Table of content for "Above knee surgical stocking" (HCPCS A4490)
General information on the “A4490” code
HCPCS Code: A4490
Long Description: Surgical stockings above knee length, each
Short Description: Above knee surgical stocking
Original information is taken from A4490 page
Pricing indicators
Pricing Indicator Code 1: 00 – Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)
Multiple Pricing Indicator Code 9 : Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Certification and additional reference information
Coverage Issues Manual Reference Section Number 1: 60-9
Coverage
Coverage: M – Non-covered by Medicare
Type of service
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: 19860101
Code Effective Date: 20030101
Action Code: N – No maintenance for this code