Table of content for "Infusion pump refill kit" (HCPCS A4220)
General information on the “A4220” code
HCPCS Code: A4220
Long Description: Refill kit for implantable infusion pump
Short Description: Infusion pump refill kit
Original information is taken from A4220 page
Pricing indicators
Pricing Indicator Code 1: 57 – Other carrier priced
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage Issues Manual Reference Section Number 1: 60-14
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Processing Note Number: 0050
Berenson-Eggers Type of Service (BETOS): D1A – Medical/surgical supplies
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 19940101
Code Effective Date: 19980303
Action Code: N – No maintenance for this code