Browse HCPCS Level II 2020 Edition

A4611 - A4629  Supplies for Respiratory and Oxygen Equipment

A4611 Battery, heavy duty; replacement for patient owned ventilator short Heavy duty battery RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 0.0 3 Date of Service Edit: Clinical CMS Policy DME 2.0 3 Date of Service Edit: Clinical Clinical: Data

A4612 Battery cables; replacement for patient-owned ventilator short Battery cables RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 0.0 3 Date of Service Edit: Clinical CMS Policy DME 2.0 3 Date of Service Edit: Clinical Clinical: Data

A4613 Battery charger; replacement for patient-owned ventilator short Battery charger RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 0.0 3 Date of Service Edit: Clinical CMS Policy DME 1.0 3 Date of Service Edit: Clinical Clinical: Data

A4614 Peak expiratory flow rate meter, hand held short Hand-held pefr meter RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 1.0 2 Date of Service Edit: Policy Nature of Equipment DME 1.0 2 Date of Service Edit: Policy Clinical: Data

A4615 Cannula, nasal short Cannula nasal RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 2.0 3 Date of Service Edit: Clinical Clinical: Data DME 0.0 3 Date of Service Edit: Clinical Published Contractor Policy

A4616 Tubing (oxygen), per foot short Tubing (oxygen) per foot RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 1.0 3 Date of Service Edit: Clinical Clinical: Data DME 0.0 3 Date of Service Edit: Clinical Published Contractor Policy

A4617 Mouth piece short Mouth piece RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 1.0 3 Date of Service Edit: Clinical Clinical: Data DME 0.0 3 Date of Service Edit: Clinical Published Contractor Policy

A4618 Breathing circuits short Breathing circuits RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 1.0 3 Date of Service Edit: Clinical Clinical: Data OPH 1.0 3 Date of Service Edit: Clinical Clinical: Data

A4619 Face tent short Face tent RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 1.0 3 Date of Service Edit: Clinical Clinical: Data DME 3.0 3 Date of Service Edit: Clinical Published Contractor Policy

A4620 Variable concentration mask short Variable concentration mask RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 1.0 3 Date of Service Edit: Clinical Clinical: Data DME 0.0 3 Date of Service Edit: Clinical Published Contractor Policy

A4623 Tracheostomy, inner cannula short Tracheostomy inner cannula RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 10.0 3 Date of Service Edit: Clinical Clinical: Data DME 200.0 3 Date of Service Edit: Clinical Published Contractor Policy

A4624 Tracheal suction catheter, any type other than closed system, each short Tracheal suction tube RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 2.0 3 Date of Service Edit: Clinical Clinical: CMS Workgroup

A4625 Tracheostomy care kit for new tracheostomy short Trach care kit for new trach RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 30.0 3 Date of Service Edit: Clinical Published Contractor Policy OPH 30.0 3 Date of Service Edit: Clinical Published Contractor Policy DME 100.0 3 Date of Service Edit: Clinical Published Contractor Policy

A4626 Tracheostomy cleaning brush, each short Tracheostomy cleaning brush RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 1.0 3 Date of Service Edit: Clinical Nature of Equipment DME 6.0 3 Date of Service Edit: Clinical Published Contractor Policy

A4627 Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler short Spacer bag/reservoir RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 0.0 3 Date of Service Edit: Clinical CMS Policy DME 0.0 3 Date of Service Edit: Clinical CMS Policy

A4628 Oropharyngeal suction catheter, each short Oropharyngeal suction cath RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 1.0 3 Date of Service Edit: Clinical Clinical: Data

A4629 Tracheostomy care kit for established tracheostomy short Tracheostomy care kit RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 1.0 3 Date of Service Edit: Clinical Clinical: Data