Type of Service (TOS) Indicator 9: Other Medical Items or Services

CPT codes

CodeDescription

CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more.  CPT code information is copyright by the AMA.

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0025U  CPT Code
0026T  CPT Code
0029T  CPT Code
0044U  CPT Code
00450  CPT Code
00452  CPT Code
00454  CPT Code
0089T  CPT Code
0103T  CPT Code
0103U  CPT Code
0104T  CPT Code
0104U  CPT Code
0105T  CPT Code
0105U  CPT Code
0106T  CPT Code
0106U  CPT Code
0107T  CPT Code
0107U  CPT Code
0108T  CPT Code
0108U  CPT Code
0109T  CPT Code
0109U  CPT Code
0110T  CPT Code
0115T  CPT Code
0115U  CPT Code
01160  CPT Code
0116T  CPT Code
0116U  CPT Code
01170  CPT Code
01173  CPT Code
0117T  CPT Code
0130T  CPT Code
0130U  CPT Code
0131U  CPT Code
01320  CPT Code
0132U  CPT Code
0133T  CPT Code
0140T  CPT Code
0162T  CPT Code
0183T  CPT Code
0187T  CPT Code
0188T  CPT Code
0189T  CPT Code
01905  CPT Code
0190T  CPT Code
0208T  CPT Code
0209T  CPT Code
0210T  CPT Code
0211T  CPT Code
0212T  CPT Code
0213T  CPT Code
0214T  CPT Code
0215T  CPT Code
0216T  CPT Code
0217T  CPT Code
0218T  CPT Code
0219T  CPT Code
0220T  CPT Code
0221T  CPT Code
0222T  CPT Code
0233T  CPT Code
0239T  CPT Code
0240T  CPT Code
0241T  CPT Code
0242T  CPT Code
0243T  CPT Code
0244T  CPT Code
0285T  CPT Code
0286T  CPT Code
0287T  CPT Code
0501F  CPT Code
90644  CPT Code
92640  CPT Code
93668  CPT Code
94775  CPT Code
94776  CPT Code
96150  CPT Code
96151  CPT Code
96152  CPT Code
96153  CPT Code
96154  CPT Code
96155  CPT Code
99000  CPT Code
99001  CPT Code
99002  CPT Code
99070  CPT Code
99071  CPT Code
99450  CPT Code
99451  CPT Code
99452  CPT Code
99453  CPT Code
99454  CPT Code
99455  CPT Code
99456  CPT Code
99601  CPT Code
99602  CPT Code
99605  CPT Code
99606  CPT Code
99607  CPT Code

HCPCS codes

CodeDescription
A4250  Urine test or reagent strips or tablets (100 tablets or strips)  
A4260  LEVONORGESTREL (CONTRACEPTIVE) IMPLANTS SYSTEM, INCLUDING IMPLANTS AND SUPPLIES  
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  
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  
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  
A4520  Incontinence garment, any type, (e.g., brief, diaper), each  
A4521  ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, SMALL SIZE, EACH  
A4522  ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, MEDIUM SIZE, EACH  
A4523  ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, LARGE SIZE, EACH  
A4524  ADULT-SIZED INCONTINENCE PRODUCT, DIAPER, EXTRA LARGE SIZE, EACH  
A4525  ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, SMALL SIZE, EACH  
A4526  ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, MEDIUM SIZE, EACH  
A4527  ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, LARGE SIZE, EACH  
A4528  ADULT-SIZED INCONTINENCE PRODUCT, BRIEF, EXTRA-LARGE SIZE, EACH  
A4529  CHILD-SIZED INCONTINENCE PRODUCT, DIAPER, SMALL/MEDIUM SIZE, EACH  
A4530  CHILD-SIZED INCONTINENCE PRODUCT, DIAPER, LARGE SIZE, EACH  
A4531  CHILD-SIZED INCONTINENCE PRODUCT, BRIEF, SMALL/MEDIUM SIZE, EACH  
A4532  CHILD-SIZED INCONTINENCE PRODUCT, BRIEF, LARGE SIZE, EACH  
A4533  YOUTH-SIZED INCONTINENCE PRODUCT, DIAPER, EACH  
A4534  YOUTH-SIZED INCONTINENCE PRODUCT, BRIEF, EACH  
A4535  DISPOSABLE LINER/SHIELD FOR INCONTINENCE, EACH  
A4536  PROTECTIVE UNDERWEAR, WASHABLE, ANY SIZE, EACH  
A4537  UNDER PAD, REUSABLE/WASHABLE, ANY SIZE, EACH  
A4538  DIAPER, REUSABLE, PROVIDED BY A DIAPER SERVICE, EACH DIAPER  
A4550  Surgical trays  
A4553  Non-disposable underpads, all sizes  
A4554  Disposable underpads, all sizes  
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  
A4932  Rectal thermometer, reusable, any type, each  
A6025  Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each  
A9150  Non-prescription drugs  
A9152  Single vitamin/mineral/trace element, oral, per dose, not otherwise specified  
A9153  Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified  
A9155  Artificial saliva, 30 ml  
A9180  Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker  
A9270  Non-covered item or service  
A9272  Wound suction, disposable, includes dressing, all accessories and components, any type, each  
A9274  External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories  
A9275  Home glucose disposable monitor, includes test strips  
A9276  Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose monitoring system, one unit = 1 day supply  
A9277  Transmitter; external, for use with interstitial continuous glucose monitoring system  
A9278  Receiver (monitor); external, for use with interstitial continuous glucose monitoring system  
A9279  Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified  
A9280  Alert or alarm device, not otherwise classified  
A9282  Wig, any type, each  
A9283  Foot pressure off loading/supportive device, any type, each  
A9300  Exercise equipment  
A9700  Supply of injectable contrast material for use in echocardiography, per study  
A9900  Miscellaneous dme supply, accessory, and/or service component of another hcpcs code  
A9901  Dme delivery, set up, and/or dispensing service component of another hcpcs code  
A9999  Miscellaneous dme supply or accessory, not otherwise specified  
C1300  Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval  
C1305  GRAFTSKIN, PER 44 SQUARE CENTIMETERS  
C1713  Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)  
C1714  Catheter, transluminal atherectomy, directional  
C1715  Brachytherapy needle  
C1716  Brachytherapy source, non-stranded, gold-198, per source  
C1717  Brachytherapy source, non-stranded, high dose rate iridium-192, per source  
C1718  BRACHYTHERAPY SOURCE, IODINE 125, PER SOURCE  
C1719  Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source  
C1720  BRACHYTHERAPY SOURCE, PALLADIUM 103, PER SOURCE  
C1721  Cardioverter-defibrillator, dual chamber (implantable)  
C1722  Cardioverter-defibrillator, single chamber (implantable)  
C1724  Catheter, transluminal atherectomy, rotational  
C1725  Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)  
C1726  Catheter, balloon dilatation, non-vascular  
C1727  Catheter, balloon tissue dissector, non-vascular (insertable)  
C1728  Catheter, brachytherapy seed administration  
C1729  Catheter, drainage  
C1730  Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)  
C1731  Catheter, electrophysiology, diagnostic, other than 3d mapping (20 or more electrodes)  
C1732  Catheter, electrophysiology, diagnostic/ablation, 3d or vector mapping  
C1733  Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, other than cool-tip  
C1734  Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)  
C1749  Endoscope, retrograde imaging/illumination colonoscope device (implantable)  
C1750  Catheter, hemodialysis/peritoneal, long-term  
C1751  Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)  
C1752  Catheter, hemodialysis/peritoneal, short-term  
C1753  Catheter, intravascular ultrasound  
C1754  Catheter, intradiscal  
C1755  Catheter, intraspinal  
C1756  Catheter, pacing, transesophageal  
C1757  Catheter, thrombectomy/embolectomy  
C1758  Catheter, ureteral  
C1759  Catheter, intracardiac echocardiography  
C1760  Closure device, vascular (implantable/insertable)  
C1762  Connective tissue, human (includes fascia lata)  
C1763  Connective tissue, non-human (includes synthetic)  
C1764  Event recorder, cardiac (implantable)  
C1765  Adhesion barrier  
C1766  Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away  
C1767  Generator, neurostimulator (implantable), non-rechargeable  
C1768  Graft, vascular  
C1769  Guide wire  
C1770  Imaging coil, magnetic resonance (insertable)  
C1771  Repair device, urinary, incontinence, with sling graft  
C1772  Infusion pump, programmable (implantable)  
C1773  Retrieval device, insertable (used to retrieve fractured medical devices)  
C1776  Joint device (implantable)  
C1777  Lead, cardioverter-defibrillator, endocardial single coil (implantable)  
C1778  Lead, neurostimulator (implantable)  
C1779  Lead, pacemaker, transvenous vdd single pass  
C1780  Lens, intraocular (new technology)  
C1781  Mesh (implantable)  
C1782  Morcellator  
C1783  Ocular implant, aqueous drainage assist device  
C1784  Ocular device, intraoperative, detached retina  
C1785  Pacemaker, dual chamber, rate-responsive (implantable)  
C1786  Pacemaker, single chamber, rate-responsive (implantable)  
C1787  Patient programmer, neurostimulator  
C1788  Port, indwelling (implantable)  
C1789  Prosthesis, breast (implantable)  
C1813  Prosthesis, penile, inflatable  
C1814  Retinal tamponade device, silicone oil  
C1815  Prosthesis, urinary sphincter (implantable)  
C1816  Receiver and/or transmitter, neurostimulator (implantable)  
C1817  Septal defect implant system, intracardiac  
C1818  Integrated keratoprosthesis  
C1819  Surgical tissue localization and excision device (implantable)  
C1820  Generator, neurostimulator (implantable), with rechargeable battery and charging system  
C1821  Interspinous process distraction device (implantable)  
C1822  Generator, neurostimulator (implantable), high frequency, with rechargeable battery and charging system  
C1823  Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads  
C1824  Generator, cardiac contractility modulation (implantable)  
C1830  Powered bone marrow biopsy needle  
C1839  Iris prosthesis  
C1840  Lens, intraocular (telescopic)  
C1841  Retinal prosthesis, includes all internal and external components  
C1842  Retinal prosthesis, includes all internal and external components; add-on to c1841  
C1874  Stent, coated/covered, with delivery system  
C1875  Stent, coated/covered, without delivery system  
C1876  Stent, non-coated/non-covered, with delivery system  
C1877  Stent, non-coated/non-covered, without delivery system  
C1878  Material for vocal cord medialization, synthetic (implantable)  
C1879  Tissue marker (implantable)  
C1880  Vena cava filter  
C1881  Dialysis access system (implantable)  
C1882  Cardioverter-defibrillator, other than single or dual chamber (implantable)  
C1883  Adapter/extension, pacing lead or neurostimulator lead (implantable)  
C1884  Embolization protective system  
C1885  Catheter, transluminal angioplasty, laser  
C1886  Catheter, extravascular tissue ablation, any modality (insertable)  
C1887  Catheter, guiding (may include infusion/perfusion capability)  
C1888  Catheter, ablation, non-cardiac, endovascular (implantable)  
C1889  Implantable/insertable device, not otherwise classified  
C1890  No implantable/insertable device used with device-intensive procedures  
C1891  Infusion pump, non-programmable, permanent (implantable)  
C1892  Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, peel-away  
C1893  Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away  
C1894  Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser  
C1895  Lead, cardioverter-defibrillator, endocardial dual coil (implantable)  
C1896  Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable)  
C1897  Lead, neurostimulator test kit (implantable)  
C1898  Lead, pacemaker, other than transvenous vdd single pass  
C1899  Lead, pacemaker/cardioverter-defibrillator combination (implantable)  
C1900  Lead, left ventricular coronary venous system  
C1982  Catheter, pressure-generating, one-way valve, intermittently occlusive  
C2596  Probe, image-guided, robotic, waterjet ablation  
C2613  Lung biopsy plug with delivery system  
C2614  Probe, percutaneous lumbar discectomy  
C2615  Sealant, pulmonary, liquid  
C2616  Brachytherapy source, non-stranded, yttrium-90, per source  
C2617  Stent, non-coronary, temporary, without delivery system  
C2618  Probe/needle, cryoablation  
C2619  Pacemaker, dual chamber, non rate-responsive (implantable)  
C2620  Pacemaker, single chamber, non rate-responsive (implantable)  
C2621  Pacemaker, other than single or dual chamber (implantable)  
C2622  Prosthesis, penile, non-inflatable  
C2623  Catheter, transluminal angioplasty, drug-coated, non-laser  
C2624  Implantable wireless pulmonary artery pressure sensor with delivery catheter, including all system components  
C2625  Stent, non-coronary, temporary, with delivery system  
C2626  Infusion pump, non-programmable, temporary (implantable)  
C2627  Catheter, suprapubic/cystoscopic  
C2628  Catheter, occlusion  
C2629  Introducer/sheath, other than guiding, other than intracardiac electrophysiological, laser  
C2630  Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, cool-tip  
C2631  Repair device, urinary, incontinence, without sling graft  
C2632  BRACHYTHERAPY SOLUTION, IODINE-125, PER MCI  
C2633  BRACHYTHERAPY SOURCE, CESIUM-131, PER SOURCE  
C2634  Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mci (nist), per source  
C2635  Brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mci (nist), per source  
C2636  Brachytherapy linear source, non-stranded, palladium-103, per 1 mm  
C9033  Injection, fosnetupitant 235 mg and palonosetron 0.25 mg  
C9034  Injection, dexamethasone 9%, intraocular, 1 mcg  
C9040  Injection, fremanezumab-vfrm, 1mg  
C9041  Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mg  
C9042  Injection, bendamustine hcl (belrapzo), 1 mg  
C9043  Injection, levoleucovorin, 1 mg  
C9044  Injection, cemiplimab-rwlc, 1 mg  
C9045  Injection, moxetumomab pasudotox-tdfk, 0.01 mg  
C9046  Cocaine hydrochloride nasal solution for topical administration, 1 mg  
C9047  Injection, caplacizumab-yhdp, 1 mg  
C9048  Dexamethasone, lacrimal ophthalmic insert, 0.1 mg  
C9049  Injection, tagraxofusp-erzs, 10 mcg  
C9050  Injection, emapalumab-lzsg, 1 mg  
C9051  Injection, omadacycline, 1 mg  
C9052  Injection, ravulizumab-cwvz, 10 mg  
C9053  Injection, crizanlizumab-tmca, 1 mg  
C9056  Injection, givosiran, 0.5 mg  
C9057  Injection, cetirizine hydrochloride, 1 mg  
C9058  Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo) 0.5 mg  
C9113  Injection, pantoprazole sodium, per vial  
C9141  Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl (jivi), 1 i.u.  
C9250  Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml  
C9251  INJECTION, C1 ESTERASE INHIBITOR (HUMAN), 10 UNITS  
C9252  INJECTION, PLERIXAFOR, 1 MG  
C9253  INJECTION, TEMOZOLOMIDE, 1 MG  
C9254  Injection, lacosamide, 1 mg  
C9255  Injection, paliperidone palmitate, 1 mg  
C9256  Injection, dexamethasone intravitreal implant, 0.1 mg  
C9257  Injection, bevacizumab, 0.25 mg  
C9258  Injection, telavancin, 10 mg  
C9259  Injection, pralatrexate, 1 mg  
C9260  Injection, ofatumumab, 10 mg  
C9261  Injection, ustekinumab, 1 mg  
C9262  Fludarabine phosphate, oral, 1 mg  
C9263  Injection, ecallantide, 1 mg  
C9264  Injection, tocilizumab, 1 mg  
C9265  Injection, romidepsin, 1 mg  
C9266  Injection, collagenase clostridium histolyticum, 0.1 mg  
C9267  Injection, von willebrand factor complex (human), wilate, per 100 iu vwf: rco  
C9268  Capsaicin, patch, 10cm2  
C9269  Injection, c-1 esterase inhibitor (human), berinert, 10 units  
C9270  Injection, immune globulin (gammaplex), intravenous, non-lyophilized (e.g. liquid), 500 mg  
C9271  Injection, velaglucerase alfa, 100 units  
C9272  Injection, denosumab, 1 mg  
C9274  Crotalidae polyvalent immune fab (ovine), 1 vial  
C9276  Injection, cabazitaxel, 1 mg  
C9277  Injection, alglucosidase alfa (lumizyme), 1 mg  
C9278  Injection, incobotulinumtoxin a, 1 unit  
C9352  Microporous collagen implantable tube (neuragen nerve guide), per centimeter length  
C9353  Microporous collagen implantable slit tube (neurawrap nerve protector), per centimeter length  
C9354  Acellular pericardial tissue matrix of non-human origin (veritas), per square centimeter  
C9355  Collagen nerve cuff (neuromatrix), per 0.5 centimeter length  
C9356  Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (tenoglide tendon protector sheet), per square centimeter  
C9357  DERMAL SUBSTITUTE, GRANULATED CROSS-LINKED COLLAGEN AND GLYCOSAMINOGLYCAN  
C9358  Dermal substitute, native, non-denatured collagen, fetal bovine origin (surgimend collagen matrix), per 0.5 square centimeters  
C9359  Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold putty, integra os osteoconductive scaffold putty), per 0.5 cc  
C9360  Dermal substitute, native, non-denatured collagen, neonatal bovine origin (surgimend collagen matrix), per 0.5 square centimeters  
C9361  Collagen matrix nerve wrap (neuromend collagen nerve wrap), per 0.5 centimeter length  
C9362  Porous purified collagen matrix bone void filler (integra mozaik osteoconductive scaffold strip), per 0.5 cc  
C9363  Skin substitute, integra meshed bilayer wound matrix, per square centimeter  
C9364  Porcine implant, permacol, per square centimeter  
C9365  Oasis ultra tri-layer matrix, per square centimeter  
C9366  Epifix, per square centimeter  
C9367  Skin substitute, endoform dermal template, per square centimeter  
C9462  Injection, delafloxacin, 1 mg  
C9463  Injection, aprepitant, 1 mg  
C9464  Injection, rolapitant, 0.5 mg  
C9465  Hyaluronan or derivative, durolane, for intra-articular injection, per dose  
C9466  Injection, benralizumab, 1 mg  
C9467  Injection, rituximab and hyaluronidase, 10 mg  
C9468  Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u.  
C9469  Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg  
C9489  Injection, nusinersen, 0.1 mg  
C9490  Injection, bezlotoxumab, 10 mg  
C9491  Injection, avelumab, 10 mg  
C9492  Injection, durvalumab, 10 mg  
C9493  Injection, edaravone, 1 mg  
C9494  Injection, ocrelizumab, 1 mg  
E0190  Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories  
E0203  Therapeutic lightbox, minimum 10,000 lux, table top model  
E0240  Bath/shower chair, with or without wheels, any size  
E0350  Control unit for electronic bowel irrigation/evacuation system  
E0352  Disposable pack (water reservoir bag, speculum, valving mechanism and collection bag/box) for use with the electronic bowel irrigation/evacuation system  
E0445  Oximeter device for measuring blood oxygen levels non-invasively  
E0446  Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories  
E0590  DISPENSING FEE COVERED DRUG ADMINISTERED THROUGH DME NEBULIZER  
E0602  Breast pump, manual, any type  
E0603  Breast pump, electric (ac and/or dc), any type  
E0604  Breast pump, hospital grade, electric (ac and / or dc), any type  
E0616  Implantable cardiac event recorder with memory, activator and programmer  
E0617  External defibrillator with integrated electrocardiogram analysis  
E0639  Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories  
E0640  Patient lift, fixed system, includes all components/accessories  
E0749  Osteogenesis stimulator, electrical, surgically implanted  
E0761  Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device  
E0769  Electrical stimulation or electromagnetic wound treatment device, not otherwise classified  
E0781  Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient  
E0786  Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)  
E1340  REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL EQUIPMENT REQUIRING THE SKILL OF A TECHNICIAN, LABOR COMPONENT, PER 15 MINUTES  
E8000  Gait trainer, pediatric size, posterior support, includes all accessories and components  
E8001  Gait trainer, pediatric size, upright support, includes all accessories and components  
E8002  Gait trainer, pediatric size, anterior support, includes all accessories and components  
G0369  PHARMACY SUPPLY FEE FOR INITIAL IMMUNOSUPPRESSIVE DRUG(S) FIRST MONTH FOLLOWING  
G0370  PHARMACY SUPPLY FEE FOR ORAL ANTI-CANCER, ORAL ANTI-EMETIC OR IMMUNOSUPPRESSIVE  
G0371  PHARMACY DISPENSING FEE FOR INHALATION DRUG(S); PER 30 DAYS  
G0374  PHARMACY DISPENSING FEE FOR INHALATION DRUG(S); PER 90 DAYS  
G0375  SMOKING AND TOBACCO USE CESSATION COUNSELING VISIT; INTERMEDIATE, GREATER THAN 3 MINUTES UP TO 10 MINUTES  
G0376  SMOKING AND TOBACCO USE CESSATION COUNSELING VISIT: INTENSIVE, GREATER THAN 3 MINUTES UP TO 10 MINUTES  
G0435  Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening  
G9147  Outpatient intravenous insulin treatment (oivit) either pulsatile or continuous, by any means, guided by the results of measurements for: respiratory quotient; and/or, urine urea nitrogen (uun); and/or, arterial, venous or capillary glucose; and/or potassium concentration  
H0001  Alcohol and/or drug assessment  
H0002  Behavioral health screening to determine eligibility for admission to treatment program  
H0003  Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs  
H0004  Behavioral health counseling and therapy, per 15 minutes  
H0005  Alcohol and/or drug services; group counseling by a clinician  
H0006  Alcohol and/or drug services; case management  
H0007  Alcohol and/or drug services; crisis intervention (outpatient)  
H0008  Alcohol and/or drug services; sub-acute detoxification (hospital inpatient)  
H0009  Alcohol and/or drug services; acute detoxification (hospital inpatient)  
H0010  Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)  
H0011  Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)  
H0012  Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient)  
H0013  Alcohol and/or drug services; acute detoxification (residential addiction program outpatient)  
H0014  Alcohol and/or drug services; ambulatory detoxification  
H0015  Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education  
H0016  Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)  
H0017  Behavioral health; residential (hospital residential treatment program), without room and board, per diem  
H0018  Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem  
H0019  Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem  
H0020  Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)  
H0021  Alcohol and/or drug training service (for staff and personnel not employed by providers)  
H0022  Alcohol and/or drug intervention service (planned facilitation)  
H0023  Behavioral health outreach service (planned approach to reach a targeted population)  
H0024  Behavioral health prevention information dissemination service (one-way direct or non-direct contact with service audiences to affect knowledge and attitude)  
H0025  Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)  
H0026  Alcohol and/or drug prevention process service, community-based (delivery of services to develop skills of impactors)  
H0027  Alcohol and/or drug prevention environmental service (broad range of external activities geared toward modifying systems in order to mainstream prevention through policy and law)  
H0028  Alcohol and/or drug prevention problem identification and referral service (e.g., student assistance and employee assistance programs), does not include assessment  
H0029  Alcohol and/or drug prevention alternatives service (services for populations that exclude alcohol and other drug use e.g., alcohol free social events)  
H0030  Behavioral health hotline service  
H0031  Mental health assessment, by non-physician  
H0032  Mental health service plan development by non-physician  
H0033  Oral medication administration, direct observation  
H0034  Medication training and support, per 15 minutes  
H0035  Mental health partial hospitalization, treatment, less than 24 hours  
H0036  Community psychiatric supportive treatment, face-to-face, per 15 minutes  
H0037  Community psychiatric supportive treatment program, per diem  
H0038  Self-help/peer services, per 15 minutes  
H0039  Assertive community treatment, face-to-face, per 15 minutes  
H0040  Assertive community treatment program, per diem  
H0041  Foster care, child, non-therapeutic, per diem  
H0042  Foster care, child, non-therapeutic, per month  
H0043  Supported housing, per diem  
H0044  Supported housing, per month  
H0045  Respite care services, not in the home, per diem  
H0046  Mental health services, not otherwise specified  
H0047  Alcohol and/or other drug abuse services, not otherwise specified  
H0048  Alcohol and/or other drug testing: collection and handling only, specimens other than blood  
H0049  Alcohol and/or drug screening  
H0050  Alcohol and/or drug services, brief intervention, per 15 minutes  
H1000  Prenatal care, at-risk assessment  
H1001  Prenatal care, at-risk enhanced service; antepartum management  
H1002  Prenatal care, at risk enhanced service; care coordination  
H1003  Prenatal care, at-risk enhanced service; education  
H1004  Prenatal care, at-risk enhanced service; follow-up home visit  
H1005  Prenatal care, at-risk enhanced service package (includes h1001-h1004)  
H1010  Non-medical family planning education, per session  
H1011  Family assessment by licensed behavioral health professional for state defined purposes  
H2000  Comprehensive multidisciplinary evaluation  
H2001  Rehabilitation program, per 1/2 day  
H2010  Comprehensive medication services, per 15 minutes  
H2011  Crisis intervention service, per 15 minutes  
H2012  Behavioral health day treatment, per hour  
H2013  Psychiatric health facility service, per diem  
H2014  Skills training and development, per 15 minutes  
H2015  Comprehensive community support services, per 15 minutes  
H2016  Comprehensive community support services, per diem  
H2017  Psychosocial rehabilitation services, per 15 minutes  
H2018  Psychosocial rehabilitation services, per diem  
H2019  Therapeutic behavioral services, per 15 minutes  
H2020  Therapeutic behavioral services, per diem  
H2021  Community-based wrap-around services, per 15 minutes  
H2022  Community-based wrap-around services, per diem  
H2023  Supported employment, per 15 minutes  
H2024  Supported employment, per diem  
H2025  Ongoing support to maintain employment, per 15 minutes  
H2026  Ongoing support to maintain employment, per diem  
H2027  Psychoeducational service, per 15 minutes  
H2028  Sexual offender treatment service, per 15 minutes  
H2029  Sexual offender treatment service, per diem  
H2030  Mental health clubhouse services, per 15 minutes  
H2031  Mental health clubhouse services, per diem  
H2032  Activity therapy, per 15 minutes  
H2033  Multisystemic therapy for juveniles, per 15 minutes  
H2034  Alcohol and/or drug abuse halfway house services, per diem  
H2035  Alcohol and/or other drug treatment program, per hour  
H2036  Alcohol and/or other drug treatment program, per diem  
H2037  Developmental delay prevention activities, dependent child of client, per 15 minutes  
J0885  Injection, epoetin alfa, (for non-esrd use), 1000 units  
J3396  Injection, verteporfin, 0.1 mg  
J7300  Intrauterine copper contraceptive  
J7301  Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg  
J7302  Levonorgestrel-releasing intrauterine contraceptive system, 52 mg  
J7303  Contraceptive supply, hormone containing vaginal ring, each  
J7304  Contraceptive supply, hormone containing patch, each  
J7306  Levonorgestrel (contraceptive) implant system, including implants and supplies  
J7307  Etonogestrel (contraceptive) implant system, including implant and supplies  
J7309  Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram  
J7310  Ganciclovir, 4.5 mg, long-acting implant  
J7335  Capsaicin 8% patch, per 10 square centimeters  
J8562  Fludarabine phosphate, oral, 10 mg  
J8565  Gefitinib, oral, 250 mg  
K0462  Temporary replacement for patient owned equipment being repaired, any type  
K0553  Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service  
K0739  Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes  
K0740  Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes  
P9012  Cryoprecipitate, each unit  
P9017  Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit  
P9019  Platelets, each unit  
P9020  Platelet rich plasma, each unit  
P9023  Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit  
P9031  Platelets, leukocytes reduced, each unit  
P9032  Platelets, irradiated, each unit  
P9033  Platelets, leukocytes reduced, irradiated, each unit  
P9034  Platelets, pheresis, each unit  
P9035  Platelets, pheresis, leukocytes reduced, each unit  
P9036  Platelets, pheresis, irradiated, each unit  
P9037  Platelets, pheresis, leukocytes reduced, irradiated, each unit  
P9041  Infusion, albumin (human), 5%, 50 ml  
P9043  Infusion, plasma protein fraction (human), 5%, 50 ml  
P9044  Plasma, cryoprecipitate reduced, each unit  
P9045  Infusion, albumin (human), 5%, 250 ml  
P9046  Infusion, albumin (human), 25%, 20 ml  
P9047  Infusion, albumin (human), 25%, 50 ml  
P9048  Infusion, plasma protein fraction (human), 5%, 250 ml  
P9050  Granulocytes, pheresis, each unit  
P9052  Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit  
P9053  Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit  
P9055  Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit  
P9059  Fresh frozen plasma between 8-24 hours of collection, each unit  
P9060  Fresh frozen plasma, donor retested, each unit  
Q0090  Levonorgestrel-releasing intrauterine contraceptive system, (skyla), 13.5 mg  
Q0136  INJECTION, EPOETIN ALPHA, (FOR NON ESRD USE), PER 1000 UNITS  
Q0510  Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant  
Q0511  Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period  
Q0512  Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period  
Q0513  Pharmacy dispensing fee for inhalation drug(s); per 30 days  
Q0514  Pharmacy dispensing fee for inhalation drug(s); per 90 days  
Q2025  Fludarabine phosphate, oral, 1 mg  
Q2026  Injection, radiesse, 0.1 ml  
Q2027  Injection, sculptra, 0.1 ml  
Q2028  Injection, sculptra, 0.5 mg  
Q2042  Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose  
Q2044  Injection, belimumab, 10 mg  
Q2050  Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg  
Q2051  Injection, zoledronic acid, not otherwise specified, 1mg  
Q3014  Telehealth originating site facility fee  
Q9984  Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mg  
Q9988  Platelets, pheresis, pathogen-reduced, each unit  
S0088  Imatinib, 100 mg  
S0091  Granisetron hydrochloride, 1 mg (for circumstances falling under the medicare statute, use q0166)  
S0092  Injection, hydromorphone hydrochloride, 250 mg (loading dose for infusion pump)  
S0093  Injection, morphine sulfate, 500 mg (loading dose for infusion pump)  
S0106  Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets  
S0107  INJECTION, OMALIZUMAB, 25 MG  
S0108  Mercaptopurine, oral, 50 mg  
S0114  INJECTION, TREPROSTINIL SODIUM, 0.5 MG  
S0115  BORTEZOMIB, 3.5 MG  
S0116  BEVACIZUMAB, 100 MG  
S0117  Tretinoin, topical, 5 grams  
S0118  INJECTION, ZICONOTIDE, FOR INTRATHECAL INFUSION, 1 MCG  
S0119  Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)  
S0133  HISTRELIN, IMPLANT, 50 MG  
S0136  Clozapine, 25 mg  
S0137  Didanosine (ddi), 25 mg  
S0138  Finasteride, 5 mg  
S0139  Minoxidil, 10 mg  
S0140  Saquinavir, 200 mg  
S0141  ZALCITABINE (DDC), 0.375 MG  
S0142  Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg  
S0143  AZTREONAM, INHALATION SOLUTION ADMINISTERED THROUGH DME, CONCENTRATED FORM, PER  
S0144  Injection, propofol, 10 mg  
S0145  Injection, pegylated interferon alfa-2a, 180 mcg per ml  
S0146  Injection, pegylated interferon alfa-2b, 10 mcg per 0.5 ml  
S0147  INJECTION, ALGLUCOSIDASE ALFA, 20 MG  
S0148  Injection, pegylated interferon alfa-2b, 10 mcg  
S0155  Sterile dilutant for epoprostenol, 50 ml  
S0156  Exemestane, 25 mg  
S0157  Becaplermin gel 0.01%, 0.5 gm  
S0158  INJECTION, LARONIDASE, 0.58 MG  
S0159  INJECTION, AGALSIDASE BETA, 35 MG  
S0160  Dextroamphetamine sulfate, 5 mg  
S0161  Calcitrol, 0.25 mg  
S0162  INJECTION, EFALIZUMAB, 125 MG  
S0163  INJECTION, RISPERIDONE, LONG ACTING, 12.5 MG  
S0164  Injection, pantoprazole sodium, 40 mg  
S0165  INJECTION, ABARELIX, 100 MG  
S0166  Injection, olanzapine, 2.5 mg  
S0167  INJECTION, APOMORPHINE HYDROCHLORIDE, 1 MG  
S0168  INJECTION, AZACITIDINE, 100 MG  
S0169  Calcitrol, 0.25 microgram  
S0171  Injection, bumetanide, 0.5 mg  
S0172  Chlorambucil, oral, 2 mg  
S0173  DEXAMETHASONE, ORAL, 4MG  
S0174  Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)  
S0175  Flutamide, oral, 125 mg  
S0176  Hydroxyurea, oral, 500 mg  
S0177  Levamisole hydrochloride, oral, 50 mg  
S0178  Lomustine, oral, 10 mg  
S0181  Ondansetron hydrochloride, oral, 4mg (for circumstances falling under the medicare statute, use q0179)  
S0182  Procarbazine hydrochloride, oral, 50 mg  
S0183  Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164)  
S0187  Tamoxifen citrate, oral, 10 mg  
S0190  Mifepristone, oral, 200 mg  
S0191  Misoprostol, oral, 200 mcg  
S0194  Dialysis/stress vitamin supplement, oral, 100 capsules  
S0195  Pneumococcal conjugate vaccine, polyvalent, intramuscular, for children from five years to nine years of age who have not previously received the vaccine  
S0196  Injectable poly-l-lactic acid, restorative implant, 1 ml, face (deep dermis, subcutaneous layers)  
S0197  Prenatal vitamins, 30-day supply  
S0198  INJECTION, PEGAPTANIB SODIUM, 0.3 MG  
S0199  Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs  
S0201  Partial hospitalization services, less than 24 hours, per diem  
S0207  Paramedic intercept, non-hospital-based als service (non-voluntary), non-transport  
S0220  Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 30 minutes  
S0221  Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes  
S0250  Comprehensive geriatric assessment and treatment planning performed by assessment team  
S0255  Hospice referral visit (advising patient and family of care options) performed by nurse, social worker, or other designated staff  
S0257  Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)  
S0260  History and physical (outpatient or office) related to surgical procedure (list separately in addition to code for appropriate evaluation and management service)  
S0265  Genetic counseling, under physician supervision, each 15 minutes  
S0270  Physician management of patient home care, standard monthly case rate (per 30 days)  
S0271  Physician management of patient home care, hospice monthly case rate (per 30 days)  
S0272  Physician management of patient home care, episodic care monthly case rate (per 30 days)  
S0273  Physician visit at member's home, outside of a capitation arrangement  
S0274  Nurse practitioner visit at member's home, outside of a capitation arrangement  
S0280  Medical home program, comprehensive care coordination and planning, initial plan  
S0281  Medical home program, comprehensive care coordination and planning, maintenance of plan  
S0285  Colonoscopy consultation performed prior to a screening colonoscopy procedure  
S0302  Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)  
S0310  Hospitalist services (list separately in addition to code for appropriate evaluation and management service)  
S0311  Comprehensive management and care coordination for advanced illness, per calendar month  
S0315  Disease management program; initial assessment and initiation of the program  
S0316  Disease management program, follow-up/reassessment  
S0317  Disease management program; per diem  
S0320  Telephone calls by a registered nurse to a disease management program member for monitoring purposes; per month  
S0340  Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage  
S0341  Lifestyle modification program for management of coronary artery disease, including all supportive services; second or third quarter / stage  
S0342  Lifestyle modification program for management of coronary artery disease, including all supportive services; fourth quarter / stage  
S0345  ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING RECORDING, MONITORING, RECEIPT OF TRANSMISSIONS, ANALYSIS, AND PHYSICIAN REVIEW AND INTERPRETATION; PER 24-HOUR PERIOD  
S0346  ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING RECORDING, MONITORING, RECEIPT OF TRANSMISSIONS, AND ANALYSIS; PER 24-HOUR PERIOD  
S0347  ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING PHYSICIAN REVIEW AND INTERPRETATION; 24-HOUR PERIOD  
S0353  Treatment planning and care coordination management for cancer, initial treatment  
S0354  Treatment planning and care coordination management for cancer, established patient with a change of regimen  
S0390  Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit  
S0395  Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic  
S0400  Global fee for extracorporeal shock wave lithotripsy treatment of kidney stone(s)  
S0595  Dispensing new spectacle lenses for patient supplied frame  
S0596  Phakic intraocular lens for correction of refractive error  
S0601  Screening proctoscopy  
S0605  DIGITAL RECTAL EXAMINATION, MALE, ANNUAL  
S0610  Annual gynecological examination, new patient  
S0612  Annual gynecological examination, established patient  
S0613  Annual gynecological examination; clinical breast examination without pelvic evaluation  
S0618  Audiometry for hearing aid evaluation to determine the level and degree of hearing loss  
S0620  Routine ophthalmological examination including refraction; new patient  
S0621  Routine ophthalmological examination including refraction; established patient  
S0622  Physical exam for college, new or established patient (list separately in addition to appropriate evaluation and management code)  
S0625  Retinal telescreening by digital imaging of multiple different fundus areas to screen for vision-threatening conditions, including imaging, interpretation and report  
S0630  Removal of sutures; by a physician other than the physician who originally closed the wound  
S0800  Laser in situ keratomileusis (lasik)  
S0810  Photorefractive keratectomy (prk)  
S0820  COMPUTERIZED CORNEAL TOPOGRAPHY, UNILATERAL  
S0830  ULTRASOUND PACHYMETRY TO DETERMINE CORNEAL THICKNESS, WITH INTERPRETATION AND REPORT, UNILATERAL  
S1015  Iv tubing extension set  
S1016  Non-pvc (polyvinyl chloride) intravenous administration set, for use with drugs that are not stable in pvc e.g., paclitaxel  
S1090  Mometasone furoate sinus implant, 370 micrograms  
S2053  Transplantation of small intestine and liver allografts  
S2054  Transplantation of multivisceral organs  
S2055  Harvesting of donor multivisceral organs, with preparation and maintenance of allografts; from cadaver donor  
S2060  Lobar lung transplantation  
S2061  Donor lobectomy (lung) for transplantation, living donor  
S2068  Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilateral  
S2070  Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with endoscopic laser treatment of ureteral calculi (includes ureteral catheterization)  
S2075  LAPAROSCOPY, SURGICAL; REPAIR INCISIONAL OR VENTRAL HERNIA  
S2076  LAPAROSCOPY, SURGICAL; REPAIR UMBILICAL HERNIA  
S2077  LAPAROSCOPY, SURGICAL; IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR INCISIONAL  
S2078  LAPAROSCOPIC SUPRACERVICAL HYSTERECTOMY (SUBTOTAL HYSTERECTOMY), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S)  
S2079  Laparoscopic esophagomyotomy (heller type)  
S2080  Laser-assisted uvulopalatoplasty (laup)  
S2082  LAPAROSCOPY, SURGICAL; GASTRIC RESTRICTIVE PROCEDURE, ADJUSTABLE GASTRIC BAND (INCLUDES PLACEMENT OF SUBCUTANEOUS PORT)  
S2083  Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline  
S2085  LAPAROSCOPY, GASTRIC RESTRICTIVE PROCEDURE, WITH GASTRIC BYPASS FOR MORBID OBESITY, WITH SHORT LIMB (LESS THAN 100 CM) ROUX-EN-Y GASTROENTEROSTOMY  
S2090  ABLATION, OPEN, ONE OR MORE RENAL TUMOR(S); CRYOSURGICAL  
S2091  ABLATION, PERCUTANEOUS, ONE OR MORE RENAL TUMOR(S); CRYOSURGICAL  
S2095  Transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres  
S2102  Islet cell tissue transplant from pancreas; allogeneic  
S2103  Adrenal tissue transplant to brain  
S2107  Adoptive immunotherapy i.e. development of specific anti-tumor reactivity (e.g., tumor-infiltrating lymphocyte therapy) per course of treatment  
S2113  ARTHROSCOPY, KNEE, SURGICAL FOR IMPLANTATION OF CULTURED ANALOGOUS CHONDROCYTES  
S2114  ARTHROSCOPY, SHOULDER, SURGICAL; TENODESIS OF BICEPS  
S2115  Osteotomy, periacetabular, with internal fixation  
S2117  Arthroereisis, subtalar  
S2118  Metal-on-metal total hip resurfacing, including acetabular and femoral components  
S2120  Low density lipoprotein (ldl) apheresis using heparin-induced extracorporeal ldl precipitation  
S2130  ENDOLUMINAL RADIOFREQUENCY ABLATION OF REFLUXING SAPHENOUS VEINS  
S2131  ENDOVASCULAR LASER ABLATION OF LONG OR SHORT SAPHENOUS VEIN, WITH OR WITHOUT PROXIMAL LIGATION OR DIVISION  
S2135  NEUROLYSIS, BY INJECTION, OF METATARSAL NEUROMA/INTERDIGITAL NEURITIS, ANY  
S2140  Cord blood harvesting for transplantation, allogeneic  
S2142  Cord blood-derived stem-cell transplantation, allogeneic  
S2150  Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre-and post-transplant care in the global definition  
S2152  Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor(s), procurement, transplantation, and related complications; including: drugs; supplies; hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services, and the number of days of pre- and post-transplant care in the global definition  
S2202  Echosclerotherapy  
S2205  Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), single coronary arterial graft  
S2206  Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using arterial graft(s), two coronary arterial grafts  
S2207  Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using venous graft only, single coronary venous graft  
S2208  Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using single arterial and venous graft(s), single venous graft  
S2209  Minimally invasive direct coronary artery bypass surgery involving mini-thoracotomy or mini-sternotomy surgery, performed under direct vision; using two arterial grafts and single venous graft  
S2211  TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENT(S), CAROTID ARTERY, PERCUTANEOUS, UNILATERAL (IF PERFORMED BILATERALLY, USE-50 MODIFIER)  
S2213  IMPLANTATION OF GASTRIC ELECTRICAL STIMULATION DEVICE  
S2215  UPPER GASTROINTESTINAL ENDOSCOPY, INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; WITH INJECTION OF IMPLANT MATERIAL INTO AND ALONG THE MUSCLE OF THE LOWER ESOPHAGEAL SPHINCTER FOR TREATMENT OF GASTROESOPHAGEAL REFLUX  
S2225  Myringotomy, laser-assisted  
S2230  Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear  
S2235  Implantation of auditory brain stem implant  
S2250  UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS  
S2255  HYSTEROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BILATERALLY BY MICRO-INSERTS FOR PERMANENT STERILIZATION  
S2260  Induced abortion, 17 to 24 weeks  
S2262  ABORTION FOR MATERNAL INDICATION, 25 WEEKS OR GREATER  
S2265  Induced abortion, 25 to 28 weeks  
S2266  Induced abortion, 29 to 31 weeks  
S2267  Induced abortion, 32 weeks or greater  
S2270  Insertion of vaginal cylinder for application of radiation source or clinical brachytherapy (report separately in addition to radiation source delivery)  
S2300  Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy  
S2325  Hip core decompression  
S2340  Chemodenervation of abductor muscle(s) of vocal cord  
S2341  Chemodenervation of adductor muscle(s) of vocal cord  
S2342  Nasal endoscopy for post-operative debridement following functional endoscopic sinus surgery, nasal and/or sinus cavity(s), unilateral or bilateral  
S2344  Nasal/sinus endoscopy, surgical; with enlargement of sinus ostium opening using inflatable device (i.e., balloon sinuplasty)  
S2348  Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar  
S2350  Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace  
S2351  Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure)  
S2360  Percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; cervical  
S2361  Each additional cervical vertebral body (list separately in addition to code for primary procedure)  
S2362  KYPHOPLASTY, ONE VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION  
S2363  KYPHOPLASTY, ONE VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; EACH ADDITIONAL VERTEBRAL BODY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)  
S2370  INTRADISCAL ELECTROTHERMAL THERAPY; SINGLE INTERSPACE  
S2371  EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)  
S2405  Repair of sacrococcygeal teratoma in the fetus, procedure performed in utero  
S2411  Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome  
S2900  Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)  
S3000  Diabetic indicator; retinal eye exam, dilated, bilateral  
S3005  Performance measurement, evaluation of patient self assessment, depression  
S3600  Stat laboratory request (situations other than s3601)  
S3601  Emergency stat laboratory charge for patient who is homebound or residing in a nursing facility  
S3618  BLOOD CHEMISTRY FOR FREE BETA HUMAN CHORIONIC GONADOTROPIN (HCG)  
S3620  Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total)  
S3625  Maternal serum triple marker screen including alpha-fetoprotein (afp), estriol, and human chorionic gonadotropin (hcg)  
S3626  Maternal serum quadruple marker screen including alpha-fetoprotein (afp), estriol, human chorionic gonadotropin (hcg) and inhibin a  
S3628  Placental alpha microglobulin-1 rapid immunoassay for detection of rupture of fetal membranes  
S3630  Eosinophil count, blood, direct  
S3645  Hiv-1 antibody testing of oral mucosal transudate  
S3650  Saliva test, hormone level; during menopause  
S3652  Saliva test, hormone level; to assess preterm labor risk  
S3655  Antisperm antibodies test (immunobead)  
S3701  IMMUNOASSAY FOR NUCLEAR MATRIX PROTEIN 22 (NMP-22), QUANTITATIVE  
S3708  Gastrointestinal fat absorption study  
S3711  Circulating tumor cell test  
S3713  Kras mutation analysis testing  
S3721  Prostate cancer antigen 3 (pca3) testing  
S3722  Dose optimization by area under the curve (auc) analysis, for infusional 5-fluorouracil  
S3800  Genetic testing for amyotrophic lateral sclerosis (als)  
S3820  Complete brca1 and brca2 gene sequence analysis for susceptibility to breast and ovarian cancer  
S3822  Single mutation analysis (in individual with a known brca1 or brca2 mutation in the family) for susceptibility to breast and ovarian cancer  
S3823  Three-mutation brca1 and brca2 analysis for susceptibility to breast and ovarian cancer in ashkenazi individuals  
S3828  Complete gene sequence analysis; mlh1 gene  
S3829  Complete gene sequence analysis; msh2 gene  
S3830  Complete mlh1 and msh2 gene sequence analysis for hereditary nonpolyposis colorectal cancer (hnpcc) genetic testing  
S3831  Single-mutation analysis (in individual with a known mlh1 and msh2 mutation in the family) for hereditary nonpolyposis colorectal cancer (hnpcc) genetic testing  
S3833  Complete apc gene sequence analysis for susceptibility to familial adenomatous polyposis (fap) and attenuated fap  
S3834  Single-mutation analysis (in individual with a known apc mutation in the family) for susceptibility to familial adenomatous polyposis (fap) and attenuated fap  
S3835  Complete gene sequence analysis for cystic fibrosis genetic testing  
S3837  Complete gene sequence analysis for hemochromatosis genetic testing  
S3840  Dna analysis for germline mutations of the ret proto-oncogene for susceptibility to multiple endocrine neoplasia type 2  
S3841  Genetic testing for retinoblastoma  
S3842  Genetic testing for von hippel-lindau disease  
S3843  Dna analysis of the f5 gene for susceptibility to factor v leiden thrombophilia  
S3844  Dna analysis of the connexin 26 gene (gjb2) for susceptibility to congenital, profound deafness  
S3845  Genetic testing for alpha-thalassemia  
S3846  Genetic testing for hemoglobin e beta-thalassemia  
S3847  Genetic testing for tay-sachs disease  
S3848  Genetic testing for gaucher disease  
S3849  Genetic testing for niemann-pick disease  
S3850  Genetic testing for sickle cell anemia  
S3851  Genetic testing for canavan disease  
S3852  Dna analysis for apoe epsilon 4 allele for susceptibility to alzheimer's disease  
S3853  Genetic testing for myotonic muscular dystrophy  
S3854  Gene expression profiling panel for use in the management of breast cancer treatment  
S3855  Genetic testing for detection of mutations in the presenilin - 1 gene  
S3860  Genetic testing, comprehensive cardiac ion channel analysis, for variants in 5 major cardiac ion channel genes for individuals with high index of suspicion for familial long qt syndrome (lqts) or related syndromes  
S3861  Genetic testing, sodium channel, voltage-gated, type v, alpha subunit (scn5a) and variants for suspected brugada syndrome  
S3862  Genetic testing, family-specific ion channel analysis, for blood-relatives of individuals (index case) who have previously tested positive for a genetic variant of a cardiac ion channel syndrome using either one of the above test configurations or confirmed results from another laboratory  
S3865  Comprehensive gene sequence analysis for hypertrophic cardiomyopathy  
S3866  Genetic analysis for a specific gene mutation for hypertrophic cardiomyopathy (hcm) in an individual with a known hcm mutation in the family  
S3870  Comparative genomic hybridization (cgh) microarray testing for developmental delay, autism spectrum disorder and/or intellectual disability  
S3890  Dna analysis, fecal, for colorectal cancer screening  
S3900  Surface electromyography (emg)  
S3902  Ballistocardiogram  
S3904  Masters two step  
S3905  Non-invasive electrodiagnostic testing with automatic computerized hand-held device to stimulate and measure neuromuscular signals in diagnosing and evaluating systemic and entrapment neuropathies  
S4005  Interim labor facility global (labor occurring but not resulting in delivery)  
S4011  In vitro fertilization; including but not limited to identification and incubation of mature oocytes, fertilization with sperm, incubation of embryo(s), and subsequent visualization for determination of development  
S4013  Complete cycle, gamete intrafallopian transfer (gift), case rate  
S4014  Complete cycle, zygote intrafallopian transfer (zift), case rate  
S4015  Complete in vitro fertilization cycle, not otherwise specified, case rate  
S4016  Frozen in vitro fertilization cycle, case rate  
S4017  Incomplete cycle, treatment cancelled prior to stimulation, case rate  
S4018  Frozen embryo transfer procedure cancelled before transfer, case rate  
S4020  In vitro fertilization procedure cancelled before aspiration, case rate  
S4021  In vitro fertilization procedure cancelled after aspiration, case rate  
S4022  Assisted oocyte fertilization, case rate  
S4023  Donor egg cycle, incomplete, case rate  
S4025  Donor services for in vitro fertilization (sperm or embryo), case rate  
S4026  Procurement of donor sperm from sperm bank  
S4027  Storage of previously frozen embryos  
S4028  Microsurgical epididymal sperm aspiration (mesa)  
S4030  Sperm procurement and cryopreservation services; initial visit  
S4031  Sperm procurement and cryopreservation services; subsequent visit  
S4035  Stimulated intrauterine insemination (iui), case rate  
S4036  INTRAVAGINAL CULTURE (IVC), CASE RATE  
S4037  Cryopreserved embryo transfer, case rate  
S4040  Monitoring and storage of cryopreserved embryos, per 30 days  
S4042  Management of ovulation induction (interpretation of diagnostic tests and studies, non-face-to-face medical management of the patient), per cycle  
S4989  Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies  
S4990  Nicotine patches, legend  
S4991  Nicotine patches, non-legend  
S4993  Contraceptive pills for birth control  
S4995  Smoking cessation gum  
S5000  Prescription drug, generic  
S5001  Prescription drug, brand name  
S5010  5% dextrose and 0.45% normal saline, 1000 ml  
S5011  5% dextrose in lactated ringer's, 1000 ml  
S5012  5% dextrose with potassium chloride, 1000 ml  
S5013  5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1000 ml  
S5014  5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1500 ml  
S5035  Home infusion therapy, routine service of infusion device (e.g., pump maintenance)  
S5036  Home infusion therapy, repair of infusion device (e.g., pump repair)  
S5100  Day care services, adult; per 15 minutes  
S5101  Day care services, adult; per half day  
S5102  Day care services, adult; per diem  
S5105  Day care services, center-based; services not included in program fee, per diem  
S5108  Home care training to home care client, per 15 minutes  
S5109  Home care training to home care client, per session  
S5110  Home care training, family; per 15 minutes  
S5111  Home care training, family; per session  
S5115  Home care training, non-family; per 15 minutes  
S5116  Home care training, non-family; per session  
S5120  Chore services; per 15 minutes  
S5121  Chore services; per diem  
S5125  Attendant care services; per 15 minutes  
S5126  Attendant care services; per diem  
S5130  Homemaker service, nos; per 15 minutes  
S5131  Homemaker service, nos; per diem  
S5135  Companion care, adult (e.g., iadl/adl); per 15 minutes  
S5136  Companion care, adult (e.g., iadl/adl); per diem  
S5140  Foster care, adult; per diem  
S5141  Foster care, adult; per month  
S5145  Foster care, therapeutic, child; per diem  
S5146  Foster care, therapeutic, child; per month  
S5150  Unskilled respite care, not hospice; per 15 minutes  
S5151  Unskilled respite care, not hospice; per diem  
S5160  Emergency response system; installation and testing  
S5161  Emergency response system; service fee, per month (excludes installation and testing)  
S5162  Emergency response system; purchase only  
S5165  Home modifications; per service  
S5170  Home delivered meals, including preparation; per meal  
S5175  Laundry service, external, professional; per order  
S5180  Home health respiratory therapy, initial evaluation  
S5181  Home health respiratory therapy, nos, per diem  
S5185  Medication reminder service, non-face-to-face; per month  
S5190  Wellness assessment, performed by non-physician  
S5199  Personal care item, nos, each  
S5497  Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S5498  Home infusion therapy, catheter care / maintenance, simple (single lumen), includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem  
S5501  Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S5502  Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (use this code for interim maintenance of vascular access not currently in use)  
S5517  Home infusion therapy, all supplies necessary for restoration of catheter patency or declotting  
S5518  Home infusion therapy, all supplies necessary for catheter repair  
S5520  Home infusion therapy, all supplies (including catheter) necessary for a peripherally inserted central venous catheter (picc) line insertion  
S5521  Home infusion therapy, all supplies (including catheter) necessary for a midline catheter insertion  
S5522  Home infusion therapy, insertion of peripherally inserted central venous catheter (picc), nursing services only (no supplies or catheter included)  
S5523  Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included)  
S5550  Insulin, rapid onset, 5 units  
S5551  Insulin, most rapid onset (lispro or aspart); 5 units  
S5552  Insulin, intermediate acting (nph or lente); 5 units  
S5553  Insulin, long acting; 5 units  
S5560  Insulin delivery device, reusable pen; 1.5 ml size  
S5561  Insulin delivery device, reusable pen; 3 ml size  
S5565  Insulin cartridge for use in insulin delivery device other than pump; 150 units  
S5566  Insulin cartridge for use in insulin delivery device other than pump; 300 units  
S5570  Insulin delivery device, disposable pen (including insulin); 1.5 ml size  
S5571  Insulin delivery device, disposable pen (including insulin); 3 ml size  
S8004  RADIOIMMUNOPHARMACEUTICAL LOCALIZATION OF TARGETED CELLS; WHOLE BODY  
S8030  Scleral application of tantalum ring(s) for localization of lesions for proton beam therapy  
S8032  Low-dose computed tomography for lung cancer screening  
S8035  Magnetic source imaging  
S8040  Topographic brain mapping  
S8042  Magnetic resonance imaging (mri), low-field  
S8049  Intraoperative radiation therapy (single administration)  
S8055  Ultrasound guidance for multifetal pregnancy reduction(s), technical component (only to be used when the physician doing the reduction procedure does not perform the ultrasound, guidance is included in the cpt code for multifetal pregnancy reduction - 59866)  
S8075  COMPUTER ANALYSIS OF FULL-FIELD DIGITAL MAMMOGRAM AND FURTHER PHYSICIAN REVIEW FOR INTERPRETATION, MAMMOGRAPHY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)  
S8080  Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical  
S8085  Fluorine-18 fluorodeoxyglucose (f-18 fdg) imaging using dual-head coincidence detection system (non-dedicated pet scan)  
S8092  Electron beam computed tomography (also known as ultrafast ct, cine ct)  
S8093  COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CORONARY ARTERIES, WITH CONTRAST MATERIAL(S)  
S8095  WIG (FOR MEDICALLY-INDUCED OR CONGENITAL HAIR LOSS)  
S8096  Portable peak flow meter  
S8097  Asthma kit (including but not limited to portable peak expiratory flow meter, instructional video, brochure, and/or spacer)  
S8100  Holding chamber or spacer for use with an inhaler or nebulizer; without mask  
S8101  Holding chamber or spacer for use with an inhaler or nebulizer; with mask  
S8110  Peak expiratory flow rate (physician services)  
S8120  Oxygen contents, gaseous, 1 unit equals 1 cubic foot  
S8121  Oxygen contents, liquid, 1 unit equals 1 pound  
S8130  Interferential current stimulator, 2 channel  
S8131  Interferential current stimulator, 4 channel  
S8182  HUMIDIFIER, HEATED, USED WITH VENTILATOR, NON-SERVO-CONTROLLED  
S8183  HUMIDIFIER, HEATED, USED WITH VENTILATOR, DUAL SERVO-CONTROLLED WITH TEMPERATURE MONITORING  
S8185  Flutter device  
S8186  Swivel adapter  
S8189  Tracheostomy supply, not otherwise classified  
S8190  ELECTRONIC SPIROMETER (OR MICROSPIROMETER)  
S8210  Mucus trap  
S8262  Mandibular orthopedic repositioning device, each  
S8265  Haberman feeder for cleft lip/palate  
S8270  Enuresis alarm, using auditory buzzer and/or vibration device  
S8301  Infection control supplies, not otherwise specified  
S8415  Supplies for home delivery of infant  
S8420  Gradient pressure aid (sleeve and glove combination), custom made  
S8421  Gradient pressure aid (sleeve and glove combination), ready made  
S8422  Gradient pressure aid (sleeve), custom made, medium weight  
S8423  Gradient pressure aid (sleeve), custom made, heavy weight  
S8424  Gradient pressure aid (sleeve), ready made  
S8425  Gradient pressure aid (glove), custom made, medium weight  
S8426  Gradient pressure aid (glove), custom made, heavy weight  
S8427  Gradient pressure aid (glove), ready made  
S8428  Gradient pressure aid (gauntlet), ready made  
S8429  Gradient pressure exterior wrap  
S8430  Padding for compression bandage, roll  
S8431  Compression bandage, roll  
S8434  INTERIM POST-OPERATIVE ORTHOTIC DEVICE FOR UPPER EXTREMITY, CUSTOM MADE  
S8460  Camisole, post-mastectomy  
S8930  Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with the patient  
S8940  Equestrian/hippotherapy, per session  
S8948  Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes  
S8950  Complex lymphedema therapy, each 15 minutes  
S8990  Physical or manipulative therapy performed for maintenance rather than restoration  
S8999  Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)  
S9001  Home uterine monitor with or without associated nursing services  
S9007  Ultrafiltration monitor  
S9015  Automated eeg monitoring  
S9022  DIGITAL SUBTRACTION ANGIOGRAPHY (USE IN ADDITION TO CPT CODE FOR THE PROCEDURE FOR FURTHER IDENTIFICATION)  
S9024  Paranasal sinus ultrasound  
S9025  Omnicardiogram/cardiointegram  
S9034  Extracorporeal shockwave lithotripsy for gall stones (if performed with ercp, use 43265)  
S9055  Procuren or other growth factor preparation to promote wound healing  
S9056  Coma stimulation per diem  
S9061  Home administration of aerosolized drug therapy (e.g., pentamidine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9075  Smoking cessation treatment  
S9083  Global fee urgent care centers  
S9088  Services provided in an urgent care center (list in addition to code for service)  
S9090  Vertebral axial decompression, per session  
S9092  CANOLITH REPOSITIONING, PER VISIT  
S9097  Home visit for wound care  
S9098  Home visit, phototherapy services (e.g., bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem  
S9109  Congestive heart failure telemonitoring, equipment rental, including telescale, computer system and software, telephone connections, and maintenance, per month  
S9110  Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month  
S9117  Back school, per visit  
S9122  Home health aide or certified nurse assistant, providing care in the home; per hour  
S9123  Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)  
S9124  Nursing care, in the home; by licensed practical nurse, per hour  
S9125  Respite care, in the home, per diem  
S9126  Hospice care, in the home, per diem  
S9127  Social work visit, in the home, per diem  
S9128  Speech therapy, in the home, per diem  
S9129  Occupational therapy, in the home, per diem  
S9131  Physical therapy; in the home, per diem  
S9140  Diabetic management program, follow-up visit to non-md provider  
S9141  Diabetic management program, follow-up visit to md provider  
S9145  Insulin pump initiation, instruction in initial use of pump (pump not included)  
S9150  Evaluation by ocularist  
S9152  Speech therapy, re-evaluation  
S9208  Home management of preterm labor, including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)  
S9209  Home management of preterm premature rupture of membranes (pprom), including administrative services, professional pharmacy services, care coordination, and all necessary supplies or equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)  
S9211  Home management of gestational hypertension, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)  
S9212  Home management of postpartum hypertension, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with any home infusion per diem code)  
S9213  Home management of preeclampsia, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately); per diem (do not use this code with any home infusion per diem code)  
S9214  Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)  
S9325  Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (do not use this code with s9326, s9327 or s9328)  
S9326  Home infusion therapy, continuous (twenty-four hours or more) pain management infusion; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9327  Home infusion therapy, intermittent (less than twenty-four hours) pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9328  Home infusion therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9329  Home infusion therapy, chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with s9330 or s9331)  
S9330  Home infusion therapy, continuous (twenty-four hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9331  Home infusion therapy, intermittent (less than twenty-four hours) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9335  Home therapy, hemodialysis; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately), per diem  
S9336  Home infusion therapy, continuous anticoagulant infusion therapy (e.g., heparin), administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9338  Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9339  Home therapy; peritoneal dialysis, administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9340  Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem  
S9341  Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem  
S9342  Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem  
S9343  Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem  
S9345  Home infusion therapy, anti-hemophilic agent infusion therapy (e.g., factor viii); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9346  Home infusion therapy, alpha-1-proteinase inhibitor (e.g., prolastin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9347  Home infusion therapy, uninterrupted, long-term, controlled rate intravenous or subcutaneous infusion therapy (e.g., epoprostenol); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9348  Home infusion therapy, sympathomimetic/inotropic agent infusion therapy (e.g., dobutamine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9349  Home infusion therapy, tocolytic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9351  Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and visits coded separately), per diem  
S9353  Home infusion therapy, continuous insulin infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9355  Home infusion therapy, chelation therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9357  Home infusion therapy, enzyme replacement intravenous therapy; (e.g., imiglucerase); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9359  Home infusion therapy, anti-tumor necrosis factor intravenous therapy; (e.g., infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9361  Home infusion therapy, diuretic intravenous therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9363  Home infusion therapy, anti-spasmotic therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9364  Home infusion therapy, total parenteral nutrition (tpn); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem (do not use with home infusion codes s9365-s9368 using daily volume scales)  
S9365  Home infusion therapy, total parenteral nutrition (tpn); one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem  
S9366  Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem  
S9367  Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem  
S9368  Home infusion therapy, total parenteral nutrition (tpn); more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem  
S9370  Home therapy, intermittent anti-emetic injection therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9372  Home therapy; intermittent anticoagulant injection therapy (e.g., heparin); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code for flushing of infusion devices with heparin to maintain patency)  
S9373  Home infusion therapy, hydration therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use with hydration therapy codes s9374-s9377 using daily volume scales)  
S9374  Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9375  Home infusion therapy, hydration therapy; more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9376  Home infusion therapy, hydration therapy; more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9377  Home infusion therapy, hydration therapy; more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies (drugs and nursing visits coded separately), per diem  
S9379  Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9381  Delivery or service to high risk areas requiring escort or extra protection, per visit  
S9401  Anticoagulation clinic, inclusive of all services except laboratory tests, per session  
S9430  Pharmacy compounding and dispensing services  
S9433  Medical food nutritionally complete, administered orally, providing 100% of nutritional intake  
S9434  Modified solid food supplements for inborn errors of metabolism  
S9435  Medical foods for inborn errors of metabolism  
S9436  Childbirth preparation/lamaze classes, non-physician provider, per session  
S9437  Childbirth refresher classes, non-physician provider, per session  
S9438  Cesarean birth classes, non-physician provider, per session  
S9439  Vbac (vaginal birth after cesarean) classes, non-physician provider, per session  
S9441  Asthma education, non-physician provider, per session  
S9442  Birthing classes, non-physician provider, per session  
S9443  Lactation classes, non-physician provider, per session  
S9444  Parenting classes, non-physician provider, per session  
S9445  Patient education, not otherwise classified, non-physician provider, individual, per session  
S9446  Patient education, not otherwise classified, non-physician provider, group, per session  
S9447  Infant safety (including cpr) classes, non-physician provider, per session  
S9449  Weight management classes, non-physician provider, per session  
S9451  Exercise classes, non-physician provider, per session  
S9452  Nutrition classes, non-physician provider, per session  
S9453  Smoking cessation classes, non-physician provider, per session  
S9454  Stress management classes, non-physician provider, per session  
S9455  Diabetic management program, group session  
S9460  Diabetic management program, nurse visit  
S9465  Diabetic management program, dietitian visit  
S9470  Nutritional counseling, dietitian visit  
S9472  Cardiac rehabilitation program, non-physician provider, per diem  
S9473  Pulmonary rehabilitation program, non-physician provider, per diem  
S9474  Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem  
S9475  Ambulatory setting substance abuse treatment or detoxification services, per diem  
S9476  Vestibular rehabilitation program, non-physician provider, per diem  
S9480  Intensive outpatient psychiatric services, per diem  
S9482  Family stabilization services, per 15 minutes  
S9484  Crisis intervention mental health services, per hour  
S9485  Crisis intervention mental health services, per diem  
S9490  Home infusion therapy, corticosteroid infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9494  Home infusion therapy, antibiotic, antiviral, or antifungal therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with home infusion codes for hourly dosing schedules s9497-s9504)  
S9497  Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 3 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9500  Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9501  Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9502  Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9503  Home infusion therapy, antibiotic, antiviral, or antifungal; once every 6 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9504  Home infusion therapy, antibiotic, antiviral, or antifungal; once every 4 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9537  Home therapy; hematopoietic hormone injection therapy (e.g., erythropoietin, g-csf, gm-csf); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9538  Home transfusion of blood product(s); administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (blood products, drugs, and nursing visits coded separately), per diem  
S9542  Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9558  Home injectable therapy; growth hormone, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9559  Home injectable therapy, interferon, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9560  Home injectable therapy; hormonal therapy (e.g.; leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9562  Home injectable therapy, palivizumab, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9590  Home therapy, irrigation therapy (e.g., sterile irrigation of an organ or anatomical cavity); including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem  
S9810  Home therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code)  
S9900  Services by a journal-listed christian science practitioner for the purpose of healing, per diem  
S9901  Services by a journal-listed christian science nurse, per hour  
S9970  Health club membership, annual  
S9975  Transplant related lodging, meals and transportation, per diem  
S9976  Lodging, per diem, not otherwise classified  
S9977  Meals, per diem, not otherwise specified  
S9981  Medical records copying fee, administrative  
S9982  Medical records copying fee, per page  
S9986  Not medically necessary service (patient is aware that service not medically necessary)  
S9988  Services provided as part of a phase i clinical trial  
S9989  Services provided outside of the united states of america (list in addition to code(s) for service(s))  
S9990  Services provided as part of a phase ii clinical trial  
S9991  Services provided as part of a phase iii clinical trial  
S9992  Transportation costs to and from trial location and local transportation costs (e.g., fares for taxicab or bus) for clinical trial participant and one caregiver/companion  
S9994  Lodging costs (e.g., hotel charges) for clinical trial participant and one caregiver/companion  
S9996  Meals for clinical trial participant and one caregiver/companion  
S9999  Sales tax  
T1000  Private duty / independent nursing service(s) - licensed, up to 15 minutes  
T1001  Nursing assessment / evaluation  
T1002  Rn services, up to 15 minutes  
T1003  Lpn/lvn services, up to 15 minutes  
T1004  Services of a qualified nursing aide, up to 15 minutes  
T1005  Respite care services, up to 15 minutes  
T1006  Alcohol and/or substance abuse services, family/couple counseling  
T1007  Alcohol and/or substance abuse services, treatment plan development and/or modification  
T1009  Child sitting services for children of the individual receiving alcohol and/or substance abuse services  
T1010  Meals for individuals receiving alcohol and/or substance abuse services (when meals not included in the program)  
T1012  Alcohol and/or substance abuse services, skills development  
T1013  Sign language or oral interpretive services, per 15 minutes  
T1014  Telehealth transmission, per minute, professional services bill separately  
T1016  Case management, each 15 minutes  
T1017  Targeted case management, each 15 minutes  
T1018  School-based individualized education program (iep) services, bundled  
T1019  Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)  
T1020  Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)  
T1021  Home health aide or certified nurse assistant, per visit  
T1022  Contracted home health agency services, all services provided under contract, per day  
T1023  Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter  
T1024  Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter  
T1025  Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem  
T1026  Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, medical and psychosocial impairments, per hour  
T1027  Family training and counseling for child development, per 15 minutes  
T1028  Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs  
T1029  Comprehensive environmental lead investigation, not including laboratory analysis, per dwelling  
T1030  Nursing care, in the home, by registered nurse, per diem  
T1031  Nursing care, in the home, by licensed practical nurse, per diem  
T1040  Medicaid certified community behavioral health clinic services, per diem  
T1041  Medicaid certified community behavioral health clinic services, per month  
T1500  DIAPER/INCONTINENT PANT, REUSABLE/WASHABLE, ANY SIZE, EACH  
T1502  Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit  
T1503  Administration of medication, other than oral and/or injectable, by a health care agency/professional, per visit  
T1505  Electronic medication compliance management device, includes all components and accessories, not otherwise classified  
T1999  Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"  
T2001  Non-emergency transportation; patient attendant/escort  
T2002  Non-emergency transportation; per diem  
T2003  Non-emergency transportation; encounter/trip  
T2004  Non-emergency transport; commercial carrier, multi-pass  
T2005  Non-emergency transportation; stretcher van  
T2006  AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT  
T2007  Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments  
T2010  Preadmission screening and resident review (pasrr) level i identification screening, per screen  
T2011  Preadmission screening and resident review (pasrr) level ii evaluation, per evaluation  
T2012  Habilitation, educational; waiver, per diem  
T2013  Habilitation, educational, waiver; per hour  
T2014  Habilitation, prevocational, waiver; per diem  
T2015  Habilitation, prevocational, waiver; per hour  
T2016  Habilitation, residential, waiver; per diem  
T2017  Habilitation, residential, waiver; 15 minutes  
T2018  Habilitation, supported employment, waiver; per diem  
T2019  Habilitation, supported employment, waiver; per 15 minutes  
T2020  Day habilitation, waiver; per diem  
T2021  Day habilitation, waiver; per 15 minutes  
T2022  Case management, per month  
T2023  Targeted case management; per month  
T2024  Service assessment/plan of care development, waiver  
T2025  Waiver services; not otherwise specified (nos)  
T2026  Specialized childcare, waiver; per diem  
T2027  Specialized childcare, waiver; per 15 minutes  
T2028  Specialized supply, not otherwise specified, waiver  
T2029  Specialized medical equipment, not otherwise specified, waiver  
T2030  Assisted living, waiver; per month  
T2031  Assisted living; waiver, per diem  
T2032  Residential care, not otherwise specified (nos), waiver; per month  
T2033  Residential care, not otherwise specified (nos), waiver; per diem  
T2034  Crisis intervention, waiver; per diem  
T2035  Utility services to support medical equipment and assistive technology/devices, waiver  
T2036  Therapeutic camping, overnight, waiver; each session  
T2037  Therapeutic camping, day, waiver; each session  
T2038  Community transition, waiver; per service  
T2039  Vehicle modifications, waiver; per service  
T2040  Financial management, self-directed, waiver; per 15 minutes  
T2041  Supports brokerage, self-directed, waiver; per 15 minutes  
T2042  Hospice routine home care; per diem  
T2043  Hospice continuous home care; per hour  
T2044  Hospice inpatient respite care; per diem  
T2045  Hospice general inpatient care; per diem  
T2046  Hospice long term care, room and board only; per diem  
T2048  Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem  
T2049  Non-emergency transportation; stretcher van, mileage; per mile  
T2101  Human breast milk processing, storage and distribution only  
T4521  Adult sized disposable incontinence product, brief/diaper, small, each  
T4522  Adult sized disposable incontinence product, brief/diaper, medium, each  
T4523  Adult sized disposable incontinence product, brief/diaper, large, each  
T4524  Adult sized disposable incontinence product, brief/diaper, extra large, each  
T4525  Adult sized disposable incontinence product, protective underwear/pull-on, small size, each  
T4526  Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each  
T4527  Adult sized disposable incontinence product, protective underwear/pull-on, large size, each  
T4528  Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each  
T4529  Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each  
T4530  Pediatric sized disposable incontinence product, brief/diaper, large size, each  
T4531  Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each  
T4532  Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each  
T4533  Youth sized disposable incontinence product, brief/diaper, each  
T4534  Youth sized disposable incontinence product, protective underwear/pull-on, each  
T4535  Disposable liner/shield/guard/pad/undergarment, for incontinence, each  
T4536  Incontinence product, protective underwear/pull-on, reusable, any size, each  
T4537  Incontinence product, protective underpad, reusable, bed size, each  
T4538  Diaper service, reusable diaper, each diaper  
T4539  Incontinence product, diaper/brief, reusable, any size, each  
T4540  Incontinence product, protective underpad, reusable, chair size, each  
T4541  Incontinence product, disposable underpad, large, each  
T4542  Incontinence product, disposable underpad, small size, each  
T4543  Adult sized disposable incontinence product, protective brief/diaper, above extra large, each  
T4544  Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each  
T5001  Positioning seat for persons with special orthopedic needs  
T5999  Supply, not otherwise specified  
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