| HCPCS Code: |
A4220 |
| Long Description: |
Refill kit for implantable infusion pump |
| Short Description: |
Infusion pump refill kit |
| Pricing Indicator 1: |
57 (Other carrier priced) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Coverage Issues Manual 1: |
60-14 |
| Statute Number: |
|
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
0050 |
| Berenson-Eggers Type of Service (BETOS) Code: |
D1A (Medical/surgical supplies) |
| Type of Service Code 1: |
P (Lump sum purchase of DME, prosthetics, orthotics) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-1994 |
| Action Effective Date: |
03-03-1998 |
| Action Code: |
N (No maintenance for this code) |
