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AMERICANMEDICALASSOCIATION
Alongwith themost currentHCPCScodesand regulations, this codebook
containseverythingyouneed for accuratemedical billingandappropriate
reimbursement including theAmericanDentalAssociation’sCDTdental
codes, acompanionwebsite thatoffersaccess to the latestupdatesand
special reports, a full-color tableofdrugswithdrug-codeannotations,
colorphotographsand illustrations.
AVAILABLEDECEMBER2016
Spiralbound, 8½" x11", approx. 389pages
Item#:OP231517
ISBN: 978-1-62202-411-7
Price: $99.95
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2016:HCPCSLEVEL IINATIONALCODES
358
X
New
Revised
✔
Reinstated
deleted
Deleted
[
Notcoveredor validbyMedicare
❂
Specialcoverage instructions
✽
Carrierdiscretion
Bill localcarrier
BillDMEMAC
S8930 –S9208 TEMPORARYNATIONALCODES ESTABLISHEDBYPRIVATEPAYERS
Figure 55
Extracorporeal shockwave lithotripsy (ESWL).
Shockwaves
Shockwave generator
Ellipsoidal
reflector
[
S9122
Home health aide or certifiednurse
assistant, providing care in the home;
per hour
[
S9123
Nursing care, in the home; by
registered nurse, per hour (use for
general nursing care only, not to be
usedwhenCPT codes 99500-99602 can
be used)
[
S9124
Nursing care, in the home; by licensed
practical nurse, per hour
[
S9125
Respite care, in the home, per diem
[
S9126
Hospice care, in the home, per diem
[
S9127
Socialwork visit, in thehome, per diem
[
S9128
Speech therapy, in the home, per diem
[
S9129
Occupational therapy, in the home, per
diem
[
S9131
Physical therapy; in the home, per diem
[
S9140
Diabeticmanagement program,
follow-up visit to non-MD provider
[
S9141
Diabeticmanagement program,
follow-up visit toMD provider
[
S9145
Insulin pump initiation, instruction
in initial use of pump (pump not
included)
[
S9150
Evaluation by ocularist
[
S9152
Speech therapy, re-evaluation
[
S9208
Homemanagement of preterm labor,
including administrative services,
professional pharmacy services, care
coordination, and all necessary supplies
or equipment (drugs and nursing visits
coded separately), per diem (do not use
this codewith any home infusion per
diem code)
[
S8930
Electrical stimulation of auricular
acupuncture points; each 15minutes of
personal one-on-one contactwith the
patient
[
S8940
Equestrian/Hippotherapy, per session
[
S8948
Application of amodality (requiring
constant provider attendance) to one
ormore areas; low-level laser; each
15minutes
[
S8950
Complex lymphedema therapy, each
15minutes
[
S8990
Physical ormanipulative therapy
performed formaintenance rather than
restoration
[
S8999
Resuscitation bag (for use by patient
on artificial respiration during power
failure or other catastrophic event)
[
S9001
Home uterinemonitorwith orwithout
associated nursing services
[
S9007
Ultrafiltrationmonitor
S9015
AutomatedEEGmonitoring
[
S9024
Paranasal sinus ultrasound
[
S9025
Omnicardiogram/cardiointegram
[
S9034
Extracorporeal shockwave lithotripsy
for gall stones (if performedwith
ERCP, use 43265)
[
S9055
Procuren or other growth factor
preparation to promotewound healing
[
S9056
Coma stimulation per diem
[
S9061
Home administration of aerosolized
drug therapy (e.g., pentamidine);
administrative services, professional
pharmacy services, care coordination,
all necessary supplies and equipment
(drugs and nursing visits coded
separately), per diem
[
S9083
Global fee urgent care centers
[
S9088
Services provided in an urgent care
center (list in addition to code for
service)
[
S9090
Vertebral axial decompression, per
session
[
S9097
Home visit forwound care
[
S9098
Home visit, phototherapy services (e.g.,
Bili-Lite), including equipment rental,
nursing services, blood draw, supplies,
and other services, per diem
[
S9110
Telemonitoring of patient in their
home, including all necessary
equipment; computer system,
connections, and software;
maintenance; patient education and
support; permonth
[
S9117
Back school, per visit
✖
SAMPLEPAGES
MEDICALAND SURGICAL SUPPLIES
115
PQRS
PQRS
Qp
QuantityPhysician
Qh
QuantityHospital
Femaleonly
Maleonly
A
Age
DMEPOS
A2-Z3
ASCPayment Indicator
A-Y
ASCStatus Indicator
CodingClinic
MEDICALANDSURGICALSUPPLIES
A4627 –A4650
✽
A4634
Replacement bulb for therapeutic light
box, tabletopmodel
N
❂
A4635
Underarm pad, crutch, replacement,
each
Qp
Qh
E
IOM: 100-03, 4, 280.1
DMEPOSModifier(s):
NU,RR,UE
❂
A4636
Replacement, handgrip, cane, crutch,
orwalker, each
Qh
E
IOM: 100-03, 4, 280.1
DMEPOSModifier(s):
NU,KE,RR,UE
❂
A4637
Replacement, tip, cane, crutch,walker,
each
Qh
E
IOM: 100-03, 4, 280.1
DMEPOSModifier(s):
NU,KE,RR,UE
✽
A4638
Replacement battery for patient-
owned ear pulse generator,
each
Qp
Qh
E
DMEPOSModifier(s):
NU,RR,UE
✽
A4639
Replacement pad for infrared heating
pad system, each
E
DMEPOSModifier(s):
RR
❂
A4640
Replacement pad for usewith
medically necessary alternating
pressure pad owned by
patient
Qp
Qh
E
IOM: 100-03, 4, 280.1; 100-08, 5, 5.2.3
DMEPOSModifier(s):
NU,RR,UE
Supplies forRadiologicalProcedures
✽
A4641
Radiopharmaceutical, diagnostic, not
otherwise classified
N1
N
Is not an applicable tracer forPET
scans
✽
A4642
Indium In-111 satumomab pendetide,
diagnostic, per study dose, up to
6millicuries
Qp
Qh
N1
N
MiscellaneousSupplies
✽
A4648
Tissuemarker, implantable, any type,
each
Qp
Qh
N1
N
CodingClinic: 2013,Q3,P9
✽
A4649
Surgical supply;miscellaneous
N
Bill local carrier ( ) if “incident to”
a physician’s service (not separately
payable) or if supply for implanted
prosthetic device or implantedDME.
✽
A4650
Implantable radiation dosimeter,
each
Qp
Qh
N1
N
Figure 6
Tracheostomy cannula.
[
A4627
Spacer, bag, or reservoir,with or
withoutmask, for usewithmetered
dose inhaler
E
Bill local carrier
( ) if “incident to”
a physician’s service (not separately
payable).
IOM: 100-02, 15, 110
✽
A4628
Oropharyngeal suction catheter,
each
Qh
N
Bill local carrier
( ) if “incident to”
a physician’s service (not separately
payable).
Nomore than three catheters perweek
are covered formedically necessary
oropharyngeal suctioning because the
catheters can be reused if cleansed and
disinfected. (MSManualSystem,Pub.
100-3,NCDmanual,Chapter 1,Section
280-1)
DMEPOSModifier(s):
NU
❂
A4629
Tracheostomy care kit for established
tracheostomy
N
Bill local carrier
( ) if “incident to”
a physician’s service (not separately
payable).
IOM: 100-02, 15, 120
DMEPOSModifier(s):
NU
Supplies forOtherDurableMedicalEquipment
❂
A4630
Replacement batteries,medically
necessary, transcutaneous electrical
stimulator, owned by patient
E
IOM: 100-03, 3, 160.7
DMEPOSModifier(s):
NU
✽
A4633
Replacement bulb/lamp for
ultraviolet light therapy system,
each
Qp
Qh
E
DMEPOSModifier(s):
NU
Samplepages from
HCPCS2016
Level II Professional Edition
.
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ICD-10-CM2017
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