Chapter 14 Durable Medical Equipment (DME)
Chapter 14 Durable Medical Equipment (DME)
Chapter 14 Durable Medical Equipment (DME)
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<strong>Durable</strong> <strong>Medical</strong> <strong>Equipment</strong> (<strong>DME</strong>) <strong>14</strong><strong>14</strong>.8 Local Code Crosswalk InformationNOTE:Use “Local” procedure codes for dates of services through 12/31/03. Use HCPCSprocedure code, with modifier(s) if applicable, for dates of service 01/01/04 andthereafter.“Local” Codethru 12/31/03HCPCS-Modifier(s)Beginning01/01/04DescriptionZ5117 E1050 Reclining Wheelchair, with fixed arms, swingawaydetachable foot restsZ5119 A4628 Catheters, suctionZ5120 A4625 Tracheostomy Tray (New Trach)Z5120 A4629 Tracheostomy Tray (established Trach)Z5121 A4622 Tracheostomy TubesZ5122 E0280 Hospital Crib w/ MattressZ5124 E1037 Transport chair, pediatric sizeZ5129 E1091 Narrow wheelchair, w/detachable arms, swingawaydetachable foot restsZ5133 E1091 Junior sized standard wheelchairZ5134 E1091 Child's standard wheelchairZ5220 E0779 Auto-syringe infusion pump for iron chelationtherapyZ5221 A4222 Infusion tubing for iron chelation therapyZ5222 A4632 Batteries (5.6 volt) for iron chelation therapyZ5223 E1399, E1340 Auto-syringe infusion pump repair for ironchelation therapyZ5311 A4335 Catheter Care KitZ5313 99503 Respiratory Therapist VisitZ53<strong>14</strong> A9900 Primary Surgical Dressing KitApril 2005 <strong>14</strong>-35
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