2010 HCPCS Schedule - DE Medical Assistance Program

A4554 DISPOSABLE UNDERPADS 3 $0.20
A4555 PRIMARY SURGICAL DRESSING KIT, (E.G 9 $0.00
A4556 ELECTRODES, PAIR 5 $0.00
A4557 LEAD WIRES, PAIR 3 $17.16
A4558 CONDUCTIVE GEL OR PASTE 3 $4.44
A4559 COUPLING GEL OR PASTE 9 $0.00
A4560 PESSARY O $0.00
A4561 PESSARY RUBBER, ANY TYPE 3 $17.78
A4562 PESSARY, NON RUBBER,ANY TYPE 3 $44.25
A4565 SLINGS 3 $60.00
A4570 SPLINT 3 $50.00
A4572 RIB BELT O $0.00
A4575 HYPERBARIC O2 CHAMBER DISPS 9 $0.00
A4580 CAST SUPPLIES (PLASTER) O $0.00
A4581 SUPPLIES RISSER JACKET 9 $0.00
A4590 SPECIAL CASTING MATERIAL O $0.00
A4595 TENS SUPPL 2 LEAD PER MONTH 3 $27.56
A4600 SLEEVE, INTER LIMB COMP DEV 6 $0.00
A4601 LITH ION BATT, NON-PROS USE 6 $0.00
A4604 TUBING WITH HEATING ELEMENT 3 $66.81
A4605 TRACH SUCTION CATH CLOSE SYS 6 $0.00
A4606 OXYGEN PROBE USED W OXIMETER 5 $0.00
A4608 TRANSTRACHEAL OXYGEN CATH 3 $58.32
A4609 TRACH SUCTION CATH CLSED SYS O $0.00
A4610 TRACH SUCTION CATH CLSED SYS O $0.00
A4611 HEAVY DUTY BATTERY 3 $187.94
A4612 BATTERY CABLES 3 $65.00
A4613 BATTERY CHARGER 3 $137.96
A4614 HAND-HELD PEFR METER 3 $22.75
A4615 CANNULA NASAL 3 $20.00
A4616 TUBING (OXYGEN) PER FOOT 3 $1.00
A4617 MOUTH PIECE 3 $5.00
A4618 BREATHING CIRCUITS 3 $8.51
A4619 FACE TENT 3 $1.21
A4620 VARIABLE CONCENTRATION MASK 3 $20.00
A4621 TRACHEOTOMY MASK OR COLLAR O $0.00
A4622 TRACHEOSTOMY OR LARNGECTOMY O $0.00
A4623 TRACHEOSTOMY INNER CANNULA 3 $6.25
A4624 TRACHEAL SUCTION TUBE 3 $2.25
A4625 TRACH CARE KIT FOR NEW TRACH 3 $6.61
A4626 TRACHEOSTOMY CLEANING BRUSH 3 $3.05
A4627 SPACER BAG/RESERVOIR 9 $0.00
A4628 OROPHARYNGEAL SUCTION CATH 3 $3.51
A4629 TRACHEOSTOMY CARE KIT 3 $4.42
A4630 REPL BAT T.E.N.S. OWN BY PT 3 $5.45
A4631 WHEELCHAIR BATTERY O $0.00
A4632 INFUS PUMP RPLCEMNT BATTERY O $0.00
A4633 UVL REPLACEMENT BULB 3 $41.04
A4634 REPLACEMENT BULB TH LIGHTBOX 5 $0.00