ࡱ>  \p Jean Bickal Ba==yX/#8X@"1* MS Sans Serif1* MS Sans Serif1* MS Sans Serif1* MS Sans Serif1* MS Sans Serif1*  MS Sans Serif1* MS Sans Serif1Arial"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)!"$"#,##0.00;[Red]"$"#,##0.00                + ) , *    "   " "8@ @  "4@ @ "0@ @  $@ @  $@ @  @ @ "4@ @  `DME fee schedule8 Convertdme_cyfee_noformat_July;7 8 "E Autograsp feature ul term dvL6882Microprocessor control uplmbL6890Prefab glove for term deviceL6895Custom glove for term deviceL6900Hand restorat thumb/1 fingerL6905Hand restoration multiple fiL6910Hand restoration no fingersL6915Hand restoration replacmnt gL6920Wrist disarticul switch ctrlL6925Wrist disart myoelectronic cL6930Below elbow switch controlL6935Below elbow myoelectronic ctL6940Elbow disarticulation switchL6945Elbow disart myoelectronic cL6950Above elbow switch controlL6955Above elbow myoelectronic ctL6960Shldr disartic switch controL6965Shldr disartic myoelectronicL6970Interscapular-thor switch ctL6975Interscap-thor myoelectronicL7010Hand otto back steeper/eq swL7015Hand sys teknik village switL7020Electronic greifer switch ctL7025Electron hand myoelectronicL7030Hand sys teknik vill myoelecL7035Electron greifer myoelectroL7040Prehensile actuator hosmer sL7045Electron hook child michiganL7170Electronic elbow hosmer switL7180Electronic elbow sequentialL7181Electronic elbo simultaneousL7185Electron elbow adolescent swL7186Electron elbow child switchL7190Elbow adolescent myoelectronL7191Elbow child myoelectronic ctL7260Electron wrist rotator ottoL7261Electron wrist rotator utahL7266Servo control steeper or equL7272Analogue control unb or equaL7274Proportional ctl 12 volt utaL7360Six volt bat otto bock/eq eaL7362Battery chrgr six volt ottoL7364Twelve volt battery utah/equL7366Battery chrgr 12 volt utah/eL7367Replacemnt lithium ionbatterL7368Lithium ion battery chargerL7900Male vacuum erection systemL8000Mastectomy braL8001Breast prosthesis bra & formL8002Brst prsth bra & bilat formL8015Ext breastprosthesis garmentL8020Mastectomy formL8030Breast prosthesis silicone/eL8035Custom breast prosthesisL8040Nasal prosthesisL8041Midfacial prosthesisL8042Orbital prosthesisL8043Upper facial prosthesisL8044Hemi-facial prosthesisL8045Auricular prosthesisL8046Partial facial prosthesisL8047Nasal septal prosthesisL8110Compression stocking BK30-40L8120Compression stocking BK40-50L8300Truss single w/ standard padL8310Truss double w/ standard padL8320Truss addition to std pad waL8330Truss add to std pad scrotalL8400Sheath below kneeL8410Sheath above kneeL8415Sheath upper limbL8417Pros sheath/sock w gel cushnL8420Prosthetic sock multi ply BKL8430Prosthetic sock multi ply AKL8435Pros sock multi ply upper lmL8440Shrinker below kneeL8460Shrinker above kneeL8465Shrinker upper limbL8470Pros sock single ply BKL8480Pros sock single ply AKL8485Pros sock single ply upper lL8500Artificial larynxL8501Tracheostomy speaking valveL8507Trach-esoph voice pros pt inL8509Trach-esoph voice pros md inL8510Voice amplifierL8511Indwelling trach insertL8512Gel cap for trach voice prosL8513Trach pros cleaning deviceL8514Repl trach puncture dilatorL8515Gel cap app device for trachL8600Implant breast silicone/eqL8603Collagen imp urinary 2.5 mlL8606Synthetic implnt urinary 1mlV2020Vision svcs frames purchasesV2100Lens spher single plano 4.00V2101Single visn sphere 4.12-7.00V2102Singl visn sphere 7.12-20.00V2103Spherocylindr 4.00d/12-2.00dV2104Spherocylindr 4.00d/2.12-4dV2105Spherocylinder 4.00d/4.25-6dV2106Spherocylinder 4.00d/>6.00dV2107Spherocylinder 4.25d/12-2dV2108Spherocylinder 4.25d/2.12-4dV2109Spherocylinder 4.25d/4.25-6dV2110Spherocylinder 4.25d/over 6dV2111Spherocylindr 7.25d/.25-2.25V2112Spherocylindr 7.25d/2.25-4dV2113Spherocylindr 7.25d/4.25-6dV2114Spherocylinder over 12.00dV2115Lens lenticular bifocalV2118Lens aniseikonic singleV2121Lenticular lens, singleV2200Lens spher bifoc plano 4.00dV2201Lens sphere bifocal 4.12-7.0V2202Lens sphere bifocal 7.12-20.V2203Lens sphcyl bifocal 4.00d/.1V2204Lens sphcy bifocal 4.00d/2.1V2205Lens sphcy bifocal 4.00d/4.2V2206Lens sphcy bifocal 4.00d/oveV2207Lens sphcy bifocal 4.25-7d/.V2208Lens sphcy bifocal 4.25-7/2.V2209Lens sphcy bifocal 4.25-7/4.V2210Lens sphcy bifocal 4.25-7/ovV2211Lens sphcy bifo 7.25-12/.25-V2212Lens sphcyl bifo 7.25-12/2.2V2213Lens sphcyl bifo 7.25-12/4.2V2214Lens sphcyl bifocal over 12.V2215V2218Lens aniseikonic bifocalV2219Lens bifocal seg width overV2220Lens bifocal add over 3.25dV2221Lenticular lens, bifocalV2300Lens sphere trifocal 4.00dV2301Lens sphere trifocal 4.12-7.V2302Lens sphere trifocal 7.12-20V2303Lens sphcy trifocal 4.0/.12-V2304Lens sphcy trifocal 4.0/2.25V2305Lens sphcy trifocal 4.0/4.25V2306Lens sphcyl trifocal 4.00/>6V2307Lens sphcy trifocal 4.25-7/.V2308Lens sphc trifocal 4.25-7/2.V2309Lens sphc trifocal 4.25-7/4.V2310Lens sphc trifocal 4.25-7/>6V2311Lens sphc trifo 7.25-12/.25-V2312Lens sphc trifo 7.25-12/2.25V2313Lens sphc trifo 7.25-12/4.25V2314Lens sphcyl trifocal over 12V2315Lens lenticular trifocalV2318Lens aniseikonic trifocalV2319Lens trifocal seg width > 28V2320Lens trifocal add over 3.25dV2321Lenticular lens, trifocalV2410Lens variab asphericity singV2430Lens variable asphericity biV2500Contact lens pmma sphericalV2501Cntct lens pmma-toric/prismV2502Contact lens pmma bifocalV2503Cntct lens pmma color visionV2510Cntct gas permeable sphericlV2511Cntct toric prism ballastV2512Cntct lens gas permbl bifoclV2513Contact lens extended wearV2520Contact lens hydrophilicV2521Cntct lens hydrophilic toricV2522Cntct lens hydrophil bifoclV2523Cntct lens hydrophil extendV2530Contact lens gas impermeableV2531Contact lens gas permeableV2623Plastic eye prosth customV2624Polishing artifical eyeV2625Enlargemnt of eye prosthesisV2626Reduction of eye prosthesisV2627Scleral cover shellV2628Fabrication & fittingV2700 Balance lensV2710Glass/plastic slab off prismV2715 Prism lens/esV2718Fresnell prism press-on lensV2730Special base curveV2744Tint photochromatic lens/esV2745Tint, any color/solid/gradV2750Anti-reflective coatingV2755 UV lens/esV2760Scratch resistant coatingOstomy irrigation setA4402Lubricant per ounceA4404Ostomy ring eachA4405Nonpectin based ostomy pasteA4406Pectin based ostomy pasteA4407Ext wear ost skn barr <=4sqA4408Ext wear ost skn barr >4sqA4409Ost skn barr w flng <=4 sqA4410Ost skn barr w flng >4sqA44132 pc drainable ost pouchA4414Ostomy sknbarr w flng <=4sqA4415Ostomy skn barr w flng >4sqA4416Ost pch clsd w barrier/filtrA4417Ost pch w bar/bltinconv/fltrA4418Ost pch clsd w/o bar w filtrA4419Ost pch for bar w flange/fltA4420Ost pch clsd for bar w lk flA4422Ost pouch absorbent materialA4423Ost pch for bar w lk fl/fltrA4424Ost pch drain w bar & filterA4425Ost pch drain for barrier flA4426Ost pch drain 2 piece systemA4427Ost pch drain/barr lk flng/fA4428Urine ost pouch w faucet/tapA4429Urine ost pouch w bltinconvA4430Ost urine pch w b/bltin convA4431Ost pch urine w barrier/tapvA4432Os pch urine w bar/fange/tapA4433Urine ost pch bar w lock flnA4434Ost pch urine w lock flng/ftA4450Non-waterproof tapeAVAWA4452Waterproof tapeA4455Adhesive remover per ounceA4462Abdmnl drssng holder/binderA4481Tracheostoma filterA4483Moisture exchangerA4556Electrodes, pairA4557Lead wires, pairA4558Conductive paste or g< elA4561Pessary rubber, any typeA4562Pessary, non rubber,any typeA4595TENS suppl 2 lead per monthA4605Trach suction cath close sysA4608Transtracheal oxygen cathA4611Heavy duty batteryA4612Battery cablesA4613Battery chargerA4614Hand-held PEFR meterA4618Breathing circuitsA4619 Face tentA4623Tracheostomy inner cannulaA4624Tracheal suction tubeA4625Trach care kit for new trachA4626Tracheostomy cleaning brushA4628Oropharyngeal suction cathA4629Tracheostomy care kitA4630Repl bat t.e.n.s. own by ptA4632Infus pump rplcemnt batteryA4633Uvl replacement bulbA4635Underarm crutch padA4636Handgrip for cane etcA4637Repl tip cane/crutch/walkerA4638Repl batt pulse gen sysA4639Infrared ht sys replcmnt padA4640Alternating pressure padA5051Pouch clsd w barr attachedA5052Clsd ostomy pouch w/o barrA5053Clsd ostomy pouch faceplateA5054Clsd ostomy pouch w/flangeA5055 Stoma capA5061Pouch drainable w barrier atA5062Drnble ostomy pouch w/o barrA5063Drain ostomy pouch w/flangeA5071Urinary pouch w/barrierA5072Urinary pouch w/o barrierA5073Urinary pouch on barr w/flngA5081Continent stoma plugA5082Continent stoma catheterA5093Ostomy accessory convex inseA5102Bedside drain btl w/wo tubeA5105Urinary suspensoryA5112Urinary leg bagA5113Latex leg strapA5114Foam/fabric leg strapA5119Skin barrier wipes box pr 50A5121Solid skin barrier 6x6A5122Solid skin barrier 8x8A5126Disk/foam pad +or- adhesiveA5131Appliance cleanerA5200Percutaneous catheter anchorA5500Diab shoe for density insertA5501Diabetic custom molded shoeA5503Diabetic shoe w/roller/rockrA5504Diabetic shoe with wedgeA5505Diab shoe w/metatarsal barA5506Diabetic shoe w/off set heelA5507Modification diabetic shoeA6010Collagen based wound fillerA6011Collagen gel/paste wound filA6021L0861Halo repl liner/interfaceL0960Post surgical support padsL0970Tlso corset frontL0972Lso corset frontL0974Tlso full corsetL0976Lso full corsetL0978Axillary crutch extensionL0980Peroneal straps pairL0982Stocking supp grips set of fL0984Protective body sock eachL1000Ctlso milwauke initial modelL1005Tension based scoliosis orthL1010Ctlso axilla slingL1020 Kyphosis padL1025Kyphosis pad floatingL1030Lumbar bolster padL1040Lumbar or lumbar rib padL1050 Sternal padL1060 Thoracic padL1070Trapezius slingL1080 OutriggerL1085Outrigger bil w/ vert extensL1090 Lumbar slingL1100Ring flange plastic/leatherL1110Ring flange plas/leather molL1120Covers for upright eachL1200Furnsh initial orthosis onlyL1210Lateral thoracic extensionL1220Anterior thoracic extensionL1230Milwaukee type superstructurL1240Lumbar derotation padL1250Anterior asis padL1260Anterior thoracic derotationL1270 Abdominal padL1280Rib gusset (elastic) eachL1290Lateral trochanteric padL1300Body jacket mold to patientL1310Post-operative body jacketL1500Thkao mobility frameL1510Thkao standing frameL1520Thkao swivel walkerL1600Abduct hip flex frejka w cvrL1610Abduct hip flex frejka covrL1620Abduct hip flex pavlik harneL1630Abduct control hip semi-flexL1640Pelv band/spread bar thigh cL1650HO abduction hip adjustableL1652HO bi thighcuffs w sprdr barL1660HO abduction static plasticL1680Pelvic & hip control thigh cL1685Post-op hip abduct custom faL1686HO post-op hip abductionL1690Combination bilateral HOL1700Leg perthes orth toronto typL1710Legg perthes orth newingtonL1720Legg perthes orthosis trilatL1730Legg perthes orth scottish rL1750Legg perthes slingL1755Legg perthes patten bottom tL1800Knee orthoses elas w staysL1810Ko elastic with jointsL1815Elastic with condylar padsL1820Ko elas w/ condyle pads & joL1825Ko elastic knee capL1830Ko immobilizer canvas longitL1831Knee orth pos locking jointL1832KO adj jnt pos rigid supportL1834Ko w/0 joint rigid molded toL1836Rigid KO wo jointsL1840Ko derot ant cruciate customL1843KO single upright custom fitL1844Ko w/adj jt rot cntrl moldedL1845Ko w/ adj flex/ext rotat cusL1846Ko w adj flex/ext rotat moldL1847KO adjustable w air chambersL1850Ko swedish typeL1855Ko plas doub upright jnt molL1858Ko polycentric pneumatic padL1860Ko supracondylar socket moldL1870Ko doub upright lacers moldeL1880Ko doub upright cuffs/lacersL1900Afo sprng wir drsflx calf bdL1901Prefab ankle orthosisL1902Afo ankle gauntletL1904Afo molded ankle gauntletL1906Afo multiligamentus ankle suL1907AFO supramalleolar customL1910Afo sing bar clasp attach shL1920Afo sing upright w/ adjust sL1930 Afo plasticL1932Afo rig ant tib prefab TCF/=L1940Afo molded to patient plastiL1945Afo molded plas rig ant tibL1950Afo spiral molded to pt plasL1951AFO spiral prefabricatedL1960Afo pos solid ank plastic moL1970Afo plastic molded w/ankle jL1971AFO w/ankle joint, prefabL1980Afo sing solid stirrup calfLg vol nebulizer disposableA7008Disposable nebulizer prefillA7009Nebulizer reservoir bottleA7010Disposable corrugated tubingA7012Nebulizer water collec devicA7013Disposable compressor filterA7014Compressor nondispos filterA7015Aerosol mask used w nebulizeA7016Nebulizer dome & mouthpieceA7017Nebulizer not used w oxygenA7018Water distilled w/nebulizerA7025Replace chest compress vestA7026Replace chst cmprss sys hoseA7030CPAP full face maskA7031Replacement facemask interfaA7032Replacement nasal cushionA7033Replacement nasal pillowsA7034Nasal application deviceA7035Pos airway press headgearA7036Pos airway press chinstrapA7037Pos airway pressure tubingA7038Pos airway pressure filterA7039Filter, non disposable w papA7040One way chest drain valveA7041Water seal drain containerA7042Implanted pleural catheterA7043Vacuum drainagebottle/tubingA7044PAP oral interfaceA7045Repl exhalation port for PAPA7046Repl water chamber, PAP devA7501Tracheostoma valve w diaphraA7502Replacement diaphragm/fplateA7503HMES filter holder or capA7504Tracheostoma HMES filterA7505HMES or trach valve housingA7506HMES/trachvalve adhesivediskA7507Integrated filter & holderA7508Housing & Integrated AdhesivA7509Heat & moisture exchange sysA7520Trach/laryn tube non-cuffedA7521Trach/laryn tube cuffedA7522Trach/laryn tube stainlessA7524Tracheostoma stent/stud/bttnA7525Tracheostomy maskA7526Tracheostomy tube collarA7527Trach/laryn tube plug/stopE0100Cane adjust/fixed with tipE0105Cane adjust/fixed quad/3 proE0110Crutch forearm pairE0111Crutch forearm eachE0112Crutch underarm pair woodE0113Crutch underarm each woodE0114Crutch underarm pair no woodE0116Crutch underarm each no woodE0117Underarm springassist crutchE0130Walker rigid adjust/fixed htE0135Walker folding adjust/fixedE0140Walker w trunk supportE0141Rigid wheeled walker adj/fixE0143Walker folding wheeled w/o sE0144Enclosed walker w rear seatE0147Walker variable wheel resistE0148Heavyduty walker no wheelsE0149Heavy duty wheeled walkerE0153Forearm crutch platform attaE0154Walker platform attachmentE0155Walker wheel attachment,pairE0156Walker seat attachmentE0157Walker crutch attachmentE0158Walker leg extenders set of4E0159Brake for wheeled walkerE0160Sitz type bath or equipment< E0161Sitz bath/equipment w/faucetE0162Sitz bath chairE0163Commode chair stationry fxdE0164Commode chair mobile fixed aE0165Commode chair stationry detE0166Commode chair mobile detachE0167Commode chair pail or panE0168Heavyduty/wide commode chairE0169Seatlift incorp commodechairE0175Commode chair foot restE0180Press pad alternating w pumpE0181Press pad alternating w/ pumE0182Pressure pad alternating pumE0184Dry pressure mattressE0185Gel pressure mattress padE0186Air pressure mattressE0187Water pressure mattressE0188Synthetic sheepskin padE0189Lambswool sheepskin padE0191Protector heel or elbowE0193Powered air flotation bedE0194Air fluidized bedE0196Gel pressure mattressE0197FeeMFee Schedule for Durable Medical Equipment, Prosthetics, Orthotics & SuppliesDrop lock retainer eachL2795Knee control full kneecapL2800Knee cap medial or lateral pL2810Knee control condylar padL2820Soft interface below knee seL2830Soft interface above knee seL2840Tibial length sock fx or equL2850Femoral lgth sock fx or equaL3031Foot lamin/prepreg compositeL3224Woman's shoe oxford braceL3225Man's shoe oxford braceL3650Shlder fig 8 abduct restrainL3651Prefab shoulder orthosisL3652Prefab dbl shoulder orthosisL3660Abduct restrainer canvas&webL3670Acromio/clavicular canvas&weL3675Canvas vest SOL3700Elbow orthoses elas w staysL3701Prefab elbow orthosisL3710Elbow elastic with metal joiL3720Forearm/arm cuffs free motioL3730Forearm/arm cuffs ext/flex aL3740Cuffs adj lock w/ active conL3760EO withjoint, PrefabricatedL3762Rigid EO wo jointsL3800Whfo short opponen no attachL3805Whfo long opponens no attachL3807WHFO,no joint, prefabricatedL3810Whfo thumb abduction barL3815Whfo second m.p. abduction aL3820Whfo ip ext asst w/ mp ext sL3825Whfo m.p. extension stopL3830Whfo m.p. extension assistL3835Whfo m.p. spring extension aL3840Whfo spring swivel thumbL3845Whfo thumb ip ext ass w/ mpL3850Action wrist w/ dorsiflex asL3855Whfo adj m.p. flexion controL3860Whfo adj m.p. flex ctrl & i.L3900Hinge extension/flex wrist/fL3901Hinge ext/flex wrist fingerL3904Whfo electric custom fittedL3906Wrist gauntlet molded to ptL3907Whfo wrst gauntlt thmb spicaL3908Wrist cock-up non-moldedL3909Prefab wrist orthosisL3910Whfo swanson designL3911Prefab hand finger orthosisL3912Flex glove w/elastic fingerL3914WHO wrist extension cock-upL3916Whfo wrist extens w/ outriggL3917Prefab metacarpl fx orthosisL3918HFO knuckle benderL3920Knuckle bender with outriggeL3922Knuckle bend 2 seg to flex jL3923HFO, no joint, prefabricatedL3924 OppenheimerL3926Thomas suspensionL3928Finger extension w/ clock spL3930Finger extension with wristL3932Safety pin spring wireL3934Safety pin modifiedL3936PalmerL3938 Dorsal wristL3940Dorsal wrist w/ outrigger atL3942Reverse knuckle benderL3944Reverse knuckle bend w/ outrL3946HFO composite elasticL3948Finger knuckle benderL3950Oppenheimer w/ knuckle bendL3952Oppenheimer w/ rev knuckle 2L3954Spreading handL3956Add joint upper ext orthosisL3960Sewho airplan desig abdu posL3962Sewho erbs palsey design abdL3963Molded w/ articulating elbowL3964Seo mobile arm sup att to wcL3965Arm supp att to wc rancho tyL3966Mobile arm supports reclininL3968Friction dampening arm suppL3969Monosuspension arm/hand suppL3970Elevat proximal arm supportL3972Offset/lat rocker arm w/ elaL3974Mobile arm support supinatorL3980Upp ext fx orthosis humeralL3982Upper ext fx orthosis rad/ulL3984Upper ext fx orthosis wristL3985Forearm hand fx orth w/ wr hL3986Humeral rad/ulna wrist fx orL3995Sock fracture or equal eachL4000Repl girdle milwaukee orthL4002Replace strap, any orthosisL4010Replace trilateral socket brL4020Replace quadlat socket brimL4030Replace socket brim cust fitL4040Replace molded thigh lacerL4045Seat lift incorp lift-chairE0628Seat lift for pt furn-electrE0629Seat lift for pt furn-non-elE0630Patient lift hydraulicE0635Patient lift electricE0636PT support & positioning sysE0650Pneuma compresor non-segmentE0651Pneum compressor segmentalE0652Pneum compres w/cal pressureE0655Pneumatic appliance half armE0660Pneumatic appliance full legE0665Pneumatic appliance full armE0666Pneumatic appliance half legE0667Seg pneumatic appl full legE0668Seg pneumatic appl full armE0669Seg pneumatic appli half legE0671Pressure pneum appl full legE0672Pressure pneum appl full armE0673Pressure pneum appl half legE0675Pneumatic compression deviceE0691Uvl pnl 2 sq ft or lessE0692Uvl sys panel 4 ftE0693Uvl sys panel 6 ftE0694Uvl md cabinet sys 6 ftE0701Helmet w face guard prefabE0720 Tens two leadE0730Tens four leadE0731Conductive garment for tens/E0740Incontinence treatment systmE0744Neuromuscular stim for scoliE0745Neuromuscular stim for shockE0747Elec osteogen stim not spineE0748Elec osteogen stim spinalE0749Elec osteogen stim implantedE0752Neurostimulator electrodeE0754Pulsegenerator pt programmerE0756Implantable pulse generatorE0757Implantable RF receiverE0758External RF transmitterE0759Replace rdfrquncy transmittrE0760Osteogen ultrasound stimltorE0765Nerve stimulator for tx n&vE0776Iv poleE0779Amb infusion pump mechanicalE0780Mech amb infusion pump <8hrsE0781External ambulatory infus puE0782Non-programble infusion pumpE0783Programmable infusion pumpE0784Ext amb infusn pump insulinE0785Replacement impl pump cathetE0786Implantable pump replacementE0791Parenteral infusion pump staE0840Tract frame attach headboardE0849Cervical pneum trac equipE0850Traction stand free standingE0855Cervical traction equipmentE0860Tract equip cervical tractE0870Tract frame attach footboardE0880Trac stand free stand extremE0890Traction frame attach pelvicE0900Trac stand free stand pelvicE0910Trapeze bar attached to bedE0920Fracture frame attached to bE0930Fracture frame free standingE0935Exercise device passive motiE0940Trapeze bar free standingE0941Gravity assisted traction deE0942Cervical head harness/halterE0944Pelvic belt/harness/bootE0945Belt/harness extremityE0946Fracture frame dual w crossE0947Fracture frame attachmnts peE0948Fracture frame attachmnts ceE0950TrayE0951 Loop heelE0952Toe loop/holder, eachE0955Cushioned headrestE0956W/c lateral trunk/hip supporE0957W/c medial thigh supportE0958Whlchr att- conv 1 arm driveE0959Amputee adapterE0960W/c shoulder harness/strapsE0961Wheelchair brake extensionE0966Wheelchair head rest extensiE0967Wheelchair hand rimsE0968Wheelchair commode seatE0969Wheelchair narrowing deviceE0971Wheelchair anti-tipping deviE0972Transfer board or deviceE0973W/Ch access det adj armrestE0974W/Ch access anti-rollbackE0977Wheelchair wedge cushionE0978W/C acc,saf belt pelv strapE0980Wheelchair safety vestE0981Seat upholstery, replacementE0982Back upholstery, replacementE0983Add pwr joystickE0984Add pwr tillerE0985W/c seat lift mechanismE0986Man w/c push-rim pow assistE0990Whellchair elevating leg resE0992Wheelchair solid seat insertSocket insert below kneeL5656Socket insert knee articulatL5658Socket insert above kneeL5661Multi-durom< eter symesL5665Multi-durometer below kneeL5666Below knee cuff suspensionL5668Socket insert w/o lock lowerL5670Bk molded supracondylar suspL5671BK/AK locking mechanismL5672Bk removable medial brim susL5673Socket insert w lock mechL5676Bk knee joints single axis pL5677Bk knee joints polycentric pL5678Bk joint covers pairL5679Socket insert w/o lock mechL5680Bk thigh lacer non-moldedL5681Intl custm cong/latyp insertL5682Bk thigh lacer glut/ischia mL5683Initial custom socket insertL5684 Bk fork strapL5685Below knee sus/seal sleeveL5686 Bk back checkL5688Bk waist belt webbingL5690Bk waist belt padded and linL5692Ak pelvic control belt lightL5694Ak pelvic control belt pad/lL5695Ak sleeve susp neoprene/equaL5696Ak/knee disartic pelvic joinL5697Ak/knee disartic pelvic bandL5698Ak/knee disartic silesian baL5699Shoulder harnessL5700Replace socket below kneeL5701Replace socket above kneeL5702Replace socket hipL5704Custom shape cover BKL5705Custom shape cover AKL5706Custom shape cvr knee disartL5707Custom shape cvr hip disartL5710Kne-shin exo sng axi mnl locL5711Knee-shin exo mnl lock ultraL5712Knee-shin exo frict swg & stL5714Knee-shin exo variable frictL5716Knee-shin exo mech stance phL5718Knee-shin exo frct swg & staL5722Knee-shin pneum swg frct exoL5724Knee-shin exo fluid swing phL5726Knee-shin ext jnts fld swg eL5728Knee-shin fluid swg & stanceL5780Knee-shin pneum/hydra pneumL5781Lower limb pros vacuum pumpL5782HD low limb pros vacuum pumpL5785Exoskeletal bk ultralt materL5790Exoskeletal ak ultra-light mL5795Exoskel hip ultra-light mateL5810Endoskel knee-shin mnl lockL5811Endo knee-shin mnl lck ultraL5812Endo knee-shin frct swg & stL5814Endo knee-shin hydral swg phL5816Endo knee-shin polyc mch staL5818L5822Endo knee-shin pneum swg frcL5824Endo knee-shin fluid swing pL5826Miniature knee jointL5828Endo knee-shin fluid swg/staL5830Endo knee-shin pneum/swg phaL5840Multi-axial knee/shin systemL5845Knee-shin sys stance flexionL5848Knee-shin sys hydraul stanceL5850Endo ak/hip knee extens assiL5855Mech hip extension assistL5856Elec knee-shin swing/stanceL5857Elec knee-shin swing onlyL5910Endo below knee alignable syL5920Endo ak/hip alignable systemL5925Above knee manual lockL5930High activity knee frameL5940Endo bk ultra-light materialL5950Endo ak ultra-light materialL5960Endo hip ultra-light materiaL5962Below knee flex cover systemL5964Above knee flex cover systemL5966Hip flexible cover systemL5968Multiaxial ankle w dorsiflexL5970Foot external keel sach footL5972Flexible keel footL5974Foot single axis ankle/footL5975Combo ankle/foot prosthesisL5976Energy storing footL5978Ft prosth multiaxial ankl/ftL5979Multi-axial ankle/ft prosthL5980Flex foot systemL5981Flex-walk sys low ext prosthL5982Exoskeletal axial rotation uL5984Endoskeletal axial rotationL5985Lwr ext dynamic prosth pylonL5986Multi-axial rotation unitL5987Shank ft w vert load pylonL5988Vertical shock reducing pyloL5990User adjustable heel heightL5995Lower ext pros heavyduty feaL6000Par hand robin-aids thum remL6010Hand robin-aids little/ringL6020Part hand robin-aids no fingL6025Part hand disart myoelectricL6050Wrst MLd sck flx hng tri padL6055Wrst mold sock w/exp interfaL6100Elb mold sock flex hinge padL6110Elbow mold sock suspension tL6120Elbow mold doub splt soc steE2310Electro connect btw controlE2311Electro connect btw 2 sysE2320Hand chin controlE2321Hand interface joystickE2322Mult mech switchesE2323Special joystick handleE2324Chin cup interfaceE2325Sip and puff interfaceE2326Breath tube kitE2327Head control interface mechE2328Head/extremity control interE2329Head control nonproportionalE2330Head control proximity switcE2340W/c wdth 20-23 in seat frameE2341W/c wdth 24-27 in seat frameE2342W/c dpth 20-21 in seat frameE2343W/c dpth 22-25 in seat frameE2351Electronic SGD interfaceE236022nf nonsealed leadacidE236122nf sealed leadacid batteryE2362Gr24 nonsealed leadacidE2363Gr24 sealed leadacid batteryE2364U1nonsealed leadacid batteryE2365U1 sealed leadacid batteryE2366Battery charger, single modeE2367Battery charger, dual modeE2368Power wc motor replacementE2369Pwr wc gear box replacementE2370Pwr wc motor/gear box comboE2402Neg press wound therapy pumpE2500SGD digitized pre-rec <=8minE2502SGD prerec msg >8min <=20minE2504SGD prerec msg>20min <=40minE2506SGD prerec msg > 40 minE2508SGD spelling phys contactE2510SGD w multi methods msg/accsE2511SGD sftwre prgrm for PC/PDAE2512SGD accessory, mounting sysE2601Gen w/c cushion wdth < 22 inE2602Gen w/c cushion wdth >=22 inE2603Skin protect wc cus wd <22inE2604Skin protect wc cus wd>=22inE2605Position wc cush wdth <22 inE2606Position wc cush wdth>=22 inE2607Skin pro/pos wc cus wd <22inE2608Skin pro/pos wc cus wd>=22inE2611Gen use back cush wdth <22inE2612Gen use back cush wdth>=22inE2613Position back cush wd <22inE2614Position back cush wd>=22inE2615Pos back post/lat wdth <22inE2616Pos back post/lat wdth>=22inE2618Wc acc solid seat supp baseE2619Replace cover w/c seat cushE2620WC planar back cush wd <22inE2621WC planar back cush wd>=22inK0001Standard wheelchairK0002Stnd hemi (low seat) whlchrK0003Lightweight wheelchairK0004High strength ltwt whlchrK0005Ultralightweight wheelchairK0006Heavy duty wheelchairK0007Extra heavy duty wheelchairK0010Stnd wt frame power whlchrK0011Stnd wt pwr whlchr w controlK0012Ltwt portbl power whlchrK0015Detach non-adjus hght armrstK0017Detach adjust armrest baseK0018Detach adjust armrst upperK0019 Arm pad eachK0020Fixed adjust armrest pairK0037High mount flip-up footrestK0038Leg strap eachK0039Leg strap h style eachK0040Adjustable angle footplateK0041Large size footplate eachK0042Standard size footplate eachK0043Ftrst lower extension tubeK0044Ftrst upper hanger bracketK0045Footrest complete assemblyK0046Elevat legrst low extensionK0047Elevat legrst up hangr brackK0050Ratchet assemblyK0051Cam relese assem ftrst/lgrstK0052Swingaway detach footrestK0053Elevate footrest articulateK0056Seat ht <17 or >=21 ltwt wcK0064Zero pressure tube flat freeK0065Spoke protectorsK0066Solid tire any size eachK0067Pneumatic tire any size eachK0068Pneumatic tire tube eachK0069Rear whl complete solid tireK0070Rear whl compl pneum tireK0071Front castr compl pneum tireK0072Frnt cstr cmpl sem-pneum tirK0073Caster pin lock eachK0074Pneumatic caster tire eachK0075Semi-pneumatic caster tireK0076Solid caster tire eachK0077Front caster assem completeK0078Pneumatic caster tire tubeK0090Rear tire power wheelchairK0091Rear tire tube power whlchrK0092Rear assem cmplt powr whlchrK0093Rear zero pressure tire tubeK0094Wheel tire for power baseK0095Wheel tire tube each baseHand mech inf steeper or equL6875 Hand bock vcL6880 Hand bock voL6881V2762Polarization, any lensV2770Occluder lens/esV2780Oversize lens/esV2782Lens, 1.54-1.65 p/1.60-1.79gV2783Lens, >= 1.66 p/>=1.80 gV2784Lens polycarb or equalV2786Occupational multifocal lensHCPCSMod DescriptionK0096Wheel assem powr bas< e compltK0097Wheel zero presure tire tubeK0098Drive belt power wheelchairK0099Pwr wheelchair front casterK0102Crutch and cane holderK0104Cylinder tank carrierK0105 Iv hangerK0106Arm trough eachK0195Elevating whlchair leg restsK0452Wheelchair bearingsK0455Pump uninterrupted infusionK0552Supply/ext inf pump syr typeK0600Functional neuromuscularstimK0601Repl batt silver oxide 1.5 vK0602Repl batt silver oxide 3 vK0603Repl batt alkaline 1.5 vK0604Repl batt lithium 3.6 vK0605Repl batt lithium 4.5 vK0606AED garment w elec analysisK0607Repl batt for AEDK0608Repl garment for AEDK0609Repl electrode for AEDK0618TLSO 2 piece rigid shellK0619TLSO 3 piece rigid shellK0620Tubular elastic dressingK0628Multi den insert direct formK0629Multi den insert custom moldK0630SIO flex pelvisacral prefabK0631SIO flex pelvisacral customK0632SIO panel prefabK0634LO flexibl L1-below L5 preK0635LO sag stays/panels pre-fabK0636LO sagitt rigid panel prefabK0637LO flex w/o rigid stays preK0639LSO post rigid panel preK0640LSO sag-coro rigid frame preK0642LSO flexion control prefabK0644LSO sagit rigid panel prefabK0645LSO sagittal rigid panel cusK0646LSO sag-coronal panel prefabK0647LSO sag-coronal panel customK0648LSO s/c shell/panel prefabK0649LSO s/c shell/panel customK0670K0671L0100Cranial orthosis/helmet moldL0110Cranial orthosis/helmet nonmL0112Cranial cervical orthosisL0120Cerv flexible non-adjustableL0130Flex thermoplastic collar moL0140Cervical semi-rigid adjustabL0150Cerv semi-rig adj molded chnL0160Cerv semi-rig wire occ/mandL0170Cervical collar molded to ptL0172Cerv col thermplas foam 2 piL0174Cerv col foam 2 piece w thorL0180Cer post col occ/man sup adjL0190Cerv collar supp adj cerv baL0200Cerv col supp adj bar & thorL0210Thoracic rib beltL0220Thor rib belt custom fabricaL0430Dewall posture protectorL0450TLSO flex prefab thoracicL0452tlso flex custom fab thoraciL0454TLSO flex prefab sacrococ-T9L0456TLSO flex prefabL0458TLSO 2Mod symphis-xipho preL0460TLSO2Mod symphysis-stern preL0462TLSO 3Mod sacro-scap preL0464TLSO 4Mod sacro-scap preL0466TLSO rigid frame pre soft apL0468TLSO rigid frame prefab pelvL0470TLSO rigid frame pre subclavL0472TLSO rigid frame hyperex preL0480TLSO rigid plastic custom faL0482TLSO rigid lined custom fabL0484TLSO rigid plastic cust fabL0486TLSO rigidlined cust fab twoL0488TLSO rigid lined pre one pieL0490TLSO rigid plastic pre oneL0700Ctlso a-p-l control moldedL0710Ctlso a-p-l control w/ interL0810Halo cervical into jckt vestL0820Halo cervical into body jackL0830Halo cerv into milwaukee typL0860Magnetic resonanc image compL8610Ocular implantL8612Aqueous shunt prosthesisL8613Ossicular implantL8614Cochlear device/systemL8615Coch implant headset replaceL8616Coch implant microphone replL8617Coch implant trans coil replL8618Coch implant tran cable replL8619Replace cochlear processorL8620Repl lithium ion batteryL8621Repl zinc air batteryL8622Repl alkaline batteryL8630Metacarpophalangeal implantL8631A4216Sterile water/saline, 10 mlA4217Sterile water/saline, 500 mlAUA4221Maint drug infus cath per wkA4222Infusion supplies with pumpA4253NUBlood glucose/reagent stripsA4254Battery for glucose monitorRRUEA4255Glucose monitor platformsA4256Calibrator solution/chipsA4257Replace Lensshield CartridgeA4258Lancet device eachA4259Lancets per boxA4265ParaffinA4280Brst prsths adhsv attchmntA4310Insert tray w/o bag/cathA4311Catheter w/o bag 2-way latexA4312Cath w/o bag 2-way siliconeA4313Catheter w/bag 3-wayA4314Cath w/drainage 2-way latexA4315Cath w/drainage 2-way silcneA4316Cath w/drainage 3-wayA4320Irrigation trayA4321Cath therapeutic irrig agentA4322Irrigation syringeA4326Male external catheterA4327Fem urinary collect dev cupA4328Fem urinary collect pouchA4330Stool collection pouchA4331Extension drainage tubingA4332Lube sterile packetA4333Urinary cath anchor deviceA4334Urinary cath leg strapA4338Indwelling catheter latexA4340Indwelling catheter specialA4344Cath indw foley 2 way silicnA4346Cath indw foley 3 wayA4348Male ext cath extended wearA4349Disposable male external catA4351Straight tip urine catheterA4352Coude tip urinary catheterA4353Intermittent urinary cathA4354Cath insertion tray w/bagA4355Bladder irrigation tubingA4356Ext ureth clmp or compr dvcA4357Bedside drainage bagA4358Urinary leg or abdomen bagA4359Urinary suspensory w/o leg bA4361Ostomy face plateA4362Solid skin barrierA4364Adhesive, liquid or equalA4365Adhesive remover wipesA4366 Ostomy ventA4367 Ostomy beltA4368 Ostomy filterA4369Skin barrier liquid per ozA4371Skin barrier powder per ozA4372Skin barrier solid 4x4 equivA4373Skin barrier with flangeA4375Drainable plastic pch w fcplA4376Drainable rubber pch w fcpltA4377Drainable plstic pch w/o fpA4378Drainable rubber pch w/o fpA4379Urinary plastic pouch w fcplA4380Urinary rubber pouch w fcpltA4381Urinary plastic pouch w/o fpA4382Urinary hvy plstc pch w/o fpA4383Urinary rubber pouch w/o fpA4384Ostomy faceplt/silicone ringA4385Ost skn barrier sld ext wearA4387Ost clsd pouch w att st barrA4388Drainable pch w ex wear barrA4389Drainable pch w st wear barrA4390Drainable pch ex wear convexA4391Urinary pouch w ex wear barrA4392Urinary pouch w st wear barrA4393Urine pch w ex wear bar convA4394Ostomy pouch liq deodorantA4395Ostomy pouch solid deodorantA4396Peristomal hernia supprt bltA4397Irrigation supply sleeveA4398Ostomy irrigation bagA4399Ostomy irrig cone/cath w brsA4400L1990Afo doub solid stirrup calfL2000Kafo sing fre stirr thi/calfL2005KAFO sng/dbl mechanical actL2010Kafo sng solid stirrup w/o jL2020Kafo dbl solid stirrup band/L2030Kafo dbl solid stirrup w/o jL2035KAFO plastic pediatric sizeL2036Kafo plas doub free knee molL2037Kafo plas sing free knee molL2038Kafo w/o joint multi-axis anL2039KAFO,plstic,medlat rotat conL2040Hkafo torsion bil rot strapsL2050Hkafo torsion cable hip pelvL2060Hkafo torsion ball bearing jL2070Hkafo torsion unilat rot strL2080Hkafo unilat torsion cableL2090Hkafo unilat torsion ball brL2106Afo tib fx cast plaster moldL2108Afo tib fx cast molded to ptL2112Afo tibial fracture softL2114Afo tib fx semi-rigidL2116Afo tibial fracture rigidL2126Kafo fem fx cast thermoplasL2128Kafo fem fx cast molded to pL2132Kafo femoral fx cast softL2134Kafo fem fx cast semi-rigidL2136Kafo femoral fx cast rigidL2180Plas shoe insert w ank jointL2182Drop lock kneeL2184Limited motion knee jointL2186Adj motion knee jnt lerman tL2188Quadrilateral brimL2190 Waist beltL2192Pelvic band & belt thigh flaL2200Limited ankle motion ea jntL2210Dorsiflexion assist each joiL2220Dorsi & plantar flex ass/resL2230Split flat caliper stirr & pL2232Rocker bottom, contact AFOL2240Round caliper and plate attaL2250Foot plate molded stirrup atL2260Reinforced solid stirrupL2265Long tongue stirrupL2270Varus/valgus strap padded/liL2275Plastic mod low ext pad/lineL2280Molded inner bootL2300Abduction bar jointed adjustL2310Abduction bar-straight< L2320Non-molded lacerL2330Lacer molded to patient modeL2335Anterior swing bandL2340Pre-tibial shell molded to pL2350Prosthetic type socket moldeL2360Extended steel shankL2370 Patten bottomL2375Torsion ank & half solid stiL2380Torsion straight knee jointL2385Straight knee joint heavy duL2390Offset knee joint eachL2395Offset knee joint heavy dutyL2397Suspension sleeve lower extL2405Knee joint drop lock ea jntL2415Knee joint cam lock each joiL2425Knee disc/dial lock/adj flexL2430Knee jnt ratchet lock ea jntL2492Knee lift loop drop lock rinL2500Thi/glut/ischia wgt bearingL2510Th/wght bear quad-lat brim mL2520Th/wght bear quad-lat brim cL2525Th/wght bear nar m-l brim moL2526Th/wght bear nar m-l brim cuL2530Thigh/wght bear lacer non-moL2540Thigh/wght bear lacer moldedL2550Thigh/wght bear high roll cuL2570Hip clevis type 2 posit jntL2580Pelvic control pelvic slingL2600Hip clevis/thrust bearing frL2610Hip clevis/thrust bearing loL2620Pelvic control hip heavy dutL2622Hip joint adjustable flexionL2624Hip adj flex ext abduct contL2627Plastic mold recipro hip & cL2628Metal frame recipro hip & caL2630Pelvic control band & belt uL2640Pelvic control band & belt bL2650Pelv & thor control glutealL2660Thoracic control thoracic baL2670Thorac cont paraspinal uprigL2680Thorac cont lat support upriL2750Plating chrome/nickel pr barL2755Carbon graphite laminationL2760Extension per extension perL2768Ortho sidebar disconnectL2770Low ext orthosis per bar/jntL2780Non-corrosive finishL2785Collagen dressing <=16 sq inA6022Collagen drsg>6<=48 sq inA6023Collagen dressing >48 sq inA6024Collagen dsg wound fillerA6154Wound pouch eachA6196Alginate dressing <=16 sq inA6197Alginate drsg >16 <=48 sq inA6199Alginate drsg wound fillerA6200Compos drsg <=16 no borderA6201Compos drsg >16<=48 no bdrA6202Compos drsg >48 no borderA6203Composite drsg <= 16 sq inA6204Composite drsg >16<=48 sq inA6207Contact layer >16<= 48 sq inA6209Foam drsg <=16 sq in w/o bdrA6210Foam drg >16<=48 sq in w/o bA6211Foam drg > 48 sq in w/o brdrA6212Foam drg <=16 sq in w/borderA6214Foam drg > 48 sq in w/borderA6216Non-sterile gauze<=16 sq inA6217Non-sterile gauze>16<=48 sqA6219Gauze <= 16 sq in w/borderA6220Gauze >16 <=48 sq in w/bordrA6222Gauze <=16 in no w/sal w/o bA6223Gauze >16<=48 no w/sal w/o bA6224Gauze > 48 in no w/sal w/o bA6229Gauze >16<=48 sq in watr/salA6231Hydrogel dsg<=16 sq inA6232Hydrogel dsg>16<=48 sq inA6233Hydrogel dressing >48 sq inA6234Hydrocolld drg <=16 w/o bdrA6235Hydrocolld drg >16<=48 w/o bA6236Hydrocolld drg > 48 in w/o bA6237Hydrocolld drg <=16 in w/bdrA6238Hydrocolld drg >16<=48 w/bdrA6240Hydrocolld drg filler pasteA6241Hydrocolloid drg filler dryA6242Hydrogel drg <=16 in w/o bdrA6243Hydrogel drg >16<=48 w/o bdrA6244Hydrogel drg >48 in w/o bdrA6245Hydrogel drg <= 16 in w/bdrA6246Hydrogel drg >16<=48 in w/bA6247Hydrogel drg > 48 sq in w/bA6248Hydrogel drsg gel fillerA6251Absorpt drg <=16 sq in w/o bA6252Absorpt drg >16 <=48 w/o bdrA6253Absorpt drg > 48 sq in w/o bA6254Absorpt drg <=16 sq in w/bdrA6255Absorpt drg >16<=48 in w/bdrA6257Transparent film <= 16 sq inA6258Transparent film >16<=48 inA6259Transparent film > 48 sq inA6266Impreg gauze no h20/sal/yardA6402Sterile gauze <= 16 sq inA6403Sterile gauze>16 <= 48 sq inA6407Packing strips, non-impregA6410Sterile eye padA6411Non-sterile eye padA6441Pad band w>=3 <5/ydA6442Conform band n/s w<3/ydA6443Conform band n/s w>=3<5/ydA6444Conform band n/s w>=5/ydA6445Conform band s w <3/ydA6446Conform band s w>=3 <5/ydA6447Conform band s w >=5/ydA6448Lt compres band <3/ydA6449Lt compres band >=3 <5/ydA6450Lt compres band >=5/ydA6451Mod compres band w>=3<5/ydA6452High compres band w>=3<5ydA6453Self-adher band w <3/ydA6454Self-adher band w>=3 <5/ydA6455Self-adher band >=5/ydA6456Zinc paste band w >=3<5/ydA6501Compres burngarment bodysuitA6502Compres burngarment chinstrpA6503Compres burngarment facehoodA6504Cmprsburngarment glove-wristA6505Cmprsburngarment glove-elbowA6506Cmprsburngrmnt glove-axillaA6507Cmprs burngarment foot-kneeA6508Cmprs burngarment foot-thighA6509Compres burn garment jacketA6510Compres burn garment leotardA6511Compres burn garment pantyA6550Neg pres wound ther drsg setA6551Neg press wound ther canistrA7000Disposable canister for pumpA7001Nondisposable pump canisterA7002Tubing used w suction pumpA7003Nebulizer administration setA7004Disposable nebulizer sml volA7005Nondisposable nebulizer setA7006Filtered nebulizer admin setA7007Replace non-molded thigh lacL4050Replace molded calf lacerL4055Replace non-molded calf laceL4060Replace high roll cuffL4070Replace prox & dist uprightL4080Repl met band kafo-afo proxL4090Repl met band kafo-afo calf/L4100Repl leath cuff kafo prox thL4110Repl leath cuff kafo-afo calL4130Replace pretibial shellL4350Ankle control orthosi prefabL4360Pneumati walking boot prefabL4370Pneumatic full leg splintL4380Pneumatic knee splintL4386Non-pneum walk boot prefabL4392Replace AFO soft interfaceL4394Replace foot drop spintL4396 Static AFOL4398Foot drop splint recumbentL5000Sho insert w arch toe fillerL5010Mold socket ank hgt w/ toe fL5020Tibial tubercle hgt w/ toe fL5050Ank symes mold sckt sach ftL5060Symes met fr leath socket arL5100Molded socket shin sach footL5105Plast socket jts/thgh lacerL5150Mold sckt ext knee shin sachL5160Mold socket bent knee shin sL5200Kne sing axis fric shin sachL5210No knee/ankle joints w/ ft bL5220No knee joint with artic aliL5230Fem focal defic constant friL5250Hip canad sing axi cons fricL5270Tilt table locking hip singL5280Hemipelvect canad sing axisL5301BK mold socket SACH ft endoL5311Knee disart, SACH ft, endoL5321AK open end SACHL5331Hip disart canadian SACH ftL5341Hemipelvectomy canadian SACHL5400Postop dress & 1 cast chg bkL5410Postop dsg bk ea add cast chL5420Postop dsg & 1 cast chg ak/dL5430Postop dsg ak ea add cast chL5450Postop app non-wgt bear dsgL5460L5500Init bk ptb plaster directL5505Init ak ischal plstr directL5510Prep BK ptb plaster moldedL5520Perp BK ptb thermopls directL5530Prep BK ptb thermopls moldedL5535Prep BK ptb open end socketL5540Prep BK ptb laminated socketL5560Prep AK ischial plast moldedL5570Prep AK ischial direct formL5580Prep AK ischial thermo moldL5585Prep AK ischial open endL5590Prep AK ischial laminatedL5595Hip disartic sach thermoplsL5600Hip disart sach laminat moldL5610Above knee hydracadenceL5611Ak 4 bar link w/fric swingL5613Ak 4 bar ling w/hydraul swigL56144-bar link above knee w/swngL5616Ak univ multiplex sys frictL5617AK/BK self-aligning unit eaL5618Test socket symesL5620Test socket below kneeL5622Test socket knee disarticulaL5624Test socket above kneeL5626Test socket hip disarticulatL5628Test socket hemipelvectomyL5629Below knee acrylic socketL5630Syme typ expandabl wall scktL5631Ak/knee disartic acrylic socL5632Symes type ptb brim design sL5634Symes type poster opening soL5636Symes type medial opening soL5637Below knee total contactL5638< Below knee leather socketL5639Below knee wood socketL5640Knee disarticulat leather soL5642Above knee leather socketL5643Hip flex inner socket ext frL5644Above knee wood socketL5645Bk flex inner socket ext fraL5646Below knee cushion socketL5647Below knee suction socketL5648Above knee cushion socketL5649Isch containmt/narrow m-l soL5650Tot contact ak/knee disart sL5651Ak flex inner socket ext fraL5652Suction susp ak/knee disartL5653Knee disart expand wall sockL5654Socket insert symesL5655Air pressure pad for mattresE0198Water pressure pad for mattrE0199Dry pressure pad for mattresE0200Heat lamp without standE0202Phototherapy light w/ photomE0205Heat lamp with standE0210Electric heat pad standardE0215Electric heat pad moistE0217Water circ heat pad w pumpE0220Hot water bottleE0225Hydrocollator unitE0230Ice cap or collarE0235Paraffin bath unit portableE0236Pump for water circulating pE0238Heat pad non-electric moistE0239Hydrocollator unit portableE0249Pad water circulating heat uE0250Hosp bed fixed ht w/ mattresE0251Hosp bed fixd ht w/o mattresE0255Hospital bed var ht w/ mattrE0256Hospital bed var ht w/o mattE0260Hosp bed semi-electr w/ mattE0261Hosp bed semi-electr w/o matE0265Hosp bed total electr w/ matE0266Hosp bed total elec w/o mattE0271Mattress innerspringE0272Mattress foam rubberE0275Bed pan standardE0276Bed pan fractureE0277Powered pres-redu air mattrsE0280 Bed cradleE0290Hosp bed fx ht w/o rails w/mE0291Hosp bed fx ht w/o rail w/oE0292Hosp bed var ht w/o rail w/oE0293Hosp bed var ht w/o rail w/E0294Hosp bed semi-elect w/ mattrE0295Hosp bed semi-elect w/o mattE0296Hosp bed total elect w/ mattE0297Hosp bed total elect w/o matE0300Enclosed ped crib hosp gradeE0301HD hosp bed, 350-600 lbsE0302Ex hd hosp bed > 600 lbsE0303Hosp bed hvy dty xtra wideE0304Hosp bed xtra hvy dty x wideE0305Rails bed side half lengthE0310Rails bed side full lengthE0316Bed safety enclosureE0325Urinal male jug-typeE0326Urinal female jug-typeE0371Nonpower mattress overlayE0372Powered air mattress overlayE0373Nonpowered pressure mattressE0424Stationary compressed gas 02E0431Portable gaseous 02E0434Portable liquid 02E0439Stationary liquid 02E0441Oxygen contents, gaseousE0442Oxygen contents, liquidE0443Portable 02 contents, gasE0444Portable 02 contents, liquidE0450Vol control vent invasiv intE0457 Chest shellE0459 Chest wrapE0460Neg press vent portabl/statnE0461Vol control vent noninv intE0462Rocking bed w/ or w/o side rE0463Press supp vent invasive intE0464Press supp vent noninv intE0470RAD w/o backup non-inv intfcE0471RAD w/backup non inv intrfcE0472RAD w backup invasive intrfcE0480Percussor elect/pneum home mE0482Cough stimulating deviceE0483Chest compression gen systemE0484Non-elec oscillatory pep dvcE0500Ippb all typesE0550Humidif extens supple w ippbE0560Humidifier supplemental w/ iE0561Humidifier nonheated w PAPE0562Humidifier heated used w PAPE0565Compressor air power sourceE0570Nebulizer with compressionE0571Aerosol compressor for svnebE0572Aerosol compressor adjust prE0574Ultrasonic generator w svnebE0575Nebulizer ultrasonicE0580Nebulizer for use w/ regulatE0585Nebulizer w/ compressor & heE0600Suction pump portab hom modlE0601Cont airway pressure deviceE0602Manual breast pumpE0605Vaporizer room typeE0606Drainage board posturalE0607Blood glucose monitor homeE0610Pacemaker monitr audible/visE0615Pacemaker monitr digital/visE0617Automatic ext defibrillatorKFE0618 Apnea monitorE0619Apnea monitor w recorderE0620Cap bld skin piercing laserE0621Patient lift sling or seatE0627L6130Elbow stump activated lock hL6200Elbow mold outsid lock hingeL6205Elbow molded w/ expand interL6250Elbow inter loc elbow forarmL6300Shlder disart int lock elbowL6310Shoulder passive restor compL6320Shoulder passive restor capL6350Thoracic intern lock elbowL6360Thoracic passive restor compL6370Thoracic passive restor capL6380Postop dsg cast chg wrst/elbL6382Postop dsg cast chg elb dis/L6384Postop dsg cast chg shlder/tL6386Postop ea cast chg & realignL6388Postop applicat rigid dsg onL6400Below elbow prosth tiss shapL6450Elb disart prosth tiss shapL6500Above elbow prosth tiss shapL6550Shldr disar prosth tiss shapL6570Scap thorac prosth tiss shapL6580Wrist/elbow bowden cable molL6582Wrist/elbow bowden cbl dir fL6584Elbow fair lead cable moldedL6586Elbow fair lead cable dir foL6588Shdr fair lead cable moldedL6590Shdr fair lead cable directL6600Polycentric hinge pairL6605Single pivot hinge pairL6610Flexible metal hinge pairL6615Disconnect locking wrist uniL6616Disconnect insert locking wrL6620Flexion/extension wrist unitL6623Spring-ass rot wrst w/ latchL6625Rotation wrst w/ cable lockL6628Quick disconn hook adapter oL6629Lamination collar w/ couplinL6630Stainless steel any wristL6632Latex suspension sleeve eachL6635Lift assist for elbowL6637Nudge control elbow lockL6638Elec lock on manual pw elbowL6640Shoulder abduction joint paiL6641Excursion amplifier pulley tL6642Excursion amplifier lever tyL6645Shoulder flexion-abduction jL6646Multipo locking shoulder jntL6647Shoulder lock actuatorL6648Ext pwrd shlder lock/unlockL6650Shoulder universal jointL6655Standard control cable extraL6660Heavy duty control cableL6665Teflon or equal cable liningL6670Hook to hand cable adapterL6672Harness chest/shlder saddleL6675Harness figure of 8 sing conL6676Harness figure of 8 dual conL6680Test sock wrist disart/bel eL6682Test sock elbw disart/aboveL6684Test socket shldr disart/thoL6686Suction socketL6687Frame typ socket bel elbow/wL6688Frame typ sock above elb/disL6689Frame typ socket shoulder diL6690Frame typ sock interscap-thoL6691Removable insert eachL6692Silicone gel insert or equalL6693Lockingelbow forearm cntrbalL6694Elbow socket ins use w/lockL6695Elbow socket ins use w/o lckL6696Cus elbo skt in for con/atypL6697Cus elbo skt in not con/atypL6698Below/above elbow lock mechL6700Terminal device model #3L6705Terminal device model #5L6710Terminal device model #5xL6715Terminal device model #5xaL6720Terminal device model #6L6725Terminal device model #7L6730Terminal device model #7loL6735Terminal device model #8L6740Terminal device model #8xL6745Terminal device model #88xL6750Terminal device model #10pL6755Terminal device model #10xL6765Terminal device model #12pL6770Terminal device model #99xL6775Terminal device model#555L6780Terminal device model #ss555L6790Hooks-accu hook or equalL6795Hooks-2 load or equalL6800Hooks-aprl vc or equalL6805Modifier wrist flexion unitL6806Trs grip vc or equalL6807Term device grip1/2 or equalL6808Term device infant or childL6809Trs super sport passiveL6810Pincher tool otto bock or eqL6825Hands dorrance voL6830 Hand aprl vcL6835Hand sierra voL6840Hand becker imperialL6845Hand becker lock gripL6850Term dvc-hand becker plyliteL6855Hand robin-aids voL6860Hand robin-aids vo softL6865Hand passive handL6867Hand detroit infant handL6868Passive inf hand steeper/hosL6870Hand child mitt<L6872Hand nyu child handL6873E0994Wheelchair arm restE0995Wheelchair calf restE0997Wheelchair caster w/ a forkE0998Wheelchair caster w/o a forkE0999Wheelchr pneumatic tire w/whE1001Wheelchair wheelE1002 Pwr seat tiltE1003Pwr seat reclineE1004Pwr seat recline mechE1005Pwr seat recline pwrE1006Pwr seat combo w/o shearE1007Pwr seat combo w/shearE1008Pwr seat combo pwr shearE1009Add mech leg elevationE1010Add pwr leg elevationE1011Ped wc modify width adjustmE1014Reclining back add ped w/cE1015Shock absorber for man w/cE1016Shock absorber for power w/cE1017HD shck absrbr for hd man wcE1018HD shck absrber for hd powwcE1020Residual limb support systemE1028W/c manual swingawayE1029W/c vent tray fixedE1030W/c vent tray gimbaledE1031Rollabout chair with castersE1035Patient transfer systemE1037Transport chair, ped sizeE1038Transport chair pt wt <250lbE1039Transport chair pt wt>=250lbE1050Whelchr fxd full length armsE1060Wheelchair detachable armsE1070Wheelchair detachable foot rE1083Hemi-wheelchair fixed armsE1084Hemi-wheelchair detachable aE1087Wheelchair lightwt fixed armE1088Wheelchair lightweight det aE1092Wheelchair wide w/ leg restsE1093Wheelchair wide w/ foot restE1100Whchr s-recl fxd arm leg resE1110Wheelchair semi-recl detachE1150Wheelchair standard w/ leg rE1160Wheelchair fixed armsE1161Manual adult wc w tiltinspacE1170Whlchr ampu fxd arm leg restE1171Wheelchair amputee w/o leg rE1172Wheelchair amputee detach arE1180Wheelchair amputee w/ foot rE1190Wheelchair amputee w/ leg reE1195Wheelchair amputee heavy dutE1200Wheelchair amputee fixed armE1210Whlchr moto ful arm leg restE1211Wheelchair motorized w/ detE1221Wheelchair spec size w footE1222Wheelchair spec size w/ legE1223E1224E1225Manual semi-reclining backE1226Manual fully reclining backE1227Wheelchair spec sz spec ht aE1228Wheelchair spec sz spec ht bE1230Power operated vehicleE1231Rigid ped w/c tilt-in-spaceE1232Folding ped wc tilt-in-spaceE1233Rig ped wc tltnspc w/o seatE1234Fld ped wc tltnspc w/o seatE1235Rigid ped wc adjustableE1236Folding ped wc adjustableE1237Rgd ped wc adjstabl w/o seatE1238Fld ped wc adjstabl w/o seatE1240Whchr litwt det arm leg restE1270Wheelchair lightweight leg rE1280Whchr h-duty det arm leg resE1295Wheelchair heavy duty fixedE1296Wheelchair special seat heigE1297Wheelchair special seat deptE1298Wheelchair spec seat depth/wE1310Whirlpool non-portableE1372Oxy suppl heater for nebulizE1390Oxygen concentratorE1391Oxygen concentrator, dualE1405O2/water vapor enrich w/heatE1406O2/water vapor enrich w/o heE1700Jaw motion rehab systemE1701Repl cushions for jaw motionE1702Repl measr scales jaw motionE1800Adjust elbow ext/flex deviceE1801SPS elbow deviceE1802Adjst forearm pro/sup deviceE1805Adjust wrist ext/flex deviceE1806SPS wrist deviceE1810Adjust knee ext/flex deviceE1811SPS knee deviceE1815Adjust ankle ext/flex deviceE1816SPS ankle deviceE1818SPS forearm deviceE1820Soft interface materialE1821Replacement interface SPSDE1825Adjust finger ext/flex devcE1830Adjust toe ext/flex deviceE1840Adj shoulder ext/flex deviceE1841Static str shldr dev rom adjE2000Gastric suction pump hme mdlE2100Bld glucose monitor w voiceE2101Bld glucose monitor w lanceE2120Pulse gen sys tx endolymp flE2201Man w/ch acc seat w>=20<24E2202Seat width 24-27 inE2203Frame depth less than 22 inE2204Frame depth 22 to 25 inE2205Manual wc accessory, handrimE2206Complete wheel lock assemblyMCP joint repl 2 pc or moreL8641Metatarsal joint implantL8642Hallux implantL8658Interphalangeal joint spacerL8659Interphalangeal joint replL8670Vascular graft, synthetic  # "'8   s!8#II%Z%'6(*~,k@.-80%1 u3b Q5> @7-;9(';=%? 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