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PPS Bundled Supply Codes for Medicare HHA Patients
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A4212 |
New Code Effective 1/1/00 (if applicable) |
Non-coring needle or stylet with or without
catheter |
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A4213 |
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Syringe, Sterile 20 cc or greater |
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A4215 |
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Needles only, sterile any size, each |
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A4310 |
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Insertion tray without drainage bag and without
catheter (accessories only) |
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A4311 |
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Insertion tray without drainage bag with
indwelling catheter, foley type, two-way latex with coating (teflon, silicone,
silicone elastomer or hydrophilic, etc.) |
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A4312 |
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Insertion tray without drainage bag with
indwelling catheter, foley type,
two-way, all silicone |
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A4313 |
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Insertion tray without drainage bag with
indwelling catheter, foley type, three-way, for continuous irrigation |
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A4314 |
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Insertion tray with drainage bag with indwelling
catheter, foley type, two-way latex with coating (teflon, silicone, silicone
elastomer or hydrophilic, etc.) |
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A4315 |
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Insertion tray with drainage bag with indwelling
catheter, foley type, three-way, for continuous irrigation |
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A4316 |
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Insertion tray with drainage bag with indwelling
catheter, foley type, three-way, for continuous irrigation |
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A4320 |
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Irrigation tray, bulb or piston syringe, any
purpose |
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A4321 |
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Therapeutic agent for urinary catheter irrigation |
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A4322 |
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Irrigation syringe, bulb or piston, each |
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A4323 |
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Sterile saline irrigation solution, 1000ml |
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A4326 |
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Male external catheter specialty type, e.g.,
inflatable, faceplate, etc., each |
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A4327 |
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Female external urinary collection device; metal
cup, each |
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A4328 |
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Female external urinary collection device; pouch,
each |
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A4329 |
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External catheter starter set, male/female,
includes catheter/urinary collection device, bag/pouch and accessories
(tubing, clamps, etc.) 7 day supply, Invalid for DMERC Claims 10/1/95 |
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A4330 |
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Perineal fecal collection pouch with adhesive,
each |
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A4335 |
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Incontinence supply; misc |
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A4338 |
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Indwelling catheter, foley type, two-way latex
with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.) |
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A4340 |
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Indwelling catheter, specialty type, (e.g., coude,
mushroom, wing, etc.) each |
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A4344 |
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Indwelling catheter, foley type, two-way, all
silicone, each |
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A4346 |
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Indwelling catheter, foley type, three-way, for
continuous irrigation, each |
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A4347 |
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Male external catheter with or without adhesive,
with or without anti-reflux device:
Invalid for DMERC claims 10/1/95 |
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A4351 |
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Intermittent urinary catheter; straight tip |
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A4352 |
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Intermittent urinary catheter; Coude (curved) tip |
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A4353 |
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Intermittent urinary catheter with insertion
supplies |
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A4354 |
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Insertion tray with drainage bag but without
catheter |
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A4355 |
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Irrigation tubing set for continuous bladder
irrigation through a three-way indwelling foley catheter |
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A4356 |
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External urethral clamp or compression device (not
to be used for catheter clamp) |
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A4357 |
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Bedside drainage bag, day or night, with or
without anti-reflux device, with or without tube |
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A4358 |
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Urinary leg bag, vinyl, with or without tube |
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A4359 |
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Urinary suspensory without leg bag |
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A4361 |
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Ostomy faceplate |
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A4362 |
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Skin barrier; solid, 4 x 4 or equivalent |
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A4363 |
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Skin barrier; liquid (spray, brush, etc.) Powder
or paste; per oz. |
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A4364 |
4369 4370 4371 |
Adhesive for ostomy or catheter; liquid (spray,
brush, etc.) cement, powder or paste; any composition (e.g., silicone, latex,
etc.) per oz. |
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A4365 |
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Ostomy adhesive remover wipes |
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A4367 |
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Ostomy belt |
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A4368 |
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Ostomy filter, any type |
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A4397 |
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Irrigation supply; sleeve |
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A4398 |
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Ostomy irrigation supply, bag |
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A4399 |
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Ostomy irrigation supply; cone/catheter including
brush |
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A4400 |
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Ostomy irrigation set, Invalid for DMERC claims 10/1/93 |
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A4402 |
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Lubricant, per oz. |
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A4404 |
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Ostomy ring |
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A4421 |
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Ostomy supply, misc |
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A4454 |
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Tape, all types and sizes Invalid for DMERC claims received 9/1/95 or after |
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A4455 |
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Adhesive remover or solvent (for tape, cement or
other adhesive), per oz. |
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A4460 |
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Elastic bandage per roll (e.g., compression
bandage) |
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A4462 |
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Abdominal dressing holder/binder |
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A4481 |
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Tracheostoma filter, any type, any size |
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A4622 |
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Tracheostomy or laryngectomy tube |
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A4623 |
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Tracheostomy, inner cannula (replacement only) |
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A4625 |
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Tracheostomy care kit for new trach |
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A4626 |
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Tracheostomy cleaning brush |
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A4649 |
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Surgical supplies, misc |
-DYNA-FLEX Multi-Layer Compression System -BARRIER Sterile Field |
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A5051 |
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Pouch, closed; with barrier attached (1 piece) |
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A5052 |
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Pouch, closed; without barrier attached (1 piece) |
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A5053 |
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Pouch, closed; for use on faceplate |
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A5054 |
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Pouch, closed; for use on barrier with flange (2
piece) |
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A5055 |
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Stoma cap |
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A5061 |
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Pouch, drainable; with barrier attached (1 piece) |
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A5062 |
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Pouch, drainable; without barrier attached (1
piece) |
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A5063 |
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Pouch, drainable; for use on barrier with flange
(2 piece system) |
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A5071 |
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Pouch, urinary; with barrier attached (1 piece) |
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