HCPCS Range Miscellaneous Supplies and Services

• 1 Haberman feeder for cleft lip/palate ( S8265 )

• 2 Enuresis alarm, using auditory buzzer and/or vibration device ( S8270 )

• 3 Infection control supplies, not otherwise specified ( S8301 )

• 4 Supplies for home delivery of infant ( S8415 )

• 5 Gradient pressure aid (sleeve and glove combination), custom made ( S8420 )

• 6 Gradient pressure aid (sleeve and glove combination), ready made ( S8421 )

• 7 Gradient pressure aid (sleeve), custom made, medium weight ( S8422 )

• 8 Gradient pressure aid (sleeve), custom made, heavy weight ( S8423 )

• 9 Gradient pressure aid (sleeve), ready made ( S8424 )

• 10 Gradient pressure aid (glove), custom made, medium weight ( S8425 )

• 11 Gradient pressure aid (glove), custom made, heavy weight ( S8426 )

• 12 Gradient pressure aid (glove), ready made ( S8427 )

• 13 Gradient pressure aid (gauntlet), ready made ( S8428 )

• 14 Gradient pressure exterior wrap ( S8429 )

• 15 Padding for compression bandage, roll ( S8430 )

• 16 Compression bandage, roll ( S8431 )

• 17 Splint, prefabricated, digit (specify digit by use of modifier) ( S8450 )

• 18 Splint, prefabricated, wrist or ankle ( S8451 )

• 19 Splint, prefabricated, elbow ( S8452 )

• 20 Camisole, post-mastectomy ( S8460 )

• 21 Insulin syringes (100 syringes, any size) ( S8490 )

• 22 Electrical stimulation of auricular acupuncture points; each 15 minutes of personal one-on-one contact with the patient ( S8930 )

• 23 Equestrian/hippotherapy, per session ( S8940 )

• 24 Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes ( S8948 )

• 25 Complex lymphedema therapy, each 15 minutes ( S8950 )

• 26 Physical or manipulative therapy performed for maintenance rather than restoration ( S8990 )

• 27 Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event) ( S8999 )

• 28 Home uterine monitor with or without associated nursing services ( S9001 )

• 29 Ultrafiltration monitor ( S9007 )

• 30 Paranasal sinus ultrasound ( S9024 )

• 31 Omnicardiogram/cardiointegram ( S9025 )

• 32 Extracorporeal shockwave lithotripsy for gall stones ( S9034 )

• 33 Procuren or other growth factor preparation to promote wound healing ( S9055 )

• 34 Coma stimulation per diem ( S9056 )

• 35 Home administration of aerosolized drug therapy (e.g., pentamidine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem ( S9061 )

• 36 Global fee urgent care centers ( S9083 )

• 37 Services provided in an urgent care center (list in addition to code for service) ( S9088 )

• 38 Vertebral axial decompression, per session ( S9090 )

• 39 Home visit for wound care ( S9097 )

• 40 Home visit, phototherapy services (e.g., Bili-lite), including equipment rental, nursing services, blood draw, supplies, and other services, per diem ( S9098 )

• 41 Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month ( S9110 )

• 42 Back school, per visit ( S9117 )

• 43 Home health aide or certified nurse assistant, providing care in the home; per hour ( S9122 )

• 44 Nursing care, in the home; by registered nurse, per hour ( S9123 )

• 45 Nursing care, in the home; by licensed practical nurse, per hour ( S9124 )

• 46 Respite care, in the home, per diem ( S9125 )

• 47 Hospice care, in the home, per diem ( S9126 )

• 48 Social work visit, in the home, per diem ( S9127 )

• 49 Speech therapy, in the home, per diem ( S9128 )

• 50 Occupational therapy, in the home, per diem ( S9129 )

• 51 Physical therapy; in the home, per diem ( S9131 )

• 52 Diabetic management program, follow-up visit to non-MD provider ( S9140 )

• 53 Diabetic management program, follow-up visit to MD provider ( S9141 )

• 54 Insulin pump initiation, instruction in initial use of pump (pump not included) ( S9145 )

• 55 Evaluation by ocularist ( S9150 )

• 56 Speech therapy, re-evaluation ( S9152 )

• 57 Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device ( S9002 )