Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

A5102 - A5200  Additional Incontinence and Ostomy supplies

A5102
Bedside drainage bottle with or without tubing, rigid or expandable, each
shortBedside drain btl w/wo tube
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
DME1.03 Date of Service Edit: ClinicalPublished Contractor Policy
A5105
Urinary suspensory with leg bag, with or without tube, each
shortUrinary suspensory
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
DME4.03 Date of Service Edit: ClinicalClinical: Data
A5112
Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each
shortUrinary leg bag
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A5113
Leg strap; latex, replacement only, per set
shortLatex leg strap
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME3.03 Date of Service Edit: ClinicalClinical: Data
A5114
Leg strap; foam or fabric, replacement only, per set
shortFoam/fabric leg strap
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME3.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
A5120
Skin barrier, wipes or swabs, each
shortSkin barrier, wipe or swab
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA150.03 Date of Service Edit: ClinicalPublished Contractor Policy
OPH150.03 Date of Service Edit: ClinicalPublished Contractor Policy
DME450.03 Date of Service Edit: ClinicalPublished Contractor Policy
A5121
Skin barrier; solid, 6 x 6 or equivalent, each
shortSolid skin barrier 6x6
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
A5122
Skin barrier; solid, 8 x 8 or equivalent, each
shortSolid skin barrier 8x8
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
A5126
Adhesive or non-adhesive; disk or foam pad
shortDisk/foam pad +or- adhesive
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
A5131
Appliance cleaner, incontinence and ostomy appliances, per 16 oz.
shortAppliance cleaner
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A5200
Percutaneous catheter/tube anchoring device, adhesive skin attachment
shortPercutaneous catheter anchor
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA2.03 Date of Service Edit: ClinicalClinical: Data
OPH2.03 Date of Service Edit: ClinicalClinical: Data