Showing codes A5055 (Stoma cap) — A5507 (For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe)

A5055 - Stoma cap
Long description: Stoma cap
Code added date: 19900101.
Code effective date: 19900101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5056 - 1 pc ost pouch w filter
Long description: Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5057 - 1 pc ost pou w built-in conv
Long description: Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5061 - Pouch drainable w barrier at
Long description: Ostomy pouch, drainable; with barrier attached, (1 piece), each
Code added date: 19900101.
Code effective date: 20030101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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A5062 - Drnble ostomy pouch w/o barr
Long description: Ostomy pouch, drainable; without barrier attached (1 piece), each
Code added date: 19900101.
Code effective date: 20030101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5063 - Drain ostomy pouch w/flange
Long description: Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each
Code added date: 19900101.
Code effective date: 20030101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5071 - Urinary pouch w/barrier
Long description: Ostomy pouch, urinary; with barrier attached (1 piece), each
Code added date: 19900101.
Code effective date: 20030101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5072 - Urinary pouch w/o barrier
Long description: Ostomy pouch, urinary; without barrier attached (1 piece), each
Code added date: 19900101.
Code effective date: 20030101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5073 - Urinary pouch on barr w/flng
Long description: Ostomy pouch, urinary; for use on barrier with flange (2 piece), each
Code added date: 19900101.
Code effective date: 20030101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5081 - Stoma plug or seal, any type
Long description: Stoma plug or seal, any type
Code added date: 19900101.
Code effective date: 20140101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5082 - Continent stoma catheter
Long description: Continent device; catheter for continent stoma
Code added date: 19900101.
Code effective date: 19900101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5083 - Stoma absorptive cover
Long description: Continent device, stoma absorptive cover for continent stoma
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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A5093 - Ostomy accessory convex inse
Long description: Ostomy accessory; convex insert
Code added date: 19900101.
Code effective date: 19900101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5102 - Bedside drain btl w/wo tube
Long description: Bedside drainage bottle with or without tubing, rigid or expandable, each
Code added date: 19900101.
Code effective date: 19970101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5105 - Urinary suspensory
Long description: Urinary suspensory with leg bag, with or without tube, each
Code added date: 19900101.
Code effective date: 20080101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5112 - Urinary leg bag
Long description: Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each
Code added date: 19900101.
Code effective date: 20110101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5113 - Latex leg strap
Long description: Leg strap; latex, replacement only, per set
Code added date: 19900101.
Code effective date: 19980101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5114 - Foam/fabric leg strap
Long description: Leg strap; foam or fabric, replacement only, per set
Code added date: 19900101.
Code effective date: 19980101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5120 - Skin barrier, wipe or swab
Long description: Skin barrier, wipes or swabs, each
Code added date: 20060101.
Code effective date: 20060101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5121 - Solid skin barrier 6x6
Long description: Skin barrier; solid, 6 x 6 or equivalent, each
Code added date: 19900101.
Code effective date: 19900101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5122 - Solid skin barrier 8x8
Long description: Skin barrier; solid, 8 x 8 or equivalent, each
Code added date: 19900101.
Code effective date: 19900101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5126 - Disk/foam pad +or- adhesive
Long description: Adhesive or non-adhesive; disk or foam pad
Code added date: 19900101.
Code effective date: 20000101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5131 - Appliance cleaner
Long description: Appliance cleaner, incontinence and ostomy appliances, per 16 oz.
Code added date: 19900101.
Code effective date: 19900101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5200 - Percutaneous catheter anchor
Long description: Percutaneous catheter/tube anchoring device, adhesive skin attachment
Code added date: 19990101.
Code effective date: 20030101.
Pricing Indicator Code(s): 37 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5500 - Diab shoe for density insert
Long description: For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe
Code added date: 19950101.
Code effective date: 20050101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5501 - Diabetic custom molded shoe
Long description: For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe
Code added date: 19950101.
Code effective date: 20050101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5503 - Diabetic shoe w/roller/rockr
Long description: For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe
Code added date: 19950101.
Code effective date: 20050101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5504 - Diabetic shoe with wedge
Long description: For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe
Code added date: 19950101.
Code effective date: 20050101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5505 - Diab shoe w/metatarsal bar
Long description: For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe
Code added date: 19950101.
Code effective date: 20050101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5506 - Diabetic shoe w/off set heel
Long description: For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe
Code added date: 19950101.
Code effective date: 20050101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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A5507 - Modification diabetic shoe
Long description: For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe
Code added date: 19950101.
Code effective date: 20050101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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