HCPCS Code Section: HCPCS S Codes

Injection, cefotetan disodium, 500 mg Short Description: Injection, cefotetan disodiu Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2000 Effective …

Injection, aztreonam, 500 mg Short Description: Injection, aztreonam, 500 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2000 Effective …

Injection, ticarcillin disodium and clavulanate potassium, 3.1 grams Short Description: Injection, ticarcillin disod Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January …

Injection, sulfamethoxazole and trimethoprim, 10 ml Short Description: Injection, sulfamethoxazole Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2000 Effective …

Mercaptopurine, oral, 50 mg Short Description: Mercaptopurine 50 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: April 1, 2002 Effective Date: …

Injection, ofloxacin, 400 mg Short Description: Injection, ofloxacin, 400 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: January 1, 2000 Effective …

Injection, pegylated interferon alfa-2a, 180 mcg per ml Short Description: Peg interferon alfa-2a/180 Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: July …

Injection, propofol, 10 mg Short Description: Inj, propofol, 10 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: July 1, 2014 Effective …

Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg Short Description: Colistimethate inh sol mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this …

Saquinavir, 200 mg Short Description: Saquinavir, 200 mg Coverage Code: Not payable by Medicare Action Code: No maintenance for this code Date Added: April 1, 2003 Effective Date: April …