HCPCS Code Section: HCPCS A Codes

Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) Short Description: Infusion supplies with pump Coverage Code: Carrier judgment Action Code: No maintenance for …

Ambulance response and treatment, no transport Short Description: Ambulance response/treatment Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2006 Effective …

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) Short Description: Supp non-insulin inf cath/wk Coverage Code: Carrier judgment Action Code: No maintenance for this …

Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) Short Description: Noncovered ambulance mileage Coverage Code: Non-covered by Medicare Action Code: No maintenance for this …

Refill kit for implantable infusion pump Short Description: Infusion pump refill kit Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Sterile saline or water, metered dose dispenser, 10 ml Short Description: Sterile saline or water Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Sterile water/saline, 500 ml Short Description: Sterile water/saline, 500 ml Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2004 Effective …

Sterile water, saline and/or dextrose, diluent/flush, 10 ml Short Description: Sterile water/saline, 10 ml Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each Short Description: Lithium batt for glucose mon Coverage Code: Carrier judgment Action Code: …

Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each Short Description: J-cell batt for glucose mon Coverage Code: Carrier judgment …