Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

A4630 - A4640  Replacement Parts

A4630
Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient
shortRepl bat t.e.n.s. own by pt
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4633
Replacement bulb/lamp for ultraviolet light therapy system, each
shortUvl replacement bulb
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME6.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
A4634
Replacement bulb for therapeutic light box, tabletop model
shortReplacement bulb th lightbox
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
DME0.03 Date of Service Edit: ClinicalCMS Policy
A4635
Underarm pad, crutch, replacement, each
shortUnderarm crutch pad
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.02 Date of Service Edit: PolicyClinical: Data
A4636
Replacement, handgrip, cane, crutch, or walker, each
shortHandgrip for cane etc
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.02 Date of Service Edit: PolicyClinical: Data
A4637
Replacement, tip, cane, crutch, walker, each.
shortRepl tip cane/crutch/walker
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME4.02 Date of Service Edit: PolicyClinical: Data
A4638
Replacement battery for patient-owned ear pulse generator, each
shortRepl batt pulse gen sys
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalClinical: Data
A4639
Replacement pad for infrared heating pad system, each
shortInfrared ht sys replcmnt pad
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalCMS Policy
A4640
Replacement pad for use with medically necessary alternating pressure pad owned by patient
shortAlternating pressure pad
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment