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HCPCS Procedure & Supply Codes

Medical And Surgical Supplies

section notes

Miscellaneous Medical and Surgical Supplies

section notes
A4206A4209   Syringe with needle, sterile
A4210   Needle-free injection device, each
A4211   Supplies for self-administered injections
A4212   Non-coring needle or stylet with or without catheter
A4213   Syringe, sterile, 20 cc or greater, each
A4215   Needle, sterile, any size, each
A4216   Sterile water, saline and/or dextrose, diluent/flush, 10 ml
A4217   Sterile water/saline, 500 ml
A4218   Sterile saline or water, metered dose dispenser, 10 ml
A4220   Refill kit for implantable infusion pump
A4221   Supplies for maintenance of non-insulin drug infusion catheter, per week (list d...
A4222   Infusion supplies for external drug infusion pump, per cassette or bag (list dru...
A4223   Infusion supplies not used with external infusion pump, per cassette or bag (lis...
A4224   Supplies for maintenance of insulin infusion catheter, per week
A4225   Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
A4226   Supplies for maintenance of insulin infusion pump with dosage rate adjustment us...
A4230   Infusion set for external insulin pump, non needle cannula type
A4231   Infusion set for external insulin pump, needle type
A4232   Syringe with needle for external insulin pump, sterile, 3 cc
A4233A4236   Replacement Battery, Home Blood Glucose Monitor
A4238A4239   Supply Allowance for Non-implanted Continuous Glucose Monitor (CGM)
A4244   Alcohol or peroxide, per pint
A4245   Alcohol wipes, per box
A4246   Betadine or phisohex solution, per pint
A4247   Betadine or iodine swabs/wipes, per box
A4248   Chlorhexidine containing antiseptic, 1 ml
A4250   Urine test or reagent strips or tablets (100 tablets or strips)
A4252   Blood ketone test or reagent strip, each
A4253   Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
A4255   Platforms for home blood glucose monitor, 50 per box
A4256   Normal, low and high calibrator solution / chips
A4257   Replacement lens shield cartridge for use with laser skin piercing device, each
A4258   Spring-powered device for lancet, each
A4259   Lancets, per box of 100
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 ...
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
A4280   Adhesive skin support attachment for use with external breast prosthesis, 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
A4450   Tape, non-waterproof, per 18 square inches
A4452   Tape, waterproof, per 18 square inches
A4455   Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
A4456   Adhesive remover, wipes, any type, each
A4458   Enema bag with tubing, reusable
A4459   Manual pump-operated enema system, includes balloon, catheter and all accessorie...
A4461   Surgical dressing holder, non-reusable, each
A4463   Surgical dressing holder, reusable, each
A4465   Non-elastic binder for extremity
A4467   Belt, strap, sleeve, garment, or covering, any type
A4470   Gravlee jet washer
A4480   Vabra aspirator
A4481   Tracheostoma filter, any type, any size, each
A4483   Moisture exchanger, disposable, for use with invasive mechanical ventilation
A4490   Surgical stockings above knee length, each
A4495   Surgical stockings thigh length, each
A4500   Surgical stockings below knee length, each
A4510   Surgical stockings full length, each
A4520   Incontinence garment, any type, (e.g., brief, diaper), each
A4550   Surgical trays
A4554   Disposable underpads, all sizes
A4555   Electrode/transducer for use with electrical stimulation device used for cancer ...
A4556   Electrodes, (e.g., apnea monitor), per pair
A4557   Lead wires, (e.g., apnea monitor), per pair
A4558   Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz
A4559   Coupling gel or paste, for use with ultrasound device, per oz
A4561   Pessary, rubber, any type
A4562   Pessary, non rubber, any type
A4565   Slings
A4566   Shoulder sling or vest design, abduction restrainer, with or without swathe cont...
A4570   Splint
A4575   Topical hyperbaric oxygen chamber, disposable
A4580   Cast supplies (e.g., plaster)
A4590   Special casting material (e.g., fiberglass)
A4595   Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)
A4596   Cranial electrotherapy stimulation (ces) system supplies and accessories, per month
A8000A8003   Helmet, protective, includes all components and accessories
A8004   Soft interface for helmet, replacement only
A9273   Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type
A9285   Inversion/eversion correction device
A9286   Hygienic item or device, disposable or non-disposable, any type, each
A9574   Air polymer-type a intrauterine foam, 0.1 ml
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