[Federal Register: November 1, 2002 (Volume 67, Number 212)]
[Rules and Regulations]
[Page 66967-67016]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr01no02-24]
[[pp. 66967-67016]] Medicare Program; Changes to the Hospital Outpatient Prospective
Payment System and Calendar Year 2003 Payment Rates; and Changes to
Payment Suspension for Unfiled Cost Reports
[[Continued from page 66966]]
[[Page 66966]]
D5919 E................ ................... Facial prosthesis.......... ........... ........... ........... ........... ...........
D5922 E................ ................... Nasal septal prosthesis.... ........... ........... ........... ........... ...........
D5923 E................ ................... Ocular prosthesis interim.. ........... ........... ........... ........... ...........
D5924 E................ ................... Cranial prosthesis......... ........... ........... ........... ........... ...........
D5925 E................ ................... Facial augmentation implant ........... ........... ........... ........... ...........
D5926 E................ ................... Replacement nasal ........... ........... ........... ........... ...........
prosthesis.
D5927 E................ ................... Auricular replacement...... ........... ........... ........... ........... ...........
D5928 E................ ................... Orbital replacement........ ........... ........... ........... ........... ...........
D5929 E................ ................... Facial replacement......... ........... ........... ........... ........... ...........
D5931 E................ ................... Surgical obturator......... ........... ........... ........... ........... ...........
D5932 E................ ................... Postsurgical obturator..... ........... ........... ........... ........... ...........
D5933 E................ ................... Refitting of obturator..... ........... ........... ........... ........... ...........
D5934 E................ ................... Mandibular flange ........... ........... ........... ........... ...........
prosthesis.
D5935 E................ ................... Mandibular denture prosth.. ........... ........... ........... ........... ...........
D5936 E................ ................... Temp obturator prosthesis.. ........... ........... ........... ........... ...........
D5937 E................ ................... Trismus appliance.......... ........... ........... ........... ........... ...........
D5951 E................ ................... Feeding aid................ ........... ........... ........... ........... ...........
D5952 E................ ................... Pediatric speech aid....... ........... ........... ........... ........... ...........
D5953 E................ ................... Adult speech aid........... ........... ........... ........... ........... ...........
D5954 E................ ................... Superimposed prosthesis.... ........... ........... ........... ........... ...........
D5955 E................ ................... Palatal lift prosthesis.... ........... ........... ........... ........... ...........
D5958 E................ ................... Intraoral con def inter plt ........... ........... ........... ........... ...........
D5959 E................ ................... Intraoral con def mod palat ........... ........... ........... ........... ...........
D5960 E................ ................... Modify speech aid ........... ........... ........... ........... ...........
prosthesis.
D5982 E................ ................... Surgical stent............. ........... ........... ........... ........... ...........
D5983 S................ ................... Radiation applicator....... 0330 4.7770 $249.13 ........... $49.83
D5984 S................ ................... Radiation shield........... 0330 4.7770 $249.13 ........... $49.83
D5985 S................ ................... Radiation cone locator..... 0330 4.7770 $249.13 ........... $49.83
D5986 E................ ................... Fluoride applicator........ ........... ........... ........... ........... ...........
D5987 S................ ................... Commissure splint.......... 0330 4.7770 $249.13 ........... $49.83
D5988 E................ ................... Surgical splint............ ........... ........... ........... ........... ...........
D5999 E................ ................... Maxillofacial prosthesis... ........... ........... ........... ........... ...........
D6010 E................ ................... Odontics endosteal implant. ........... ........... ........... ........... ...........
D6020 E................ ................... Odontics abutment placement ........... ........... ........... ........... ...........
D6040 E................ ................... Odontics eposteal implant.. ........... ........... ........... ........... ...........
D6050 E................ ................... Odontics transosteal implnt ........... ........... ........... ........... ...........
D6053 E................ NI................. Implnt/abtmnt spprt remv ........... ........... ........... ........... ...........
dnt.
D6054 E................ NI................. Implnt/abtmnt spprt ........... ........... ........... ........... ...........
remvprtl.
D6055 E................ ................... Implant connecting bar..... ........... ........... ........... ........... ...........
D6056 E................ ................... Prefabricated abutment..... ........... ........... ........... ........... ...........
D6057 E................ ................... Custom abutment............ ........... ........... ........... ........... ...........
D6058 E................ ................... Abutment supported crown... ........... ........... ........... ........... ...........
D6059 E................ ................... Abutment supported mtl ........... ........... ........... ........... ...........
crown.
D6060 E................ ................... Abutment supported mtl ........... ........... ........... ........... ...........
crown.
D6061 E................ ................... Abutment supported mtl ........... ........... ........... ........... ...........
crown.
D6062 E................ ................... Abutment supported mtl ........... ........... ........... ........... ...........
crown.
D6063 E................ ................... Abutment supported mtl ........... ........... ........... ........... ...........
crown.
D6064 E................ ................... Abutment supported mtl ........... ........... ........... ........... ...........
crown.
D6065 E................ ................... Implant supported crown.... ........... ........... ........... ........... ...........
D6066 E................ ................... Implant supported mtl crown ........... ........... ........... ........... ...........
D6067 E................ ................... Implant supported mtl crown ........... ........... ........... ........... ...........
D6068 E................ ................... Abutment supported retainer ........... ........... ........... ........... ...........
D6069 E................ ................... Abutment supported retainer ........... ........... ........... ........... ...........
D6070 E................ ................... Abutment supported retainer ........... ........... ........... ........... ...........
D6071 E................ ................... Abutment supported retainer ........... ........... ........... ........... ...........
D6072 E................ ................... Abutment supported retainer ........... ........... ........... ........... ...........
D6073 E................ ................... Abutment supported retainer ........... ........... ........... ........... ...........
D6074 E................ ................... Abutment supported retainer ........... ........... ........... ........... ...........
D6075 E................ ................... Implant supported retainer. ........... ........... ........... ........... ...........
D6076 E................ ................... Implant supported retainer. ........... ........... ........... ........... ...........
D6077 E................ ................... Implant supported retainer. ........... ........... ........... ........... ...........
D6078 E................ ................... Implnt/abut suprtd fixd ........... ........... ........... ........... ...........
dent.
D6079 E................ ................... Implnt/abut suprtd fixd ........... ........... ........... ........... ...........
dent.
D6080 E................ ................... Implant maintenance........ ........... ........... ........... ........... ...........
D6090 E................ ................... Repair implant............. ........... ........... ........... ........... ...........
[[Page 66967]]
D6095 E................ ................... Odontics repr abutment..... ........... ........... ........... ........... ...........
D6100 E................ ................... Removal of implant......... ........... ........... ........... ........... ...........
D6199 E................ ................... Implant procedure.......... ........... ........... ........... ........... ...........
D6210 E................ ................... Prosthodont high noble ........... ........... ........... ........... ...........
metal.
D6211 E................ ................... Bridge base metal cast..... ........... ........... ........... ........... ...........
D6212 E................ ................... Bridge noble metal cast.... ........... ........... ........... ........... ...........
D6240 E................ ................... Bridge porcelain high noble ........... ........... ........... ........... ...........
D6241 E................ ................... Bridge porcelain base metal ........... ........... ........... ........... ...........
D6242 E................ ................... Bridge porcelain nobel ........... ........... ........... ........... ...........
metal.
D6245 E................ ................... Bridge porcelain/ceramic... ........... ........... ........... ........... ...........
D6250 E................ ................... Bridge resin w/high noble.. ........... ........... ........... ........... ...........
D6251 E................ ................... Bridge resin base metal.... ........... ........... ........... ........... ...........
D6252 E................ ................... Bridge resin w/noble metal. ........... ........... ........... ........... ...........
D6253 E................ NI................. Provisional pontic......... ........... ........... ........... ........... ...........
D6519 E................ DG................. Inlay/onlay porce/ceramic.. ........... ........... ........... ........... ...........
D6520 E................ DG................. Dental retainer two ........... ........... ........... ........... ...........
surfaces.
D6530 E................ DG................. Retainer metallic 3+ ........... ........... ........... ........... ...........
surface.
D6543 E................ DG................. Dental retainr onlay 3 surf ........... ........... ........... ........... ...........
D6544 E................ DG................. Dental retainr onlay 4/more ........... ........... ........... ........... ...........
D6545 E................ ................... Dental retainr cast metl... ........... ........... ........... ........... ...........
D6548 E................ ................... Porcelain/ceramic retainer. ........... ........... ........... ........... ...........
D6600 E................ NI................. Porcelain/ceramic inlay ........... ........... ........... ........... ...........
2srf.
D6601 E................ NI................. Porc/ceram inlay = 3 surfac.
D6602 E................ NI................. Cst hgh nble mtl inlay 2 ........... ........... ........... ........... ...........
srf.
D6603 E................ NI................. Cst hgh nble mtl inlay =3sr.
D6604 E................ NI................. Cst bse mtl inlay 2 ........... ........... ........... ........... ...........
surfaces.
D6605 E................ NI................. Cst bse mtl inlay = 3 surfa.
D6606 E................ NI................. Cast noble metal inlay 2 ........... ........... ........... ........... ...........
sur.
D6607 E................ NI................. Cst noble mtl inlay =3 surf.
D6608 E................ NI................. Onlay porc/crmc 2 surfaces. ........... ........... ........... ........... ...........
D6609 E................ NI................. Onlay porc/crmc =3 surfaces.
D6610 E................ NI................. Onlay cst hgh nbl mtl 2 ........... ........... ........... ........... ...........
srfc.
D6611 E................ NI................. Onlay cst hgh nbl mtl =3srf.
D6612 E................ NI................. Onlay cst base mtl 2 ........... ........... ........... ........... ...........
surface.
D6613 E................ NI................. Onlay cst base mtl =3 surfa.
D6614 E................ NI................. Onlay cst nbl mtl 2 ........... ........... ........... ........... ...........
surfaces.
D6615 E................ NI................. Onlay cst nbl mtl =3 surfac.
D6720 E................ ................... Retain crown resin w hi ........... ........... ........... ........... ...........
nble.
D6721 E................ ................... Crown resin w/base metal... ........... ........... ........... ........... ...........
D6722 E................ ................... Crown resin w/noble metal.. ........... ........... ........... ........... ...........
D6740 E................ ................... Crown porcelain/ceramic.... ........... ........... ........... ........... ...........
D6750 E................ ................... Crown porcelain high noble. ........... ........... ........... ........... ...........
D6751 E................ ................... Crown porcelain base metal. ........... ........... ........... ........... ...........
D6752 E................ ................... Crown porcelain noble metal ........... ........... ........... ........... ...........
D6780 E................ ................... Crown 3/4 high noble metal. ........... ........... ........... ........... ...........
D6781 E................ ................... Crown 3/4 cast based metal. ........... ........... ........... ........... ...........
D6782 E................ ................... Crown 3/4 cast noble metal. ........... ........... ........... ........... ...........
D6783 E................ ................... Crown 3/4 porcelain/ceramic ........... ........... ........... ........... ...........
D6790 E................ ................... Crown full high noble metal ........... ........... ........... ........... ...........
D6791 E................ ................... Crown full base metal cast. ........... ........... ........... ........... ...........
D6792 E................ ................... Crown full noble metal cast ........... ........... ........... ........... ...........
D6793 E................ NI................. Provisional retainer crown. ........... ........... ........... ........... ...........
D6920 S................ ................... Dental connector bar....... 0330 4.7770 $249.13 ........... $49.83
D6930 E................ ................... Dental recement bridge..... ........... ........... ........... ........... ...........
D6940 E................ ................... Stress breaker............. ........... ........... ........... ........... ...........
D6950 E................ ................... Precision attachment....... ........... ........... ........... ........... ...........
D6970 E................ ................... Post & core plus retainer.. ........... ........... ........... ........... ...........
D6971 E................ ................... Cast post bridge retainer.. ........... ........... ........... ........... ...........
D6972 E................ ................... Prefab post & core plus ........... ........... ........... ........... ...........
reta.
D6973 E................ ................... Core build up for retainer. ........... ........... ........... ........... ...........
D6975 E................ ................... Coping metal............... ........... ........... ........... ........... ...........
D6976 E................ ................... Each addtnl cast post...... ........... ........... ........... ........... ...........
D6977 E................ ................... Each addtl prefab post..... ........... ........... ........... ........... ...........
D6980 E................ ................... Bridge repair.............. ........... ........... ........... ........... ...........
D6985 E................ NI................. Pediatric partial denture ........... ........... ........... ........... ...........
fx.
[[Page 66968]]
D6999 E................ ................... Fixed prosthodontic proc... ........... ........... ........... ........... ...........
D7110 S................ DG................. Oral surgery single tooth.. 0330 4.7770 $249.13 ........... $49.83
D7111 S................ NI................. Coronal remnants deciduous 0330 4.7770 $249.13 ........... $49.83
t.
D7120 S................ DG................. Each add tooth extraction.. 0330 4.7770 $249.13 ........... $49.83
D7130 S................ DG................. Tooth root removal......... 0330 4.7770 $249.13 ........... $49.83
D7140 S................ NI................. Extraction erupted tooth/ 0330 4.7770 $249.13 ........... $49.83
exr.
D7210 S................ ................... Rem imp tooth w mucoper flp 0330 4.7770 $249.13 ........... $49.83
D7220 S................ ................... Impact tooth remov soft 0330 4.7770 $249.13 ........... $49.83
tiss.
D7230 S................ ................... Impact tooth remov part 0330 4.7770 $249.13 ........... $49.83
bony.
D7240 S................ ................... Impact tooth remov comp 0330 4.7770 $249.13 ........... $49.83
bony.
D7241 S................ ................... Impact tooth rem bony w/ 0330 4.7770 $249.13 ........... $49.83
comp.
D7250 S................ ................... Tooth root removal......... 0330 4.7770 $249.13 ........... $49.83
D7260 S................ ................... Oral antral fistula closure 0330 4.7770 $249.13 ........... $49.83
D7261 S................ NI................. Primary closure sinus perf. 0330 4.7770 $249.13 ........... $49.83
D7270 E................ ................... Tooth reimplantation....... ........... ........... ........... ........... ...........
D7272 E................ ................... Tooth transplantation...... ........... ........... ........... ........... ...........
D7280 E................ ................... Exposure impact tooth ........... ........... ........... ........... ...........
orthod.
D7281 E................ ................... Exposure tooth aid eruption ........... ........... ........... ........... ...........
D7282 E................ NI................. Mobilize erupted/malpos ........... ........... ........... ........... ...........
toot.
D7285 E................ ................... Biopsy of oral tissue hard. ........... ........... ........... ........... ...........
D7286 E................ ................... Biopsy of oral tissue soft. ........... ........... ........... ........... ...........
D7287 E................ NI................. Cytology sample collection. ........... ........... ........... ........... ...........
D7290 E................ ................... Repositioning of teeth..... ........... ........... ........... ........... ...........
D7291 S................ ................... Transseptal fiberotomy..... 0330 4.7770 $249.13 ........... $49.83
D7310 E................ ................... Alveoplasty w/ extraction.. ........... ........... ........... ........... ...........
D7320 E................ ................... Alveoplasty w/o extraction. ........... ........... ........... ........... ...........
D7340 E................ ................... Vestibuloplasty ridge ........... ........... ........... ........... ...........
extens.
D7350 E................ ................... Vestibuloplasty exten graft ........... ........... ........... ........... ...........
D7410 E................ ................... Rad exc lesion up to 1.25 ........... ........... ........... ........... ...........
cm.
D7411 E................ NI................. Excision benign lesion1.25c.
D7412 E................ NI................. Excision benign lesion ........... ........... ........... ........... ...........
compl.
D7413 E................ NI................. Excision malig ........... ........... ........... ........... ...........
lesion<=1.25c.
D7414 E................ NI................. Excision malig lesion1.25cm.
D7415 E................ NI................. Excision malig les ........... ........... ........... ........... ...........
complicat.
D7420 E................ DG................. Lesion 1.25 cm. ........... ........... ........... ........... ...........
D7430 E................ DG................. Exc benign tumor to 1.25 cm ........... ........... ........... ........... ...........
D7431 E................ DG................. Benign tumor exc 1.25 cm.
D7440 E................ ................... Malig tumor exc to 1.25 cm. ........... ........... ........... ........... ...........
D7441 E................ ................... Malig tumor ........... ........... ........... ........... ...........
1.25 cm.
D7450 E................ ................... Rem odontogen cyst to ........... ........... ........... ........... ...........
1.25cm.
D7451 E................ ................... Rem odontogen cyst 1.25 cm.
D7460 E................ ................... Rem nonodonto cyst to ........... ........... ........... ........... ...........
1.25cm.
D7461 E................ ................... Rem nonodonto cyst 1.25 cm.
D7465 E................ ................... Lesion destruction......... ........... ........... ........... ........... ...........
D7471 E................ ................... Rem exostosis any site..... ........... ........... ........... ........... ...........
D7472 E................ NI................. Removal of torus palatinus. ........... ........... ........... ........... ...........
D7473 E................ NI................. Remove torus mandibularis.. ........... ........... ........... ........... ...........
D7480 E................ DG................. Partial ostectomy.......... ........... ........... ........... ........... ...........
D7485 E................ NI................. Surg reduct ........... ........... ........... ........... ...........
osseoustuberosit.
D7490 E................ ................... Mandible resection......... ........... ........... ........... ........... ...........
D7510 E................ ................... I&d absc intraoral soft ........... ........... ........... ........... ...........
tiss.
D7520 E................ ................... I&d abscess extraoral...... ........... ........... ........... ........... ...........
D7530 E................ ................... Removal fb skin/areolar ........... ........... ........... ........... ...........
tiss.
D7540 E................ ................... Removal of fb reaction..... ........... ........... ........... ........... ...........
D7550 E................ ................... Removal of sloughed off ........... ........... ........... ........... ...........
bone.
D7560 E................ ................... Maxillary sinusotomy....... ........... ........... ........... ........... ...........
D7610 E................ ................... Maxilla open reduct simple. ........... ........... ........... ........... ...........
D7620 E................ ................... Clsd reduct simpl maxilla ........... ........... ........... ........... ...........
fx.
D7630 E................ ................... Open red simpl mandible fx. ........... ........... ........... ........... ...........
D7640 E................ ................... Clsd red simpl mandible fx. ........... ........... ........... ........... ...........
D7650 E................ ................... Open red simp malar/zygom ........... ........... ........... ........... ...........
fx.
D7660 E................ ................... Clsd red simp malar/zygom ........... ........... ........... ........... ...........
fx.
D7670 E................ ................... Closd rductn splint ........... ........... ........... ........... ...........
alveolus.
D7671 E................ NI................. Alveolus open reduction.... ........... ........... ........... ........... ...........
D7680 E................ ................... Reduct simple facial bone ........... ........... ........... ........... ...........
fx.
[[Page 66969]]
D7710 E................ ................... Maxilla open reduct ........... ........... ........... ........... ...........
compound.
D7720 E................ ................... Clsd reduct compd maxilla ........... ........... ........... ........... ...........
fx.
D7730 E................ ................... Open reduct compd mandble ........... ........... ........... ........... ...........
fx.
D7740 E................ ................... Clsd reduct compd mandble ........... ........... ........... ........... ...........
fx.
D7750 E................ ................... Open red comp malar/zygma ........... ........... ........... ........... ...........
fx.
D7760 E................ ................... Clsd red comp malar/zygma ........... ........... ........... ........... ...........
fx.
D7770 E................ ................... Open reduc compd alveolus ........... ........... ........... ........... ...........
fx.
D7771 E................ NI................. Alveolus clsd reduc stblz ........... ........... ........... ........... ...........
te.
D7780 E................ ................... Reduct compnd facial bone ........... ........... ........... ........... ...........
fx.
D7810 E................ ................... Tmj open reduct-dislocation ........... ........... ........... ........... ...........
D7820 E................ ................... Closed tmp manipulation.... ........... ........... ........... ........... ...........
D7830 E................ ................... Tmj manipulation under ........... ........... ........... ........... ...........
anest.
D7840 E................ ................... Removal of tmj condyle..... ........... ........... ........... ........... ...........
D7850 E................ ................... Tmj meniscectomy........... ........... ........... ........... ........... ...........
D7852 E................ ................... Tmj repair of joint disc... ........... ........... ........... ........... ...........
D7854 E................ ................... Tmj excisn of joint ........... ........... ........... ........... ...........
membrane.
D7856 E................ ................... Tmj cutting of a muscle.... ........... ........... ........... ........... ...........
D7858 E................ ................... Tmj reconstruction......... ........... ........... ........... ........... ...........
D7860 E................ ................... Tmj cutting into joint..... ........... ........... ........... ........... ...........
D7865 E................ ................... Tmj reshaping components... ........... ........... ........... ........... ...........
D7870 E................ ................... Tmj aspiration joint fluid. ........... ........... ........... ........... ...........
D7871 E................ ................... Lysis + lavage w catheters. ........... ........... ........... ........... ...........
D7872 E................ ................... Tmj diagnostic arthroscopy. ........... ........... ........... ........... ...........
D7873 E................ ................... Tmj arthroscopy lysis ........... ........... ........... ........... ...........
adhesn.
D7874 E................ ................... Tmj arthroscopy disc ........... ........... ........... ........... ...........
reposit.
D7875 E................ ................... Tmj arthroscopy synovectomy ........... ........... ........... ........... ...........
D7876 E................ ................... Tmj arthroscopy discectomy. ........... ........... ........... ........... ...........
D7877 E................ ................... Tmj arthroscopy debridement ........... ........... ........... ........... ...........
D7880 E................ ................... Occlusal orthotic appliance ........... ........... ........... ........... ...........
D7899 E................ ................... Tmj unspecified therapy.... ........... ........... ........... ........... ...........
D7910 E................ ................... Dent sutur recent wnd to ........... ........... ........... ........... ...........
5cm.
D7911 E................ ................... Dental suture wound to 5 cm ........... ........... ........... ........... ...........
D7912 E................ ................... Suture complicate wnd 5 cm.
D7920 E................ ................... Dental skin graft.......... ........... ........... ........... ........... ...........
D7940 S................ ................... Reshaping bone orthognathic 0330 4.7770 $249.13 ........... $49.83
D7941 E................ ................... Bone cutting ramus closed.. ........... ........... ........... ........... ...........
D7943 E................ ................... Cutting ramus open w/graft. ........... ........... ........... ........... ...........
D7944 E................ ................... Bone cutting segmented..... ........... ........... ........... ........... ...........
D7945 E................ ................... Bone cutting body mandible. ........... ........... ........... ........... ...........
D7946 E................ ................... Reconstruction maxilla ........... ........... ........... ........... ...........
total.
D7947 E................ ................... Reconstruct maxilla segment ........... ........... ........... ........... ...........
D7948 E................ ................... Reconstruct midface no ........... ........... ........... ........... ...........
graft.
D7949 E................ ................... Reconstruct midface w/graft ........... ........... ........... ........... ...........
D7950 E................ ................... Mandible graft............. ........... ........... ........... ........... ...........
D7955 E................ ................... Repair maxillofacial ........... ........... ........... ........... ...........
defects.
D7960 E................ ................... Frenulectomy/frenulotomy... ........... ........... ........... ........... ...........
D7970 E................ ................... Excision hyperplastic ........... ........... ........... ........... ...........
tissue.
D7971 E................ ................... Excision pericoronal ........... ........... ........... ........... ...........
gingiva.
D7972 E................ NI................. Surg redct fibrous ........... ........... ........... ........... ...........
tuberosit.
D7980 E................ ................... Sialolithotomy............. ........... ........... ........... ........... ...........
D7981 E................ ................... Excision of salivary gland. ........... ........... ........... ........... ...........
D7982 E................ ................... Sialodochoplasty........... ........... ........... ........... ........... ...........
D7983 E................ ................... Closure of salivary fistula ........... ........... ........... ........... ...........
D7990 E................ ................... Emergency tracheotomy...... ........... ........... ........... ........... ...........
D7991 E................ ................... Dental coronoidectomy...... ........... ........... ........... ........... ...........
D7995 E................ ................... Synthetic graft facial ........... ........... ........... ........... ...........
bones.
D7996 E................ ................... Implant mandible for ........... ........... ........... ........... ...........
augment.
D7997 E................ ................... Appliance removal.......... ........... ........... ........... ........... ...........
D7999 E................ ................... Oral surgery procedure..... ........... ........... ........... ........... ...........
D8010 E................ ................... Limited dental tx primary.. ........... ........... ........... ........... ...........
D8020 E................ ................... Limited dental tx ........... ........... ........... ........... ...........
transition.
D8030 E................ ................... Limited dental tx ........... ........... ........... ........... ...........
adolescent.
D8040 E................ ................... Limited dental tx adult.... ........... ........... ........... ........... ...........
D8050 E................ ................... Intercep dental tx primary. ........... ........... ........... ........... ...........
D8060 E................ ................... Intercep dental tx transitn ........... ........... ........... ........... ...........
[[Page 66970]]
D8070 E................ ................... Compre dental tx transition ........... ........... ........... ........... ...........
D8080 E................ ................... Compre dental tx adolescent ........... ........... ........... ........... ...........
D8090 E................ ................... Compre dental tx adult..... ........... ........... ........... ........... ...........
D8210 E................ ................... Orthodontic rem appliance ........... ........... ........... ........... ...........
tx.
D8220 E................ ................... Fixed appliance therapy ........... ........... ........... ........... ...........
habt.
D8660 E................ ................... Preorthodontic tx visit.... ........... ........... ........... ........... ...........
D8670 E................ ................... Periodic orthodontc tx ........... ........... ........... ........... ...........
visit.
D8680 E................ ................... Orthodontic retention...... ........... ........... ........... ........... ...........
D8690 E................ ................... Orthodontic treatment...... ........... ........... ........... ........... ...........
D8691 E................ ................... Repair ortho appliance..... ........... ........... ........... ........... ...........
D8692 E................ ................... Replacement retainer....... ........... ........... ........... ........... ...........
D8999 E................ ................... Orthodontic procedure...... ........... ........... ........... ........... ...........
D9110 N................ ................... Tx dental pain minor proc.. ........... ........... ........... ........... ...........
D9210 E................ ................... Dent anesthesia w/o surgery ........... ........... ........... ........... ...........
D9211 E................ ................... Regional block anesthesia.. ........... ........... ........... ........... ...........
D9212 E................ ................... Trigeminal block anesthesia ........... ........... ........... ........... ...........
D9215 E................ ................... Local anesthesia........... ........... ........... ........... ........... ...........
D9220 E................ ................... General anesthesia......... ........... ........... ........... ........... ...........
D9221 E................ ................... General anesthesia ea ad ........... ........... ........... ........... ...........
15m.
D9230 N................ ................... Analgesia.................. ........... ........... ........... ........... ...........
D9241 E................ ................... Intravenous sedation....... ........... ........... ........... ........... ...........
D9242 E................ ................... IV sedation ea ad 30 m..... ........... ........... ........... ........... ...........
D9248 N................ ................... Sedation (non-iv).......... ........... ........... ........... ........... ...........
D9310 E................ ................... Dental consultation........ ........... ........... ........... ........... ...........
D9410 E................ ................... Dental house call.......... ........... ........... ........... ........... ...........
D9420 E................ ................... Hospital call.............. ........... ........... ........... ........... ...........
D9430 E................ ................... Office visit during hours.. ........... ........... ........... ........... ...........
D9440 E................ ................... Office visit after hours... ........... ........... ........... ........... ...........
D9450 E................ NI................. Case presentation tx plan.. ........... ........... ........... ........... ...........
D9610 E................ ................... Dent therapeutic drug ........... ........... ........... ........... ...........
inject.
D9630 S................ ................... Other drugs/medicaments.... 0330 4.7770 $249.13 ........... $49.83
D9910 E................ ................... Dent appl desensitizing med ........... ........... ........... ........... ...........
D9911 E................ ................... Appl desensitizing resin... ........... ........... ........... ........... ...........
D9920 E................ ................... Behavior management........ ........... ........... ........... ........... ...........
D9930 S................ ................... Treatment of complications. 0330 4.7770 $249.13 ........... $49.83
D9940 S................ ................... Dental occlusal guard...... 0330 4.7770 $249.13 ........... $49.83
D9941 E................ ................... Fabrication athletic guard. ........... ........... ........... ........... ...........
D9950 S................ ................... Occlusion analysis......... 0330 4.7770 $249.13 ........... $49.83
D9951 S................ ................... Limited occlusal adjustment 0330 4.7770 $249.13 ........... $49.83
D9952 S................ ................... Complete occlusal 0330 4.7770 $249.13 ........... $49.83
adjustment.
D9970 E................ ................... Enamel microabrasion....... ........... ........... ........... ........... ...........
D9971 E................ ................... Odontoplasty 1-2 teeth..... ........... ........... ........... ........... ...........
D9972 E................ ................... Extrnl bleaching per arch.. ........... ........... ........... ........... ...........
D9973 E................ ................... Extrnl bleaching per tooth. ........... ........... ........... ........... ...........
D9974 E................ ................... Intrnl bleaching per tooth. ........... ........... ........... ........... ...........
D9999 E................ ................... Adjunctive procedure....... ........... ........... ........... ........... ...........
E0100 A................ ................... Cane adjust/fixed with tip. ........... ........... ........... ........... ...........
E0105 A................ ................... Cane adjust/fixed quad/3 ........... ........... ........... ........... ...........
pro.
E0110 A................ ................... Crutch forearm pair........ ........... ........... ........... ........... ...........
E0111 A................ ................... Crutch forearm each........ ........... ........... ........... ........... ...........
E0112 A................ ................... Crutch underarm pair wood.. ........... ........... ........... ........... ...........
E0113 A................ ................... Crutch underarm each wood.. ........... ........... ........... ........... ...........
E0114 A................ ................... Crutch underarm pair no ........... ........... ........... ........... ...........
wood.
E0116 A................ ................... Crutch underarm each no ........... ........... ........... ........... ...........
wood.
E0117 A................ NI................. Underarm springassist ........... ........... ........... ........... ...........
crutch.
E0130 A................ ................... Walker rigid adjust/fixed ........... ........... ........... ........... ...........
ht.
E0135 A................ ................... Walker folding adjust/fixed ........... ........... ........... ........... ...........
E0141 A................ ................... Rigid walker wheeled wo ........... ........... ........... ........... ...........
seat.
E0142 A................ ................... Walker rigid wheeled with ........... ........... ........... ........... ...........
se.
E0143 A................ ................... Walker folding wheeled w/o ........... ........... ........... ........... ...........
s.
E0144 A................ ................... Enclosed walker w rear seat ........... ........... ........... ........... ...........
E0145 A................ ................... Walker whled seat/crutch ........... ........... ........... ........... ...........
att.
E0146 A................ ................... Folding walker wheels w ........... ........... ........... ........... ...........
seat.
E0147 A................ ................... Walker variable wheel ........... ........... ........... ........... ...........
resist.
E0148 A................ ................... Heavyduty walker no wheels. ........... ........... ........... ........... ...........
[[Page 66971]]
E0149 A................ ................... Heavy duty wheeled walker.. ........... ........... ........... ........... ...........
E0153 A................ ................... Forearm crutch platform ........... ........... ........... ........... ...........
atta.
E0154 A................ ................... Walker platform attachment. ........... ........... ........... ........... ...........
E0155 A................ ................... Walker wheel ........... ........... ........... ........... ...........
attachment,pair.
E0156 A................ ................... Walker seat attachment..... ........... ........... ........... ........... ...........
E0157 A................ ................... Walker crutch attachment... ........... ........... ........... ........... ...........
E0158 A................ ................... Walker leg extenders set ........... ........... ........... ........... ...........
of4.
E0159 A................ ................... Brake for wheeled walker... ........... ........... ........... ........... ...........
E0160 A................ ................... Sitz type bath or equipment ........... ........... ........... ........... ...........
E0161 A................ ................... Sitz bath/equipment w/ ........... ........... ........... ........... ...........
faucet.
E0162 A................ ................... Sitz bath chair............ ........... ........... ........... ........... ...........
E0163 A................ ................... Commode chair stationry fxd ........... ........... ........... ........... ...........
E0164 A................ ................... Commode chair mobile fixed ........... ........... ........... ........... ...........
a.
E0165 A................ ................... Commode chair stationry det ........... ........... ........... ........... ...........
E0166 A................ ................... Commode chair mobile detach ........... ........... ........... ........... ...........
E0167 A................ ................... Commode chair pail or pan.. ........... ........... ........... ........... ...........
E0168 A................ ................... Heavyduty/wide commode ........... ........... ........... ........... ...........
chair.
E0169 A................ ................... Seatlift incorp ........... ........... ........... ........... ...........
commodechair.
E0175 A................ ................... Commode chair foot rest.... ........... ........... ........... ........... ...........
E0176 A................ ................... Air pressre pad/cushion ........... ........... ........... ........... ...........
nonp.
E0177 A................ ................... Water press pad/cushion ........... ........... ........... ........... ...........
nonp.
E0178 A................ ................... Gel pressre pad/cushion ........... ........... ........... ........... ...........
nonp.
E0179 A................ ................... Dry pressre pad/cushion ........... ........... ........... ........... ...........
nonp.
E0180 A................ ................... Press pad alternating w ........... ........... ........... ........... ...........
pump.
E0181 A................ ................... Press pad alternating w/ ........... ........... ........... ........... ...........
pum.
E0182 A................ ................... Pressure pad alternating ........... ........... ........... ........... ...........
pum.
E0184 A................ ................... Dry pressure mattress...... ........... ........... ........... ........... ...........
E0185 A................ ................... Gel pressure mattress pad.. ........... ........... ........... ........... ...........
E0186 A................ ................... Air pressure mattress...... ........... ........... ........... ........... ...........
E0187 A................ ................... Water pressure mattress.... ........... ........... ........... ........... ...........
E0188 E................ ................... Synthetic sheepskin pad.... ........... ........... ........... ........... ...........
E0189 E................ ................... Lambswool sheepskin pad.... ........... ........... ........... ........... ...........
E0191 A................ ................... Protector heel or elbow.... ........... ........... ........... ........... ...........
E0192 A................ ................... Pad wheelchr low press/ ........... ........... ........... ........... ...........
posit.
E0193 A................ ................... Powered air flotation bed.. ........... ........... ........... ........... ...........
E0194 A................ ................... Air fluidized bed.......... ........... ........... ........... ........... ...........
E0196 A................ ................... Gel pressure mattress...... ........... ........... ........... ........... ...........
E0197 A................ ................... Air pressure pad for ........... ........... ........... ........... ...........
mattres.
E0198 A................ ................... Water pressure pad for ........... ........... ........... ........... ...........
mattr.
E0199 A................ ................... Dry pressure pad for ........... ........... ........... ........... ...........
mattres.
E0200 A................ ................... Heat lamp without stand.... ........... ........... ........... ........... ...........
E0202 A................ ................... Phototherapy light w/ ........... ........... ........... ........... ...........
photom.
E0203 A................ NI................. Therapeutic lightbox ........... ........... ........... ........... ...........
tabletp.
E0205 A................ ................... Heat lamp with stand....... ........... ........... ........... ........... ...........
E0210 A................ ................... Electric heat pad standard. ........... ........... ........... ........... ...........
E0215 A................ ................... Electric heat pad moist.... ........... ........... ........... ........... ...........
E0217 A................ ................... Water circ heat pad w pump. ........... ........... ........... ........... ...........
E0218 E................ ................... Water circ cold pad w pump. ........... ........... ........... ........... ...........
E0220 A................ ................... Hot water bottle........... ........... ........... ........... ........... ...........
E0221 A................ ................... Infrared heating pad system ........... ........... ........... ........... ...........
E0225 A................ ................... Hydrocollator unit......... ........... ........... ........... ........... ...........
E0230 A................ ................... Ice cap or collar.......... ........... ........... ........... ........... ...........
E0231 E................ ................... Wound warming device....... ........... ........... ........... ........... ...........
E0232 E................ ................... Warming card for NWT....... ........... ........... ........... ........... ...........
E0235 A................ ................... Paraffin bath unit portable ........... ........... ........... ........... ...........
E0236 A................ ................... Pump for water circulating ........... ........... ........... ........... ...........
p.
E0238 A................ ................... Heat pad non-electric moist ........... ........... ........... ........... ...........
E0239 A................ ................... Hydrocollator unit portable ........... ........... ........... ........... ...........
E0241 E................ ................... Bath tub wall rail......... ........... ........... ........... ........... ...........
E0242 E................ ................... Bath tub rail floor........ ........... ........... ........... ........... ...........
E0243 E................ ................... Toilet rail................ ........... ........... ........... ........... ...........
E0244 E................ ................... Toilet seat raised......... ........... ........... ........... ........... ...........
E0245 E................ ................... Tub stool or bench......... ........... ........... ........... ........... ...........
E0246 E................ ................... Transfer tub rail ........... ........... ........... ........... ...........
attachment.
E0249 A................ ................... Pad water circulating heat ........... ........... ........... ........... ...........
u.
[[Page 66972]]
E0250 A................ ................... Hosp bed fixed ht w/ ........... ........... ........... ........... ...........
mattres.
E0251 A................ ................... Hosp bed fixd ht w/o ........... ........... ........... ........... ...........
mattres.
E0255 A................ ................... Hospital bed var ht w/ ........... ........... ........... ........... ...........
mattr.
E0256 A................ ................... Hospital bed var ht w/o ........... ........... ........... ........... ...........
matt.
E0260 A................ ................... Hosp bed semi-electr w/ ........... ........... ........... ........... ...........
matt.
E0261 A................ ................... Hosp bed semi-electr w/o ........... ........... ........... ........... ...........
mat.
E0265 A................ ................... Hosp bed total electr w/ ........... ........... ........... ........... ...........
mat.
E0266 A................ ................... Hosp bed total elec w/o ........... ........... ........... ........... ...........
matt.
E0270 E................ ................... Hospital bed institutional ........... ........... ........... ........... ...........
t.
E0271 A................ ................... Mattress innerspring....... ........... ........... ........... ........... ...........
E0272 A................ ................... Mattress foam rubber....... ........... ........... ........... ........... ...........
E0273 E................ ................... Bed board.................. ........... ........... ........... ........... ...........
E0274 E................ ................... Over-bed table............. ........... ........... ........... ........... ...........
E0275 A................ ................... Bed pan standard........... ........... ........... ........... ........... ...........
E0276 A................ ................... Bed pan fracture........... ........... ........... ........... ........... ...........
E0277 A................ ................... Powered pres-redu air ........... ........... ........... ........... ...........
mattrs.
E0280 A................ ................... Bed cradle................. ........... ........... ........... ........... ...........
E0290 A................ ................... Hosp bed fx ht w/o rails w/ ........... ........... ........... ........... ...........
m.
E0291 A................ ................... Hosp bed fx ht w/o rail w/o ........... ........... ........... ........... ...........
E0292 A................ ................... Hosp bed var ht w/o rail w/ ........... ........... ........... ........... ...........
o.
E0293 A................ ................... Hosp bed var ht w/o rail w/ ........... ........... ........... ........... ...........
E0294 A................ ................... Hosp bed semi-elect w/ ........... ........... ........... ........... ...........
mattr.
E0295 A................ ................... Hosp bed semi-elect w/o ........... ........... ........... ........... ...........
matt.
E0296 A................ ................... Hosp bed total elect w/ ........... ........... ........... ........... ...........
matt.
E0297 A................ ................... Hosp bed total elect w/o ........... ........... ........... ........... ...........
mat.
E0305 A................ ................... Rails bed side half length. ........... ........... ........... ........... ...........
E0310 A................ ................... Rails bed side full length. ........... ........... ........... ........... ...........
E0315 E................ ................... Bed accessory brd/tbl/ ........... ........... ........... ........... ...........
supprt.
E0316 A................ ................... Bed safety enclosure....... ........... ........... ........... ........... ...........
E0325 A................ ................... Urinal male jug-type....... ........... ........... ........... ........... ...........
E0326 A................ ................... Urinal female jug-type..... ........... ........... ........... ........... ...........
E0350 E................ ................... Control unit bowel system.. ........... ........... ........... ........... ...........
E0352 E................ ................... Disposable pack w/bowel ........... ........... ........... ........... ...........
syst.
E0370 E................ ................... Air elevator for heel...... ........... ........... ........... ........... ...........
E0371 A................ ................... Nonpower mattress overlay.. ........... ........... ........... ........... ...........
E0372 A................ ................... Powered air mattress ........... ........... ........... ........... ...........
overlay.
E0373 A................ ................... Nonpowered pressure ........... ........... ........... ........... ...........
mattress.
E0424 A................ ................... Stationary compressed gas ........... ........... ........... ........... ...........
02.
E0425 E................ ................... Gas system stationary ........... ........... ........... ........... ...........
compre.
E0430 E................ ................... Oxygen system gas portable. ........... ........... ........... ........... ...........
E0431 A................ ................... Portable gaseous 02........ ........... ........... ........... ........... ...........
E0434 A................ ................... Portable liquid 02......... ........... ........... ........... ........... ...........
E0435 E................ ................... Oxygen system liquid ........... ........... ........... ........... ...........
portabl.
E0439 A................ ................... Stationary liquid 02....... ........... ........... ........... ........... ...........
E0440 E................ ................... Oxygen system liquid ........... ........... ........... ........... ...........
station.
E0441 A................ ................... Oxygen contents, gaseous... ........... ........... ........... ........... ...........
E0442 A................ ................... Oxygen contents, liquid.... ........... ........... ........... ........... ...........
E0443 A................ ................... Portable 02 contents, gas.. ........... ........... ........... ........... ...........
E0444 A................ ................... Portable 02 contents, ........... ........... ........... ........... ...........
liquid.
E0445 A................ NI................. Oximeter non-invasive...... ........... ........... ........... ........... ...........
E0450 A................ ................... Volume vent stationary/ ........... ........... ........... ........... ...........
porta.
E0454 A................ NI................. Pressure ventilator........ ........... ........... ........... ........... ...........
E0455 A................ ................... Oxygen tent excl croup/ped ........... ........... ........... ........... ...........
t.
E0457 A................ ................... Chest shell................ ........... ........... ........... ........... ...........
E0459 A................ ................... Chest wrap................. ........... ........... ........... ........... ...........
E0460 A................ ................... Neg press vent portabl/ ........... ........... ........... ........... ...........
statn.
E0461 A................ NI................. Vol vent noninvasive ........... ........... ........... ........... ...........
interfa.
E0462 A................ ................... Rocking bed w/ or w/o side ........... ........... ........... ........... ...........
r.
E0480 A................ ................... Percussor elect/pneum home ........... ........... ........... ........... ...........
m.
E0481 A................ ................... Intrpulmnry percuss vent ........... ........... ........... ........... ...........
sys.
E0482 A................ ................... Cough stimulating device... ........... ........... ........... ........... ...........
E0483 A................ NI................. Chest compression gen ........... ........... ........... ........... ...........
system.
E0484 A................ NI................. Non-elec oscillatory pep ........... ........... ........... ........... ...........
dvc.
E0500 A................ ................... Ippb all types............. ........... ........... ........... ........... ...........
E0550 A................ ................... Humidif extens supple w ........... ........... ........... ........... ...........
ippb.
[[Page 66973]]
E0555 A................ ................... Humidifier for use w/ ........... ........... ........... ........... ...........
regula.
E0560 A................ ................... Humidifier supplemental w/ ........... ........... ........... ........... ...........
i.
E0565 A................ ................... Compressor air power source ........... ........... ........... ........... ...........
E0570 A................ ................... Nebulizer with compression. ........... ........... ........... ........... ...........
E0571 A................ ................... Aerosol compressor for ........... ........... ........... ........... ...........
svneb.
E0572 A................ ................... Aerosol compressor adjust ........... ........... ........... ........... ...........
pr.
E0574 A................ ................... Ultrasonic generator w ........... ........... ........... ........... ...........
svneb.
E0575 A................ ................... Nebulizer ultrasonic....... ........... ........... ........... ........... ...........
E0580 A................ ................... Nebulizer for use w/ ........... ........... ........... ........... ...........
regulat.
E0585 A................ ................... Nebulizer w/ compressor & ........... ........... ........... ........... ...........
he.
E0590 A................ ................... Dispensing fee dme neb drug ........... ........... ........... ........... ...........
E0600 A................ ................... Suction pump portab hom ........... ........... ........... ........... ...........
modl.
E0601 A................ ................... Cont airway pressure device ........... ........... ........... ........... ...........
E0602 E................ ................... Manual breast pump......... ........... ........... ........... ........... ...........
E0603 A................ ................... Electric breast pump....... ........... ........... ........... ........... ...........
E0604 A................ ................... Hosp grade elec breast pump ........... ........... ........... ........... ...........
E0605 A................ ................... Vaporizer room type........ ........... ........... ........... ........... ...........
E0606 A................ ................... Drainage board postural.... ........... ........... ........... ........... ...........
E0607 A................ ................... Blood glucose monitor home. ........... ........... ........... ........... ...........
E0608 A................ DG................. Apnea monitor.............. ........... ........... ........... ........... ...........
E0610 A................ ................... Pacemaker monitr audible/ ........... ........... ........... ........... ...........
vis.
E0615 A................ ................... Pacemaker monitr digital/ ........... ........... ........... ........... ...........
vis.
E0616 N................ ................... Cardiac event recorder..... ........... ........... ........... ........... ...........
E0617 A................ ................... Automatic ext defibrillator ........... ........... ........... ........... ...........
E0618 A................ NI................. Apnea monitor.............. ........... ........... ........... ........... ...........
E0619 A................ NI................. Apnea monitor w recorder... ........... ........... ........... ........... ...........
E0620 A................ ................... Cap bld skin piercing laser ........... ........... ........... ........... ...........
E0621 A................ ................... Patient lift sling or seat. ........... ........... ........... ........... ...........
E0625 E................ ................... Patient lift bathroom or ........... ........... ........... ........... ...........
toi.
E0627 A................ ................... Seat lift incorp lift-chair ........... ........... ........... ........... ...........
E0628 A................ ................... Seat lift for pt furn- ........... ........... ........... ........... ...........
electr.
E0629 A................ ................... Seat lift for pt furn-non- ........... ........... ........... ........... ...........
el.
E0630 A................ ................... Patient lift hydraulic..... ........... ........... ........... ........... ...........
E0635 A................ ................... Patient lift electric...... ........... ........... ........... ........... ...........
E0636 A................ NI................. PT support & positioning ........... ........... ........... ........... ...........
sys.
E0650 A................ ................... Pneuma compresor non- ........... ........... ........... ........... ...........
segment.
E0651 A................ ................... Pneum compressor segmental. ........... ........... ........... ........... ...........
E0652 A................ ................... Pneum compres w/cal ........... ........... ........... ........... ...........
pressure.
E0655 A................ ................... Pneumatic appliance half ........... ........... ........... ........... ...........
arm.
E0660 A................ ................... Pneumatic appliance full ........... ........... ........... ........... ...........
leg.
E0665 A................ ................... Pneumatic appliance full ........... ........... ........... ........... ...........
arm.
E0666 A................ ................... Pneumatic appliance half ........... ........... ........... ........... ...........
leg.
E0667 A................ ................... Seg pneumatic appl full leg ........... ........... ........... ........... ...........
E0668 A................ ................... Seg pneumatic appl full arm ........... ........... ........... ........... ...........
E0669 A................ ................... Seg pneumatic appli half ........... ........... ........... ........... ...........
leg.
E0671 A................ ................... Pressure pneum appl full ........... ........... ........... ........... ...........
leg.
E0672 A................ ................... Pressure pneum appl full ........... ........... ........... ........... ...........
arm.
E0673 A................ ................... Pressure pneum appl half ........... ........... ........... ........... ...........
leg.
E0690 A................ DG................. Ultraviolet cabinet........ ........... ........... ........... ........... ...........
E0691 A................ NI................. Uvl pnl 2 sq ft or less.... ........... ........... ........... ........... ...........
E0692 A................ NI................. Uvl sys panel 4 ft......... ........... ........... ........... ........... ...........
E0693 A................ NI................. Uvl sys panel 6 ft......... ........... ........... ........... ........... ...........
E0694 A................ NI................. Uvl md cabinet sys 6 ft.... ........... ........... ........... ........... ...........
E0700 E................ ................... Safety equipment........... ........... ........... ........... ........... ...........
E0701 A................ NI................. Helmet w face guard prefab. ........... ........... ........... ........... ...........
E0710 E................ ................... Restraints any type........ ........... ........... ........... ........... ...........
E0720 A................ ................... Tens two lead.............. ........... ........... ........... ........... ...........
E0730 A................ ................... Tens four lead............. ........... ........... ........... ........... ...........
E0731 A................ ................... Conductive garment for tens/ ........... ........... ........... ........... ...........
.
E0740 E................ ................... Incontinence treatment ........... ........... ........... ........... ...........
systm.
E0744 A................ ................... Neuromuscular stim for ........... ........... ........... ........... ...........
scoli.
E0745 A................ ................... Neuromuscular stim for ........... ........... ........... ........... ...........
shock.
E0746 E................ ................... Electromyograph biofeedback ........... ........... ........... ........... ...........
E0747 A................ ................... Elec osteogen stim not ........... ........... ........... ........... ...........
spine.
E0748 A................ ................... Elec osteogen stim spinal.. ........... ........... ........... ........... ...........
[[Page 66974]]
E0749 N................ ................... Elec osteogen stim ........... ........... ........... ........... ...........
implanted.
E0752 E................ ................... Neurostimulator electrode.. ........... ........... ........... ........... ...........
E0754 A................ ................... Pulsegenerator pt ........... ........... ........... ........... ...........
programmer.
E0755 E................ ................... Electronic salivary reflex ........... ........... ........... ........... ...........
s.
E0756 E................ ................... Implantable pulse generator ........... ........... ........... ........... ...........
E0757 E................ ................... Implantable RF receiver.... ........... ........... ........... ........... ...........
E0758 A................ ................... External RF transmitter.... ........... ........... ........... ........... ...........
E0759 A................ ................... Replace rdfrquncy ........... ........... ........... ........... ...........
transmittr.
E0760 E................ ................... Osteogen ultrasound ........... ........... ........... ........... ...........
stimltor.
E0761 E................ NI................. Nontherm electromgntc ........... ........... ........... ........... ...........
device.
E0765 E................ ................... Nerve stimulator for tx n&v ........... ........... ........... ........... ...........
E0776 A................ ................... Iv pole.................... ........... ........... ........... ........... ...........
E0779 A................ ................... Amb infusion pump ........... ........... ........... ........... ...........
mechanical.
E0780 A................ ................... Mech amb infusion pump ........... ........... ........... ........... ...........
<8hrs.
E0781 A................ ................... External ambulatory infus ........... ........... ........... ........... ...........
pu.
E0782 E................ ................... Non-programble infusion ........... ........... ........... ........... ...........
pump.
E0783 E................ ................... Programmable infusion pump. ........... ........... ........... ........... ...........
E0784 A................ ................... Ext amb infusn pump insulin ........... ........... ........... ........... ...........
E0785 E................ ................... Replacement impl pump ........... ........... ........... ........... ...........
cathet.
E0786 E................ ................... Implantable pump ........... ........... ........... ........... ...........
replacement.
E0791 A................ ................... Parenteral infusion pump ........... ........... ........... ........... ...........
sta.
E0830 N................ ................... Ambulatory traction device. ........... ........... ........... ........... ...........
E0840 A................ ................... Tract frame attach ........... ........... ........... ........... ...........
headboard.
E0850 A................ ................... Traction stand free ........... ........... ........... ........... ...........
standing.
E0855 A................ ................... Cervical traction equipment ........... ........... ........... ........... ...........
E0860 A................ ................... Tract equip cervical tract. ........... ........... ........... ........... ...........
E0870 A................ ................... Tract frame attach ........... ........... ........... ........... ...........
footboard.
E0880 A................ ................... Trac stand free stand ........... ........... ........... ........... ...........
extrem.
E0890 A................ ................... Traction frame attach ........... ........... ........... ........... ...........
pelvic.
E0900 A................ ................... Trac stand free stand ........... ........... ........... ........... ...........
pelvic.
E0910 A................ ................... Trapeze bar attached to bed ........... ........... ........... ........... ...........
E0920 A................ ................... Fracture frame attached to ........... ........... ........... ........... ...........
b.
E0930 A................ ................... Fracture frame free ........... ........... ........... ........... ...........
standing.
E0935 A................ ................... Exercise device passive ........... ........... ........... ........... ...........
moti.
E0940 A................ ................... Trapeze bar free standing.. ........... ........... ........... ........... ...........
E0941 A................ ................... Gravity assisted traction ........... ........... ........... ........... ...........
de.
E0942 A................ ................... Cervical head harness/ ........... ........... ........... ........... ...........
halter.
E0943 A................ ................... Cervical pillow............ ........... ........... ........... ........... ...........
E0944 A................ ................... Pelvic belt/harness/boot... ........... ........... ........... ........... ...........
E0945 A................ ................... Belt/harness extremity..... ........... ........... ........... ........... ...........
E0946 A................ ................... Fracture frame dual w cross ........... ........... ........... ........... ...........
E0947 A................ ................... Fracture frame attachmnts ........... ........... ........... ........... ...........
pe.
E0948 A................ ................... Fracture frame attachmnts ........... ........... ........... ........... ...........
ce.
E0950 E................ ................... Tray....................... ........... ........... ........... ........... ...........
E0951 E................ ................... Loop heel.................. ........... ........... ........... ........... ...........
E0952 E................ ................... Loop tie................... ........... ........... ........... ........... ...........
E0953 E................ ................... Pneumatic tire............. ........... ........... ........... ........... ...........
E0954 E................ ................... Wheelchair semi-pneumatic ........... ........... ........... ........... ...........
ca.
E0958 A................ ................... Whlchr att- conv 1 arm ........... ........... ........... ........... ...........
drive.
E0959 E................ ................... Amputee adapter............ ........... ........... ........... ........... ...........
E0961 E................ ................... Wheelchair brake extension. ........... ........... ........... ........... ...........
E0962 A................ ................... Wheelchair 1 inch cushion.. ........... ........... ........... ........... ...........
E0963 A................ ................... Wheelchair 2 inch cushion.. ........... ........... ........... ........... ...........
E0964 A................ ................... Wheelchair 3 inch cushion.. ........... ........... ........... ........... ...........
E0965 A................ ................... Wheelchair 4 inch cushion.. ........... ........... ........... ........... ...........
E0966 E................ ................... Wheelchair head rest ........... ........... ........... ........... ...........
extensi.
E0967 E................ ................... Wheelchair hand rims....... ........... ........... ........... ........... ...........
E0968 A................ ................... Wheelchair commode seat.... ........... ........... ........... ........... ...........
E0969 E................ ................... Wheelchair narrowing device ........... ........... ........... ........... ...........
E0970 E................ ................... Wheelchair no. 2 footplates ........... ........... ........... ........... ...........
E0971 E................ ................... Wheelchair anti-tipping ........... ........... ........... ........... ...........
devi.
E0972 A................ ................... Transfer board or device... ........... ........... ........... ........... ...........
E0973 E................ ................... Wheelchair adjustabl height ........... ........... ........... ........... ...........
E0974 E................ ................... Wheelchair grade-aid....... ........... ........... ........... ........... ...........
E0975 E................ ................... Wheelchair reinforced seat ........... ........... ........... ........... ...........
u.
[[Page 66975]]
E0976 E................ ................... Wheelchair reinforced back ........... ........... ........... ........... ...........
u.
E0977 E................ ................... Wheelchair wedge cushion... ........... ........... ........... ........... ...........
E0978 E................ ................... Wheelchair belt w/airplane ........... ........... ........... ........... ...........
b.
E0979 E................ ................... Wheelchair belt with velcro ........... ........... ........... ........... ...........
E0980 E................ ................... Wheelchair safety vest..... ........... ........... ........... ........... ...........
E0990 E................ ................... Whellchair elevating leg ........... ........... ........... ........... ...........
res.
E0991 E................ ................... Wheelchair upholstry seat.. ........... ........... ........... ........... ...........
E0992 E................ ................... Wheelchair solid seat ........... ........... ........... ........... ...........
insert.
E0993 E................ ................... Wheelchair back upholstery. ........... ........... ........... ........... ...........
E0994 E................ ................... Wheelchair arm rest........ ........... ........... ........... ........... ...........
E0995 E................ ................... Wheelchair calf rest....... ........... ........... ........... ........... ...........
E0996 E................ ................... Wheelchair tire solid...... ........... ........... ........... ........... ...........
E0997 E................ ................... Wheelchair caster w/ a fork ........... ........... ........... ........... ...........
E0998 E................ ................... Wheelchair caster w/o a ........... ........... ........... ........... ...........
fork.
E0999 E................ ................... Wheelchr pneumatic tire w/ ........... ........... ........... ........... ...........
wh.
E1000 E................ ................... Wheelchair tire pneumatic ........... ........... ........... ........... ...........
ca.
E1001 E................ ................... Wheelchair wheel........... ........... ........... ........... ........... ...........
E1011 A................ NI................. Ped wc modify width adjustm ........... ........... ........... ........... ...........
E1012 A................ NI................. Int seat sys planar ped w/c ........... ........... ........... ........... ...........
E1013 A................ NI................. Int seat sys contour ped w/ ........... ........... ........... ........... ...........
c.
E1014 A................ NI................. Reclining back add ped w/c. ........... ........... ........... ........... ...........
E1015 A................ NI................. Shock absorber for man w/c. ........... ........... ........... ........... ...........
E1016 A................ NI................. Shock absorber for power w/ ........... ........... ........... ........... ...........
c.
E1017 A................ NI................. HD shck absrbr for hd man ........... ........... ........... ........... ...........
wc.
E1018 A................ NI................. HD shck absrber for hd ........... ........... ........... ........... ...........
powwc.
E1020 A................ NI................. Residual limb support ........... ........... ........... ........... ...........
system.
E1025 A................ NI................. Pedwc lat/thor sup ........... ........... ........... ........... ...........
nocontour.
E1026 A................ NI................. Pedwc contoured lat/thor ........... ........... ........... ........... ...........
sup.
E1027 A................ NI................. Ped wc lat/ant support..... ........... ........... ........... ........... ...........
E1031 A................ ................... Rollabout chair with ........... ........... ........... ........... ...........
casters.
E1035 E................ ................... Patient transfer system.... ........... ........... ........... ........... ...........
E1037 A................ NI................. Transport chair, ped size.. ........... ........... ........... ........... ...........
E1038 A................ NI................. Transport chair, adult size ........... ........... ........... ........... ...........
E1050 A................ ................... Whelchr fxd full length ........... ........... ........... ........... ...........
arms.
E1060 A................ ................... Wheelchair detachable arms. ........... ........... ........... ........... ...........
E1065 E................ ................... Wheelchair power attachment ........... ........... ........... ........... ...........
E1066 E................ ................... Wheelchair battery charger. ........... ........... ........... ........... ...........
E1069 E................ ................... Wheelchair deep cycle ........... ........... ........... ........... ...........
batter.
E1070 A................ ................... Wheelchair detachable foot ........... ........... ........... ........... ...........
r.
E1083 A................ ................... Hemi-wheelchair fixed arms. ........... ........... ........... ........... ...........
E1084 A................ ................... Hemi-wheelchair detachable ........... ........... ........... ........... ...........
a.
E1085 A................ ................... Hemi-wheelchair fixed arms. ........... ........... ........... ........... ...........
E1086 A................ ................... Hemi-wheelchair detachable ........... ........... ........... ........... ...........
a.
E1087 A................ ................... Wheelchair lightwt fixed ........... ........... ........... ........... ...........
arm.
E1088 A................ ................... Wheelchair lightweight det ........... ........... ........... ........... ...........
a.
E1089 A................ ................... Wheelchair lightwt fixed ........... ........... ........... ........... ...........
arm.
E1090 A................ ................... Wheelchair lightweight det ........... ........... ........... ........... ...........
a.
E1091 A................ ................... Wheelchair youth........... ........... ........... ........... ........... ...........
E1092 A................ ................... Wheelchair wide w/ leg ........... ........... ........... ........... ...........
rests.
E1093 A................ ................... Wheelchair wide w/ foot ........... ........... ........... ........... ...........
rest.
E1100 A................ ................... Whchr s-recl fxd arm leg ........... ........... ........... ........... ...........
res.
E1110 A................ ................... Wheelchair semi-recl detach ........... ........... ........... ........... ...........
E1130 A................ ................... Whlchr stand fxd arm ft ........... ........... ........... ........... ...........
rest.
E1140 A................ ................... Wheelchair standard detach ........... ........... ........... ........... ...........
a.
E1150 A................ ................... Wheelchair standard w/ leg ........... ........... ........... ........... ...........
r.
E1160 A................ ................... Wheelchair fixed arms...... ........... ........... ........... ........... ...........
E1161 A................ NI................. Manual adult wc w ........... ........... ........... ........... ...........
tiltinspac.
E1170 A................ ................... Whlchr ampu fxd arm leg ........... ........... ........... ........... ...........
rest.
E1171 A................ ................... Wheelchair amputee w/o leg ........... ........... ........... ........... ...........
r.
E1172 A................ ................... Wheelchair amputee detach ........... ........... ........... ........... ...........
ar.
E1180 A................ ................... Wheelchair amputee w/ foot ........... ........... ........... ........... ...........
r.
E1190 A................ ................... Wheelchair amputee w/ leg ........... ........... ........... ........... ...........
re.
E1195 A................ ................... Wheelchair amputee heavy ........... ........... ........... ........... ...........
dut.
E1200 A................ ................... Wheelchair amputee fixed ........... ........... ........... ........... ...........
arm.
E1210 A................ ................... Whlchr moto ful arm leg ........... ........... ........... ........... ...........
rest.
[[Page 66976]]
E1211 A................ ................... Wheelchair motorized w/ det ........... ........... ........... ........... ...........
E1212 A................ ................... Wheelchair motorized w full ........... ........... ........... ........... ...........
E1213 A................ ................... Wheelchair motorized w/ det ........... ........... ........... ........... ...........
E1220 A................ ................... Whlchr special size/constrc ........... ........... ........... ........... ...........
E1221 A................ ................... Wheelchair spec size w foot ........... ........... ........... ........... ...........
E1222 A................ ................... Wheelchair spec size w/ leg ........... ........... ........... ........... ...........
E1223 A................ ................... Wheelchair spec size w foot ........... ........... ........... ........... ...........
E1224 A................ ................... Wheelchair spec size w/ leg ........... ........... ........... ........... ...........
E1225 A................ ................... Wheelchair spec sz semi- ........... ........... ........... ........... ...........
recl.
E1226 E................ ................... Wheelchair spec sz full- ........... ........... ........... ........... ...........
recl.
E1227 E................ ................... Wheelchair spec sz spec ht ........... ........... ........... ........... ...........
a.
E1228 A................ ................... Wheelchair spec sz spec ht ........... ........... ........... ........... ...........
b.
E1230 A................ ................... Power operated vehicle..... ........... ........... ........... ........... ...........
E1231 A................ NI................. Rigid ped w/c tilt-in-space ........... ........... ........... ........... ...........
E1232 A................ NI................. Folding ped wc tilt-in- ........... ........... ........... ........... ...........
space.
E1233 A................ NI................. Rig ped wc tltnspc w/o seat ........... ........... ........... ........... ...........
E1234 A................ NI................. Fld ped wc tltnspc w/o seat ........... ........... ........... ........... ...........
E1235 A................ NI................. Rigid ped wc adjustable.... ........... ........... ........... ........... ...........
E1236 A................ NI................. Folding ped wc adjustable.. ........... ........... ........... ........... ...........
E1237 A................ NI................. Rgd ped wc adjstabl w/o ........... ........... ........... ........... ...........
seat.
E1238 A................ NI................. Fld ped wc adjstabl w/o ........... ........... ........... ........... ...........
seat.
E1240 A................ ................... Whchr litwt det arm leg ........... ........... ........... ........... ...........
rest.
E1250 A................ ................... Wheelchair lightwt fixed ........... ........... ........... ........... ...........
arm.
E1260 A................ ................... Wheelchair lightwt foot ........... ........... ........... ........... ...........
rest.
E1270 A................ ................... Wheelchair lightweight leg ........... ........... ........... ........... ...........
r.
E1280 A................ ................... Whchr h-duty det arm leg ........... ........... ........... ........... ...........
res.
E1285 A................ ................... Wheelchair heavy duty fixed ........... ........... ........... ........... ...........
E1290 A................ ................... Wheelchair hvy duty detach ........... ........... ........... ........... ...........
a.
E1295 A................ ................... Wheelchair heavy duty fixed ........... ........... ........... ........... ...........
E1296 A................ ................... Wheelchair special seat ........... ........... ........... ........... ...........
heig.
E1297 A................ ................... Wheelchair special seat ........... ........... ........... ........... ...........
dept.
E1298 A................ ................... Wheelchair spec seat depth/ ........... ........... ........... ........... ...........
w.
E1300 E................ ................... Whirlpool portable......... ........... ........... ........... ........... ...........
E1310 A................ ................... Whirlpool non-portable..... ........... ........... ........... ........... ...........
E1340 A................ ................... Repair for DME, per 15 min. ........... ........... ........... ........... ...........
E1353 A................ ................... Oxygen supplies regulator.. ........... ........... ........... ........... ...........
E1355 A................ ................... Oxygen supplies stand/rack. ........... ........... ........... ........... ...........
E1372 A................ ................... Oxy suppl heater for ........... ........... ........... ........... ...........
nebuliz.
E1390 A................ ................... Oxygen concentrator........ ........... ........... ........... ........... ...........
E1399 A................ ................... Durable medical equipment ........... ........... ........... ........... ...........
mi.
E1405 A................ ................... O2/water vapor enrich w/ ........... ........... ........... ........... ...........
heat.
E1406 A................ ................... O2/water vapor enrich w/o ........... ........... ........... ........... ...........
he.
E1500 A................ ................... Centrifuge................. ........... ........... ........... ........... ...........
E1510 A................ ................... Kidney dialysate delivry ........... ........... ........... ........... ...........
sys.
E1520 A................ ................... Heparin infusion pump...... ........... ........... ........... ........... ...........
E1530 A................ ................... Replacement air bubble ........... ........... ........... ........... ...........
detec.
E1540 A................ ................... Replacement pressure alarm. ........... ........... ........... ........... ...........
E1550 A................ ................... Bath conductivity meter.... ........... ........... ........... ........... ...........
E1560 A................ ................... Replace blood leak detector ........... ........... ........... ........... ...........
E1570 A................ ................... Adjustable chair for esrd ........... ........... ........... ........... ...........
pt.
E1575 A................ ................... Transducer protect/fld bar. ........... ........... ........... ........... ...........
E1580 A................ ................... Unipuncture control system. ........... ........... ........... ........... ...........
E1590 A................ ................... Hemodialysis machine....... ........... ........... ........... ........... ...........
E1592 A................ ................... Auto interm peritoneal ........... ........... ........... ........... ...........
dialy.
E1594 A................ ................... 
