HCPCS Code Section: HCPCS A Codes

Infusion set for external insulin pump, non needle cannula type Short Description: Infus insulin pump non needl Coverage Code: Special coverage instructions apply Action Code: No maintenance for this …

Platforms for home blood glucose monitor, 50 per box Short Description: Glucose monitor platforms Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week Short Description: Weekly supply maint cgs pump Coverage Code: Carrier judgment …

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips Short Description: Blood glucose/reagent strips Coverage Code: Special coverage instructions apply Action Code: No maintenance …

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each Short Description: Sup/ext insulin inf pump syr Coverage Code: Special coverage instructions apply Action Code: No maintenance for …

Blood ketone test or reagent strip, each Short Description: Blood ketone test or strip Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date Added: …

Urine test or reagent strips or tablets (100 tablets or strips) Short Description: Urine reagent strips/tablets Coverage Code: Non-covered by Medicare Action Code: No maintenance for this code Date …

Chlorhexidine containing antiseptic, 1 ml Short Description: Chlorhexidine antisept Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2004 Effective Date: January 1, …

Contraceptive supply, condom, male, each Short Description: Male condom Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2003 Effective Date: …

Diaphragm for contraceptive use Short Description: Diaphragm Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2003 Effective Date: January 1, …