71. Complete front caster assembly for wheelchair with two semi-pneumatic tires K0072
72. IV hanger (each) K0105
73. Leg strap (for wheelchair) K0038
74. Lightweight portable motorized wheelchair K0012
75. Replacement alkaline battery, 1.5 volt, for patient-owned external infusion pump K0603
Orthotic Procedures and Devices (L0000-L4999)
76. Cervical wire frame, semi-rigid, for occipital/ mandibular support L0160
77. Custom- fabricated thoracic rib belt L0220
78. HALO procedure; cervical halo incorporated into Milwaukee orthosis L0830
79. Neoprene heel and sole elevation lift (one inch) L3310
80. Posterior solid ankle plastic AFO, custom fabricated L1960
81. Spenco foot insert L3001
Prosthetic Procedures (L5000-L9999)
82. Below-knee disarticulation prosthesis, molded socket, shin, with SACH foot L5301
83. Electric hand, myoelectrical controlled, adult L7007
84. Partial foot prosthesis, shoe insert with longitudinal arch, toe filler L5000
85. Preparatory prosthesis for hip disarticulation-hemipelvectomy; L5595
86. Silicone breast prosthesis L8030
Medical Services (M0000-M0301)
87. Brief office visit to change prescription medication used for treating the patient’s personality disorder M0064
88. Cellular therapy M0075
89. Chemical endarterecomy (IV chelation theraphy) M0300
90. Fabric wrapping of abdominal aneurysm M0301
91. Prolotherapy M0076
Pathology and Laboratory Services (P0000- P9999)
92. Cathererization for collection of specimen (one patient) P9612
93. Congo red, blood P2029
94. Platelets, each unit P9019
95. Two units’ whole blood for transfusion P9010
Q Codes: (Temporary) Diagnostic (Q0035- Q9968)
96. Chemotherapy administration by push Q0083
97. Collagen skin test Q3031
98. Oral magnetic resonance contrast agent, 100 ml Q9945
99. Injection, sermorelin acetate, 1 mcg Q0515
100. KOH preparation Q0112
101. Pinworm examination Q0113
Diagnostic Radiology Services