HCPCS codes Radiologic Procedures, Ostomy Supplies

Supplies For Radiologic Procedures

A4641

Radiopharmaceutical, diagnostic, not otherwise classified

A4642

Indium In-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries

A4648

Tissue marker, implantable, any type, each

A4649

Surgical supply; miscellaneous

A4650

Implantable radiation dosimeter, each

A4651

Calibrated microcapillary tube, each

A4652

Microcapillary tube sealant

A4653

Peritoneal dialysis catheter anchoring device, belt, each

A4657

Syringe, with or without needle, each

A4660

Sphygmomanometer/blood pressure apparatus with cuff and stethoscope

A4663

Blood pressure cuff only

A4670

Automatic blood pressure monitor

A4671

Disposable cycler set used with cycler dialysis machine, each

A4672

Drainage extension line, sterile, for dialysis, each

A4673

Extension line with easy lock connectors, used with dialysis

A4674

Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz

A4680

Activated carbon filter for hemodialysis, each

A4690

Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each

A4706

Bicarbonate concentrate, solution, for hemodialysis, per gallon

A4707

Bicarbonate concentrate, powder, for hemodialysis, per packet

A4708

Acetate concentrate solution, for hemodialysis, per gallon

A4709

Acid concentrate, solution, for hemodialysis, per gallon

A4714

Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon

A4719

“Y set” tubing for peritoneal dialysis

A4720

Dialysate solution, any concentration of dextrose, fluid volume greater than 249cc, but less than or equal to 999cc, for peritoneal dialysis

A4721

Dialysate solution, any concentration of dextrose, fluid volume greater than 999cc but less than or equal to 1999cc, for peritoneal dialysis

A4722

Dialysate solution, any concentration of dextrose, fluid volume greater than 1999cc but less than or equal to 2999cc, for peritoneal dialysis

A4723

Dialysate solution, any concentration of dextrose, fluid volume greater than 2999cc but less than or equal to 3999cc, for peritoneal dialysis

A4724

Dialysate solution, any concentration of dextrose, fluid volume greater than 3999cc but less than or equal to 4999cc, for peritoneal dialysis

A4725

Dialysate solution, any concentration of dextrose, fluid volume greater than 4999cc but less than or equal to 5999cc, for peritoneal dialysis

A4726

Dialysate solution, any concentration of dextrose, fluid volume greater than 5999cc, for peritoneal dialysis

A4728

Dialysate solution, non-dextrose containing, 500 ml

A4730

Fistula cannulation set for hemodialysis, each

A4736

Topical anesthetic, for dialysis, per gram

A4737

Injectable anesthetic, for dialysis, per 10 ml

A4740

Shunt accessory, for hemodialysis, any type, each

A4750

Blood tubing, arterial or venous, for hemodialysis, each

A4755

Blood tubing, arterial and venous combined, for hemodialysis, each

A4760

Dialysate solution test kit, for peritoneal dialysis, any type, each

A4765

Dialysate concentrate, powder, additive for peritoneal dialysis, per packet

A4766

Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml

A4770

Blood collection tube, vacuum, for dialysis, per 50

A4771

Serum clotting time tube, for dialysis, per 50

A4772

Blood glucose test strips, for dialysis, per 50

A4773

Occult blood test strips, for dialysis, per 50

A4774

Ammonia test strips, for dialysis, per 50

A4802

Protamine sulfate, for hemodialysis, per 50 mg

A4860

Disposable catheter tips for peritoneal dialysis, per 10

A4870

Plumbing and/or electrical work for home hemodialysis equipment

A4890

Contracts, repair and maintenance, for hemodialysis equipment

A4911

Drain bag/bottle, for dialysis, each

A4913

Miscellaneous dialysis supplies, not otherwise specified

A4918

Venous pressure clamp, for hemodialysis, each

A4927

Gloves, non-sterile, per 100

A4928

Surgical mask, per 20

A4929

Tourniquet for dialysis, each

A4930

Gloves, sterile, per pair

A4931

Oral thermometer, reusable, any type, each

A4932

Rectal thermometer, reusable, any type, each

Additional Ostomy Supplies

A5051

Ostomy pouch, closed; with barrier attached (1 piece), each

A5052

Ostomy pouch, closed; without barrier attached (1 piece), each

A5053

Ostomy pouch, closed; for use on faceplate, each

A5054

Ostomy pouch, closed; for use on barrier with flange (2 piece), each

A5055

Stoma cap

A5056

Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each

A5057

Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each

A5061

Ostomy pouch, drainable; with barrier attached, (1 piece), each

A5062

Ostomy pouch, drainable; without barrier attached (1 piece), each

A5063

Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each

A5071

Ostomy pouch, urinary; with barrier attached (1 piece), each

A5072

Ostomy pouch, urinary; without barrier attached (1 piece), each

A5073

Ostomy pouch, urinary; for use on barrier with flange (2 piece), each

A5081

Stoma plug or seal, any type

A5082

Continent device; catheter for continent stoma

A5083

Continent device, stoma absorptive cover for continent stoma

A5093

Ostomy accessory; convex insert

Additional Incontinence Appliances/Supplies

A5102

Bedside drainage bottle with or without tubing, rigid or expandable, each

A5105

Urinary suspensory with leg bag, with or without tube, each

A5112

Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each

A5113

Leg strap; latex, replacement only, per set

A5114

Leg strap; foam or fabric, replacement only, per set

Supplies For Either Incontinence Or Ostomy Appliances

A5120

Skin barrier, wipes or swabs, each

A5121

Skin barrier; solid, 6 x 6 or equivalent, each

A5122

Skin barrier; solid, 8 x 8 or equivalent, each

A5126

Adhesive or non-adhesive; disk or foam pad

A5131

Appliance cleaner, incontinence and ostomy appliances, per 16 oz.

A5200

Percutaneous catheter/tube anchoring device, adhesive skin attachment