A4375

Short Description

• Drainable plastic pch w fcpl

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2003

HCPCS Code Added Date

• January 01, 2000

HCPCS Pricing Indicator Code

• 37 = Ostomy, tracheostomy and urological supplies (price subject to floors and ceilings)

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Medicare Carriers Manual Reference Section Number

• 2130

HCPCS Type Of Service Code

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

HCPCS Anesthesia Base Unit Quantity

• 0