E2389

Short Description

• Foam caster tire

Procedure Note

• 0125 = NCD MANUAL 280.1.

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2007

HCPCS Code Added Date

• January 01, 2007

HCPCS Pricing Indicator Code

• 32 = Inexpensive & routinely purchased DME (price subject to floors and ceilings)

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Type Of Service Code

• A = Used durable medical equipment (DME)P = Lump sum purchase of DME, prosthetics, orthotics R = Rental of DME

HCPCS Anesthesia Base Unit Quantity

• 0