for use with pneumatic compressor, half leg
• E0700 — Safety equipment, device or accessory, any type
• E0710 — Restraints, any type (body, chest, wrist or ankle)
• E0720 — Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation
• E0730 — Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation
• E0740 — Non-implanted pelvic floor electrical stimulator, complete system
• E0745 — Neuromuscular stimulator, electronic shock unit
• E0747 — Osteogenesis stimulator, electrical, non-invasive, other than spinal applications
• E0749 — Osteogenesis stimulator, electrical, surgically implanted
• E0782 — Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)
• E0860 — Traction equipment, overdoor, cervical
• E0870 — Traction frame, attached to footboard, extremity traction, (e.g., buck's)
• E0880 — Traction stand, free standing, extremity traction
• E0890 — Traction frame, attached to footboard, pelvic traction
• E0900 — Traction stand, free standing, pelvic traction, (e.g., buck's)
• E0910 — Trapeze bars, a/k/a patient helper, attached to bed, with grab bar
• E0920 — Fracture frame, attached to bed, includes weights
• E0930 — Fracture frame, free standing, includes weights
• E0935 — Continuous passive motion exercise device for use on knee only
• E0940 — Trapeze bar, free standing, complete with grab bar
• E0941 — Gravity assisted traction device, any type
• E0942 — Cervical head harness/halter
• E0946 — Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)
• E0947 — Fracture frame, attachments for complex pelvic traction
• E0948 — Fracture frame, attachments for complex cervical traction
• E0950 — Wheelchair accessory, tray, each
• E0951 — Heel loop/holder, any type, with or without ankle strap, each
• E0952 — Toe loop/holder, any type, each
• E0958 — Manual wheelchair accessory, one-arm drive attachment, each
• E0959 — Manual wheelchair accessory, adapter for amputee, each
• E0961 — Manual wheelchair accessory, wheel lock brake extension (handle), each
• E0966 — Manual wheelchair accessory, headrest extension, each
• E0967 — Manual wheelchair accessory, hand rim with projections, any type, replacement only, each
• E0968 — Commode seat, wheelchair
• E0969 — Narrowing device, wheelchair
• E0970 — No. 2 footplates, except for elevating leg rest
• E0971 — Manual wheelchair accessory, anti-tipping device, each
• E0973 — Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each
• E0974 — Manual wheelchair accessory, anti-rollback device, each
• E0978 — Wheelchair accessory, positioning belt/safety belt/pelvic strap, each
• E0980 — Safety vest, wheelchair
• E0990 — Wheelchair accessory, elevating leg rest, complete assembly, each
• E0992 — Manual wheelchair accessory, solid seat insert
• E0994 — Arm rest, each
• E0995 — Wheelchair accessory, calf rest/pad, replacement only, each
• E1050 — Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests
• E1060 — Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests
• E1070 — Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest
• E1083 — Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest
• E1084 — Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests
• E1085 — Hemi-wheelchair, fixed full length arms, swing away detachable foot rests
• E1086 — Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests
• E1087 — High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests
• E1088 — High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests
• E1089 — High strength lightweight wheelchair, fixed length arms, swing away detachable footrest
• E1090 — High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable foot rests
• E1092 — Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests
• E1093 — Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests
• E1100 — Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests
• E1110 — Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest
• E1130 — Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests
• E1140 — Wheelchair, detachable arms, desk or full length, swing away detachable footrests
• E1150 — Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests
• E1160 — Wheelchair, fixed full length arms, swing away detachable elevating legrests
• E1170 — Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests
• E1171 — Amputee wheelchair, fixed full length arms, without footrests or legrest
• E1172 — Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest
• E1180 — Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests
• E1190 — Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests
• E1195 — Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests
• E1200 — Amputee wheelchair, fixed full length arms, swing away detachable footrest
• E1220 — Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
• E1221 — Wheelchair with fixed arm, footrests
• E1222 — Wheelchair with fixed arm, elevating legrests
• E1223 — Wheelchair with detachable arms, footrests
• E1224 — Wheelchair with detachable arms, elevating legrests
• E1225 — Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each
• E1226 — Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
• E1227 — Special height arms for wheelchair
• E1228 — Special back height for wheelchair
• E1230 — Power operated vehicle (three or four wheel nonhighway) specify brand name and model number
• E1240 — Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest
• E1250 — Lightweight wheelchair, fixed full length arms, swing away detachable footrest
• E1260 — Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest
• E1270 — Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests
• E1280 — Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests
• E1285 — Heavy duty wheelchair, fixed full length arms, swing away detachable footrest
• E1290 — Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest
• E1295 — Heavy duty wheelchair, fixed full length arms, elevating legrest
• E1296 — Special wheelchair seat height from floor
• E1297 — Special wheelchair seat depth, by upholstery
• E1298 — Special wheelchair seat depth and/or width, by construction
• E1300 — Whirlpool, portable (overtub type)
• E1310 — Whirlpool, non-portable (built-in type)
• E1353 — Regulator
• E1355 — Stand/rack
• E1372 — Immersion external heater for nebulizer
• E1399 — Durable medical equipment, miscellaneous
• E1510 — Kidney, dialysate delivery syst kidney machine, pump recirculating, air removal syst, flowrate meter, power off, heater and temperature control with alarm, i.v. poles, pressure gauge, concentrate container
• E1520 — Heparin infusion pump for hemodialysis
• E1530 — Air bubble detector for hemodialysis, each, replacement
• E1540 — Pressure alarm for hemodialysis, each, replacement
• E1550 — Bath conductivity meter for hemodialysis, each
• E1560 — Blood leak detector for hemodialysis, each, replacement
• E1570 — Adjustable chair, for esrd patients
• E1575 — Transducer protectors/fluid barriers, for hemodialysis, any size, per 10
• E1580 — Unipuncture control system for hemodialysis
• E1590 — Hemodialysis machine
• E1592 — Automatic intermittent peritoneal dialysis system
• E1594 — Cycler dialysis machine for peritoneal dialysis
• E1600 — Delivery and/or installation charges for hemodialysis equipment
• E1610 — Reverse osmosis water purification system, for hemodialysis
• E1615 — Deionizer water purification system, for hemodialysis
• E1620 — Blood pump for hemodialysis, replacement
• E1625 — Water softening system, for hemodialysis
• E1630 — Reciprocating peritoneal dialysis system
• E1632 — Wearable artificial kidney, each
• E1635 — Compact (portable) travel hemodialyzer system
• E1636 — Sorbent cartridges, for hemodialysis, per 10
• E1699 — Dialysis equipment, not otherwise specified
• J0120 — Injection, tetracycline, up to 250 mg
• J0330 — Injection, succinylcholine chloride, up to 20 mg
• J0350 — Injection, anistreplase, per 30 units
• J0360 — Injection, hydralazine hcl, up to 20 mg
• J0390 — Injection, chloroquine hydrochloride, up to 250 mg
• J0500 — Injection, dicyclomine hcl, up to 20 mg
• J0670 — Injection, mepivacaine hydrochloride, per 10 ml
• J0725 — Injection, chorionic gonadotropin, per 1,000 usp units
• J0745 — Injection, codeine phosphate, per 30 mg
• J1212 — Injection, dmso, dimethyl sulfoxide, 50%, 50 ml
• J1330 — Injection, ergonovine maleate, up to 0.2 mg
• J1610 — Injection, glucagon hydrochloride, per 1 mg
• J1630 — Injection, haloperidol, up to 5 mg
• J1670 — Injection, tetanus immune globulin, human, up to 250 units
• J1950 — Injection, leuprolide acetate (for depot suspension), per 3.75 mg
• J2150 — Injection, mannitol, 25% in 50 ml
• J2175 — Injection, meperidine hydrochloride, per 100 mg
• J2260 — Injection, milrinone lactate, 5 mg
• J2320 — Injection, nandrolone decanoate, up to 50 mg
• J2400 — Injection, chloroprocaine hydrochloride, per 30 ml
• J2440 — Injection, papaverine hcl, up to 60 mg
• J2590 — Injection, oxytocin, up to 10 units
• J2670 — Injection, tolazoline hcl, up to 25 mg
• J2675 — Injection, progesterone, per 50 mg
• J2730 — Injection, pralidoxime chloride, up to 1 gm
• J2790 — Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)
• J2995 — Injection, streptokinase, per 250,000 iu
• J3030 — Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
• J3240 — Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
• J3350 — Injection, urea, up to 40 gm
• J3370 — Injection, vancomycin hcl, 500 mg
• J3420 — Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
• J3490 — Unclassified drugs
• J3520 — Edetate disodium, per 150 mg
• J3530 — Nasal vaccine inhalation
• J3570 — Laetrile, amygdalin, vitamin b17
• J7190 — Factor viii (antihemophilic factor, human) per i.u.
• J7194 — Factor ix, complex, per i.u.
• J7300 — Intrauterine copper contraceptive (paragard)
• J9100 — Injection, cytarabine, 100 mg
• J9130 — Dacarbazine, 100 mg
• J9150 — Injection, daunorubicin, 10 mg
• J9230 — Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg
• J9280 — Injection, mitomycin, 5 mg
• J9320 — Injection, streptozocin, 1 gram
• J9360 — Injection, vinblastine sulfate, 1 mg
• J9370 — Vincristine sulfate, 1 mg
• J9999 — Not otherwise classified, antineoplastic drugs
• L0170 — Cervical, collar, molded to patient model
• L0810 — Halo procedure, cervical halo incorporated into jacket vest
• L0820 — Halo procedure, cervical halo incorporated into plaster body jacket
• L0830 — Halo procedure, cervical halo incorporated into milwaukee type orthosis
• L0980 — Peroneal straps, prefabricated, off-the-shelf, pair
• L1000 — Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model
• L1010 — Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling
• L1020 — Addition to ctlso or scoliosis orthosis, kyphosis pad
• L1030 — Addition to ctlso or scoliosis orthosis, lumbar bolster pad
• L1040 — Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad
• L1050 — Addition to ctlso or scoliosis orthosis, sternal pad
• L1060 — Addition to ctlso or scoliosis orthosis, thoracic pad
• L1070 — Addition to ctlso or scoliosis orthosis, trapezius sling
• L1080 — Addition to ctlso or scoliosis orthosis, outrigger
• L1090 — Addition to ctlso or scoliosis orthosis, lumbar sling
• L1100 — Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather
• L1110 — Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model
• L1120 — Addition to ctlso, scoliosis orthosis, cover for upright, each
• L1200 — Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only
• L1210 — Addition to tlso, (low profile), lateral thoracic extension
• L1220 — Addition to tlso, (low profile), anterior thoracic extension
• L1230 — Addition to tlso, (low profile), milwaukee type superstructure
• L1300 — Other scoliosis procedure, body jacket molded to patient model
• L1310 — Other scoliosis procedure, post-operative body jacket
• L1600 — Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise
• L1820 — Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1830 — Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf
• L1840 — Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated
• L1900 — Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated
• L2010 — Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated
• L2030 — Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated
• L2040 — Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated
• L2080 — Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated
• L2200 — Addition to lower extremity, limited ankle motion, each joint
• L2210 — Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
• L2220 — Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint
• L2230 — Addition to lower extremity, split flat caliper stirrups and plate attachment
• L2240 — Addition to lower extremity, round caliper and plate attachment
• L2250 — Addition to lower extremity, foot plate, molded to patient model, stirrup attachment
• L2260 — Addition to lower extremity, reinforced solid stirrup (scott-craig type)
• L2270 — Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad
• L2280 — Addition to lower extremity, molded inner boot
• L2300 — Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable
• L2310 — Addition to lower extremity, abduction bar-straight
• L2320 — Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only
• L2330 — Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
• L2340 — Addition to lower extremity, pre-tibial shell, molded to patient model
• L2350 — Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)
• L2360 — Addition to lower extremity, extended steel shank
• L2500 — Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring
• L2510 — Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model
• L2520 — Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted
• L2530 — Addition to lower extremity, thigh-weight bearing, lacer, non-molded
• L2540 — Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model
• L2550 — Addition to lower extremity, thigh/weight bearing, high roll cuff
• L2570 — Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each
• L2580 — Addition to lower extremity, pelvic control, pelvic sling
• L2600 — Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each
• L2610 — Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each
• L2620 — Addition to lower extremity, pelvic control, hip joint, heavy duty, each
• L2630 — Addition to lower extremity, pelvic control, band and belt, unilateral
• L2640 — Addition to lower extremity, pelvic control, band and belt, bilateral
• L2650 — Addition to lower extremity, pelvic and thoracic control, gluteal pad, each
• L2660 — Addition to lower extremity, thoracic control, thoracic band
• L2670 — Addition to lower extremity, thoracic control, paraspinal uprights
• L2680 — Addition to lower extremity, thoracic control, lateral support uprights
• L2750 — Addition to lower extremity orthosis, plating chrome or nickel, per bar
• L2760 — Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)
• L2780 — Addition to lower extremity orthosis, non-corrosive finish, per bar
• L3020 — Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each
• L3030 — Foot, insert, removable, formed to patient foot, each
• L3160 — Foot, adjustable shoe-styled positioning device
• L3300 — Lift, elevation, heel, tapered to metatarsals, per inch
• L3310 — Lift, elevation, heel and sole, neoprene, per inch
• L3320 — Lift, elevation, heel and sole, cork, per inch
• L3330 — Lift, elevation, metal extension (skate)
• L3332 — Lift, elevation, inside shoe, tapered, up to one-half inch
• L3334 — Lift, elevation, heel, per inch
• L3500 — Orthopedic shoe addition, insole, leather
• L3510 — Orthopedic shoe addition, insole, rubber
• L3520 — Orthopedic shoe addition, insole, felt covered with leather
• L3530 — Orthopedic shoe addition, sole, half
• L3540 — Orthopedic shoe addition, sole, full
• L3550 — Orthopedic shoe addition, toe tap standard
• L3560 — Orthopedic shoe addition, toe tap, horseshoe
• L3570 — Orthopedic shoe addition, special extension to instep (leather with eyelets)
• L3580 — Orthopedic shoe addition, convert instep to velcro closure
• L3590 — Orthopedic shoe addition, convert firm shoe counter to soft counter
• L3595 — Orthopedic shoe addition, march bar
• L3600 — Transfer of an orthosis from one shoe to another, caliper plate, existing
• L3610 — Transfer of an orthosis from one shoe to another, caliper plate, new
• L3620 — Transfer of an orthosis from one shoe to another, solid stirrup, existing
• L3630 — Transfer of an orthosis from one shoe to another, solid stirrup, new
• L3640 — Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes
• L3650 — Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf
• L3710 — Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf
• L3900 — Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated
• L3906 — Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3908 — Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf
• L3960 — Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment
• L4070 — Replace proximal and distal upright for kafo
• L4080 — Replace metal bands kafo, proximal thigh
• L4100 — Replace leather cuff kafo, proximal thigh
• L5410 — Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment
• L5430 — Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment
• L5500 — Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
• L5505 — Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
• L5510 — Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model
• L5520 — Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed
• L5530 — Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model
• L5540 — Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model
• L5560 — Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model
• L5570 — Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed
• L5580 — Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model
• L5590 — Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model
• L5610 — Addition to lower extremity, endoskeletal system, above knee, hydracadence system
• L5616 — Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control
• L5618 — Addition to lower extremity, test socket, symes
• L5620 — Addition to lower extremity, test socket, below knee
• L5622 — Addition to lower extremity, test socket, knee disarticulation
• L5624 — Addition to lower extremity, test socket, above knee
• L5626 — Addition to lower extremity, test socket, hip disarticulation
• L5628 — Addition to lower extremity, test socket, hemipelvectomy
• L5630 — Addition to lower extremity, symes type, expandable wall socket
• L5632 — Addition to lower extremity, symes type, 'ptb' brim design socket
• L5634 — Addition to lower extremity, symes type, posterior opening (canadian) socket
• L5636 — Addition to lower extremity, symes type, medial opening socket
• L5638 — Addition to lower extremity, below knee, leather socket
• L5640 — Addition to lower extremity, knee disarticulation, leather socket
• L5642 — Addition to lower extremity, above knee, leather socket
• L5644 — Addition to lower extremity, above knee, wood socket
• L5646 — Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket
• L5648 — Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket
• L5650 — Additions to lower extremity, total contact, above knee or knee disarticulation socket
• L5652 — Addition to lower extremity, suction suspension, above knee or knee disarticulation socket
• L5653 — Addition to lower extremity, knee disarticulation, expandable wall socket
• L5654 — Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)
• L5655 — Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)
• L5656 — Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)
• L5658 — Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)
• L5666 — Addition to lower extremity, below knee, cuff suspension
• L5668 — Addition to lower extremity, below knee, molded distal cushion
• L5670 — Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)
• L5672 — Addition to lower extremity, below knee, removable medial brim suspension
• L5676 — Additions to lower extremity, below knee, knee joints, single axis, pair
• L5680 — Addition to lower extremity, below knee, thigh lacer, nonmolded
• L5682 — Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded
• L5684 — Addition to lower extremity, below knee, fork strap
• L5686 — Addition to lower extremity, below knee, back check (extension control)
• L5688 — Addition to lower extremity, below knee, waist belt, webbing
• L5690 — Addition to lower extremity, below knee, waist belt, padded and lined
• L5692 — Addition to lower extremity, above knee, pelvic control belt, light
• L5694 — Addition to lower extremity, above knee, pelvic control belt, padded and lined
• L5696 — Addition to lower extremity, above knee or knee disarticulation, pelvic joint
• L5697 — Addition to lower extremity, above knee or knee disarticulation, pelvic band
• L5698 — Addition to lower extremity, above knee or knee disarticulation, silesian bandage
• L5699 — All lower extremity prostheses, shoulder harness
• L5710 — Addition, exoskeletal knee-shin system, single axis, manual lock
• L5712 — Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
• L5714 — Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control
• L5716 — Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock
• L5718 — Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control
• L5722 — Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control
• L5724 — Addition, exoskeletal knee-shin system, single axis, fluid swing phase control
• L5726 — Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control
• L5728 — Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control
• L5780 — Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control
• L6360 — Interscapular thoracic, passive restoration (complete prosthesis)
• L6370 — Interscapular thoracic, passive restoration (shoulder cap only)
• L6615 — Upper extremity addition, disconnect locking wrist unit
• L6620 — Upper extremity addition, flexion/extension wrist unit, with or without friction
• L6625 — Upper extremity addition, rotation wrist unit with cable lock
• L6630 — Upper extremity addition, stainless steel, any wrist
• L6635 — Upper extremity addition, lift assist for elbow
• L6645 — Upper extremity addition, shoulder flexion-abduction joint, each
• L6650 — Upper extremity addition, shoulder universal joint, each
• L6655 — Upper extremity addition, standard control cable, extra
• L6660 — Upper extremity addition, heavy duty control cable
• L6665 — Upper extremity addition, teflon, or equal, cable lining
• L6670 — Upper extremity addition, hook to hand, cable adapter
• L6672 — Upper extremity addition, harness, chest or shoulder, saddle type
• L6675 — Upper extremity addition, harness, (e.g., figure of eight type), single cable design
• L6676 — Upper extremity addition, harness, (e.g., figure of eight type), dual cable design
• L6680 — Upper extremity addition, test socket, wrist disarticulation or below elbow
• L6682 — Upper extremity addition, test socket, elbow disarticulation or above elbow
• L6684 — Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic
• L6890 — Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment
• L6895 — Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated
• L6905 — Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining
• L8000 — Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type
• L8010 — Breast prosthesis, mastectomy sleeve
• L8020 — Breast prosthesis, mastectomy form
• L8300 — Truss, single with standard pad
• L8310 — Truss, double with standard pads
• L8320 — Truss, addition to standard pad, water pad
• L8330 — Truss, addition to standard pad, scrotal pad
• M0075 — Cellular therapy
• M0076 — Prolotherapy
• M0100 — Intragastric hypothermia using gastric freezing
• M0300 — Iv chelation therapy (chemical endarterectomy)
• M0301 — Fabric wrapping of abdominal aneurysm
• P2028 — Cephalin floculation, blood
• P2029 — Congo red, blood
• P2031 — Hair analysis (excluding arsenic)
• P2033 — Thymol turbidity, blood
• P2038 — Mucoprotein, blood (seromucoid) (medical necessity procedure)
• P7001 — Culture, bacterial, urine; quantitative, sensitivity study
• R0075 — Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen
• V5030 — Hearing aid, monaural, body worn, air conduction
• V5040 — Hearing aid, monaural, body worn, bone conduction