A4220

Short Description

• Infusion pump refill kit

Procedure Note

• 0050 = THIS CODE MUST INCLUDE NON-CORING NEEDLES, PRESSURE MONITOR WITH STOPCOCK AND TEMPLATES. CARRIERS SHOULD NOT ALLOW SEPARATE PAYMENT FOR THIS CODE AND FOR A4212.

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• March 03, 1998

HCPCS Code Added Date

• January 01, 1994

HCPCS Pricing Indicator Code

• 57 = Other carrier priced

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Coverage Issues Manual Reference Section Number

• 60-14

HCPCS Type Of Service Code

• P = Lump sum purchase of DME, prosthetics, orthotics

HCPCS Anesthesia Base Unit Quantity

• 0