Procedure Code | Full Description | Date Code Added to the Policy | Date Code Removed from the Policy |
A4640 | Replacement pad for use with medically necessary alternating pressure pad owned by patient | 01-01-1991 |  |
A4649 | Surgical supply; miscellaneous | 01-01-1982 | |
A4651 | Calibrated microcapillary tube, each | 01-01-2002 | |
A4652 | Microcapillary tube sealant | 01-01-2002 | |
A4653 | Peritoneal dialysis catheter anchoring device, belt, each | 01-01-2003 | |
A4657 | Syringe, with or without needle, each | 01-01-2002 | |
A4660 | Sphygmomanometer/blood pressure apparatus with cuff and stethoscope | 01-01-1986 | |
A4663 | Blood pressure cuff only | 01-01-1986 | |
A4670 | Automatic blood pressure monitor | 01-01-1986 | |
A4671 | Disposable cycler set used with cycler dialysis machine, each | 01-01-2004 | |
A4672 | Drainage extension line, sterile, for dialysis, each | 01-01-2004 | |
A4673 | Extension line with easy lock connectors, used with dialysis | 01-01-2004 | |
A4674 | Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz. | 01-01-2004 | |
A4680 | Activated carbon filter for hemodialysis, each | 01-01-1986 | |
A4690 | Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each | 01-01-1986 | |
A4706 | Bicarbonate concentrate, solution, for hemodialysis, per gallon | 01-01-2002 | |
A4707 | Bicarbonate concentrate, powder, for hemodialysis, per packet | 01-01-2002 | |
A4708 | Acetate concentrate solution, for hemodialysis, per gallon | 01-01-2002 | |
A4709 | Acid concentrate, solution, for hemodialysis, per gallon | 01-01-2002 | |
A4714 | Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon | 01-01-1986 | |
A4719 | Y set tubing for peritoneal dialysis | 01-01-2002 | |
A4720 | Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis | 01-01-2002 | |
A4721 | Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc, but less than or equal to 1999 cc, for peritoneal dialysis | 01-01-2002 | |
A4722 | Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc, but less than or equal to 2999 cc, for peritoneal dialysis | 01-01-2002 | |
A4723 | Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc, but less than or equal to 3999 cc, for peritoneal dialysis | 01-01-2002 | |
A4724 | Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc, but less than or equal to 4999 cc, for peritoneal dialysis | 01-01-2002 | |
A4725 | Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc, but less than or equal to 5999 cc, for peritoneal dialysis | 01-01-2002 | |
A4726 | Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc | 01-01-2002 | |
A4728 | Dialysate solution, nondextrose containing, 500 ml | 01-01-2004 | |
A4730 | Fistula cannulation set for hemodialysis, each | 01-01-1986 | |
A4736 | Topical anesthetic, for dialysis, per gm | 01-01-2002 | |
A4737 | Injectable anesthetic, for dialysis, per 10 ml | 01-01-2002 | |
A4740 | Shunt accessory, for hemodialysis, any type | 01-01-1986 | |
A4750 | Blood tubing, arterial or venous, for hemodialysis, each | 01-01-1986 | |
A4755 | Blood tubing, arterial and venous combined, for hemodialysis, each | 01-01-1986 | |
A4760 | Dialysate solution test kit, for peritoneal dialysis, any type, each | 01-01-1986 | |
A4765 | Dialysate concentrate, powder, additive for peritoneal dialysis, per packet | 01-01-1986 | |
A4766 | Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml | 01-01-2002 | |
A4770 | Blood collection tube, vacuum, for dialysis, per 50 | 01-01-1986 | |
A4771 | Serum clotting time tube, for dialysis, per 50 | 01-01-1986 | |
A4772 | Blood glucose test strips, for dialysis, per 50 | 01-01-1986 | |
A4773 | Occult blood test strips, for dialysis, per 50 | 01-01-1986 | |
A4774 | Ammonia test strips, for dialysis, per 50 | 01-01-1986 | |
A4802 | Protamine sulfate, for hemodialysis, per 50 mg | 01-01-2002 | |
A4860 | Disposable catheter tips for peritoneal dialysis, per 10 | 01-01-1986 | |
A4870 | Plumbing and/or electrical work for home hemodialysis equipment | 01-01-1986 | |
A4890 | Contracts, repair and maintenance, for hemodialysis equipment | 01-01-1986 | |
A4911 | Drain bag/bottle, for dialysis, each | 01-01-2002 | |
A4913 | Miscellaneous dialysis supplies, not otherwise specified | 01-01-1986 | |
A4918 | Venous pressure clamp, for hemodialysis, each | 01-01-1986 | |
A4927 | Gloves, nonsterile, per 100 | 01-01-1986 | |
A4928 | Surgical mask, per 20 | 01-01-2002 | |
A4929 | Tourniquet for dialysis, each | 01-01-2002 | |
A4930 | Gloves, sterile, per pair | 01-01-2003 | |
A4931 | Oral thermometer, reusable, any type, each | 01-01-2003 | |
A4932 | Rectal thermometer, reusable, any type, each | 01-01-2003 | |
A5051 | Ostomy pouch, closed; with barrier attached (one piece), each | 01-01-1990 | |
A5052 | Ostomy pouch, closed; without barrier attached (one piece), each | 01-01-1990 | |
A5053 | Ostomy pouch, closed; for use on faceplate, each | 01-01-1990 | |
A5054 | Ostomy pouch, closed; for use on barrier with flange (two piece), each | 01-01-1990 | |
A5055 | Stoma cap | 01-01-1990 | |
A5056 | Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each | 01-01-2012 | |
A5057 | Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each | 01-01-2012 | |
A5061 | Ostomy pouch, drainable; with barrier attached, (one piece), each | 01-01-1990 | |
A5062 | Ostomy pouch, drainable; without barrier attached (one piece), each | 01-01-1990 | |
A5063 | Ostomy pouch, drainable; for use on barrier with flange (two piece system), each | 01-01-1990 | |
A5071 | Ostomy pouch, urinary; with barrier attached (one piece), each | 01-01-1990 | |
A5072 | Ostomy pouch, urinary; without barrier attached (one piece), each | 01-01-1990 | |
A5073 | Ostomy pouch, urinary; for use on barrier with flange (two piece), each | 01-01-1990 | |
A5081 | Stoma plug or seal, any type | 01-01-1990 | |
A5082 | Continent device; catheter for continent stoma | 01-01-1990 | |
A5083 | Continent device, stoma absorptive cover for continent stoma | 01-01-2008 | |
A5093 | Ostomy accessory; convex insert | 01-01-1990 | |
A5102 | Bedside drainage bottle, with or without tubing, rigid or expandable, each | 01-01-1990 | |
A5105 | Urinary suspensory with leg bag, with or without tube, each | 01-01-1990 | |
A5112 | Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each | 01-01-1990 | |
A5113 | Leg strap; latex, replacement only, per set | 01-01-1990 | |
A5114 | Leg strap; foam or fabric, replacement only, per set | 01-01-1990 | |
A5120 | Skin barrier, wipes or swabs, each | 01-01-2006 | |
A5121 | Skin barrier; solid, 6 x 6 or equivalent, each | 01-01-1990 | |
A5122 | Skin barrier; solid, 8 x 8 or equivalent, each | 01-01-1990 | |
A5126 | Adhesive or nonadhesive; disk or foam pad | 01-01-1990 | |
A5131 | Appliance cleaner, incontinence and ostomy appliances, per 16 oz. | 01-01-1990 | |
A5200 | Percutaneous catheter/tube anchoring device, adhesive skin attachment | 01-01-1999 | |
A5500 | 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 | 01-01-1995 | |
A5501 | 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 | 01-01-1995 | |
A5503 | 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 | 01-01-1995 | |
A5504 | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with wedge(s), per shoe | 01-01-1995 | |
A5505 | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with metatarsal bar, per shoe | 01-01-1995 | |
A5506 | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe with off-set heel(s), per shoe | 01-01-1995 | |
A5507 | For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom molded shoe, per shoe | 01-01-1995 | |
A5508 | For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe | 01-01-2000 | |
A5510 | For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe | 01-01-2002 | |
A6000 | Noncontact wound-warming wound cover for use with the noncontact wound-warming device and warming card | 01-01-2002 | |
A6010 | Collagen based wound filler, dry form, sterile, per gram of collagen | 01-01-2002 | |
A6011 | Collagen based wound filler, gel/paste, per gram of collagen | 01-01-2003 | |
A6021 | Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each | 01-01-2001 | |
A6022 | Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each | 01-01-2001 | |
A6023 | Collagen dressing, sterile, size more than 48 sq. in., each | 01-01-2001 | |
A6024 | Collagen dressing wound filler, sterile, per 6 inches | 01-01-2001 | |
A6025 | Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each | 01-01-1997 | |
A6154 | Wound pouch, each | 01-01-1997 | |
A6196 | Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. In. Or less, each dressing | 01-01-1997 | |
A6197 | 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 | 01-01-1997 | |
A6198 | Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. In., each dressing | 01-01-1997 | |
A6199 | Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches | 01-01-1997 | |
A6200 | Composite dressing, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1999 | 12-31-2009 |
A6201 | Composite dressing, pad size more than 16 sq. In. But less than or equal to 48 sq. In., without adhesive border, each dressing | 01-01-1999 | 12-31-2009 |
A6202 | Composite dressing, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1999 | 12-31-2009 |
A6203 | Composite dressing, sterile, pad size 16 sq. In. Or less, with any size adhesive border, each dressing | 01-01-1997 | |
A6204 | 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 | 01-01-1997 | |
A6205 | Composite dressing, sterile, pad size more than 48 sq. In., with any size adhesive border, each dressing | 01-01-1997 | |
A6206 | Contact layer, sterile, 16 sq. In. Or less, each dressing | 01-01-1997 | |
A6207 | Contact layer, sterile, more than 16 sq. In. But less than or equal to 48 sq. In., each dressing | 01-01-1997 | |
A6208 | Contact layer, sterile, more than 48 sq. In., each dressing | 01-01-1997 | |
A6209 | Foam dressing, wound cover, sterile, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1997 | |
A6210 | 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 | 01-01-1997 | |
A6211 | Foam dressing, wound cover, sterile, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6212 | Foam dressing, wound cover, sterile, pad size 16 sq. In. Or less, with any size adhesive border, each dressingfoam dressing, wound cover, sterile, pad size 16 sq. In. Or less, with any size adhesive border, each dressing | 01-01-1997 | |
A6213 | 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 | 01-01-1997 | |
A6214 | Foam dressing, wound cover, sterile, pad size more than 48 sq. In., with any size adhesive border, each dressing | 01-01-1997 | |
A6215 | Foam dressing, wound filler, sterile, per gram | 01-01-1997 | |
A6216 | Gauze, nonimpregnated, nonsterile, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1997 | |
A6217 | Gauze, nonimpregnated, nonsterile, pad size more than 16 sq. In. But less than or equal to 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6218 | Gauze, nonimpregnated, nonsterile, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6219 | Gauze, non-impregnated, sterile, pad size 16 sq. In. Or less, with any size adhesive border, each dressing | 01-01-1997 | |
A6220 | 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 | 01-01-1997 | |
A6221 | Gauze, non-impregnated, sterile, pad size more than 48 sq. In., with any size adhesive border, each dressing | 01-01-1997 | |
A6222 | Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1997 | |
A6223 | 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 | 01-01-1997 | |
A6224 | Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6228 | Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1997 | |
A6229 | 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 | 01-01-1997 | |
A6230 | Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6231 | Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. In. Or less, each dressing | 01-01-2001 | |
A6232 | 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 | 01-01-2001 | |
A6233 | Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. In., each dressing | 01-01-2001 | |
A6234 | Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1997 | |
A6235 | 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 | 01-01-1997 | |
A6236 | Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6237 | Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. In. Or less, with any size adhesive border, each dressing | 01-01-1997 | |
A6238 | 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 | 01-01-1997 | |
A6239 | Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. In., with any size adhesive border, each dressing | 01-01-1997 | |
A6240 | Hydrocolloid dressing, wound filler, paste, sterile, per ounce | 01-01-1997 | |
A6241 | Hydrocolloid dressing, wound filler, dry form, sterile, per gram | 01-01-1997 | |
A6242 | Hydrogel dressing, wound cover, sterile, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1997 | |
A6243 | 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 | 01-01-1997 | |
A6244 | Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6245 | Hydrogel dressing, wound cover, sterile, pad size 16 sq. In. Or less, with any size adhesive border, each dressing | 01-01-1997 | |
A6246 | 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 | 01-01-1997 | |
A6247 | Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. In., with any size adhesive border, each dressing | 01-01-1997 | |
A6248 | Hydrogel dressing, wound filler, gel, per fluid ounce | 01-01-1997 | |
A6250 | Skin sealants, protectants, moisturizers, ointments, any type, any size | 01-01-1997 | |
A6251 | Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1997 | |
A6252 | 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 | 01-01-1997 | |
A6253 | Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6254 | Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. In. Or less, with any size adhesive border, each dressing | 01-01-1997 | |
A6255 | 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 | 01-01-1997 | |
A6256 | Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. In., with any size adhesive border, each dressing | 01-01-1997 | |
A6257 | Transparent film, sterile, 16 sq. In. Or less, each dressing | 01-01-1997 | |
A6258 | Transparent film, sterile, more than 16 sq. In. But less than or equal to 48 sq. In., each dressing | 01-01-1997 | |
A6259 | Transparent film, sterile, more than 48 sq. In., each dressing | 01-01-1997 | |
A6260 | Wound cleansers, any type, any size | 01-01-1997 | |
A6261 | Wound filler, gel/paste, per fluid ounce, not otherwise specified | 01-01-1997 | |
A6262 | Wound filler, dry form, per gram, not otherwise specified | 01-01-1997 | |
A6266 | Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard | 01-01-1997 | |
A6402 | Gauze, nonimpregnated, sterile, pad size 16 sq. In. Or less, without adhesive border, each dressing | 01-01-1997 | |
A6403 | Gauze, nonimpregnated, sterile, pad size more than 16 sq. In. But less than or equal to 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6404 | Gauze, nonimpregnated, sterile, pad size more than 48 sq. In., without adhesive border, each dressing | 01-01-1997 | |
A6407 | Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard | 01-01-2004 | |
A6410 | Eye pad, sterile, each | 01-01-2003 | |
A6411 | Eye pad, nonsterile, each | 01-01-2003 | |
A6412 | Eye patch, occlusive, each | 01-01-2003 | |
A6413 | Adhesive bandage, first-aid type, any size, each | 01-01-2008 | |
A6441 | Padding bandage, nonelastic, nonwoven/nonknitted, width greater than or equal to 3 in. And less than 5 in., per yd. | 01-01-2004 | |
A6442 | Conforming bandage, nonelastic, knitted/woven, nonsterile, width less than 3 in., per yd. | 01-01-2004 | |
A6443 | Conforming bandage, nonelastic, knitted/woven, nonsterile, width greater than or equal to 3 in. And less than 5 in., per yd. | 01-01-2004 | |
A6444 | Conforming bandage, nonelastic, knitted/woven, nonsterile, width greater than or equal to 5 in., per yd. | 01-01-2004 | |
A6445 | Conforming bandage, nonelastic, knitted/woven, sterile, width less than 3 in., per yd. | 01-01-2004 | |
A6446 | Conforming bandage, nonelastic, knitted/woven, sterile, width greater than or equal to 3 in. And less than 5 in., per yd. | 01-01-2004 | |
A6447 | Conforming bandage, nonelastic, knitted/woven, sterile, width greater than or equal to 5 in., per yd. | 01-01-2004 | |
A6448 | Light compression bandage, elastic, knitted/woven, width less than 3 in., per yd. | 01-01-2004 | |
A6449 | Light compression bandage, elastic, knitted/woven, width greater than or equal to 3 in. And less than 5 in., per yd. | 01-01-2004 | |
A6450 | Light compression bandage, elastic, knitted/woven, width greater than or equal to 5 in., per yd. | 01-01-2004 | |
A6451 | 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 3 in. And less than 5 in., per yd. | 01-01-2004 | |
A6452 | 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 3 in. And less than 5 in., per yd. | 01-01-2004 | |
A6453 | Self-adherent bandage, elastic, nonknitted/nonwoven, width less than 3 in., per yd. | 01-01-2004 | |
A6454 | Self-adherent bandage, elastic, nonknitted/nonwoven, width greater than or equal to 3 in. And less than 5 in., per yd. | 01-01-2004 | |
A6455 | Self-adherent bandage, elastic, nonknitted/nonwoven, width greater than or equal to 5 in., per yd. | 01-01-2004 | |
A6456 | Zinc paste impregnated bandage, nonelastic, knitted/woven, width greater than or equal to 3 in. And less than 5 in., per yd. | 01-01-2004 | |
A6457 | Tubular dressing with or without elastic, any width, per linear yard | 01-01-2006 | |
A6460 | Synthetic resorbable wound dressing, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | 01-01-2019 | |
A6461 | 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 | 01-01-2019 | |
A6501 | Compression burn garment, bodysuit (head to foot), custom fabricated | 01-01-2003 | |
A6502 | Compression burn garment, chin strap, custom fabricated | 01-01-2003 | |
A6503 | Compression burn garment, facial hood, custom fabricated | 01-01-2003 | |
A6504 | Compression burn garment, glove to wrist, custom fabricated | 01-01-2003 | |
A6505 | Compression burn garment, glove to elbow, custom fabricated | 01-01-2003 | |
A6506 | Compression burn garment, glove to axilla, custom fabricated | 01-01-2003 | |
A6507 | Compression burn garment, foot to knee length, custom fabricated | 01-01-2003 | |
A6508 | Compression burn garment, foot to thigh length, custom fabricated | 01-01-2003 | |
A6509 | Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated | 01-01-2003 | |
A6510 | Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated | 01-01-2003 | |
A6511 | Compression burn garment, lower trunk including leg openings (panty), custom fabricated | 01-01-2003 | |
A6512 | Compression burn garment, not otherwise classified | 01-01-2003 | |
A6513 | Compression burn mask, face and/or neck, plastic or equal, custom fabricated | 01-01-2006 | |
A6531 | Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each | 01-01-2006 | |
A6532 | Gradient compression stocking, below knee, 40-50 mmhg, eachGradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each | 01-01-2006 | |
A6545 | Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each | 01-01-2009 | |
A6550 | Wound care set, for negative pressure wound therapy electrical pump, includes all accessories | 01-01-2004 | |
A6590
| External urinary catheters; disposable, with wicking material, for use with suction pump, per month
| 04-01-2023
| |
A6591
| External urinary catheter; non-disposable, for use with suction pump, per month
| 04-01-2023
| |
A7000 | Canister, disposable, used with suction pump, each | 01-01-2000 | |
A7001 | Canister, nondisposable, used with suction pump, each | 01-01-2000 | |
A7002 | Tubing, used with suction pump, each | 01-01-2000 | |
A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | 01-01-2000 | |
