Showing codes K0901 (Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf) — K1028 (Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application)

K0901 - Ko single upright pre ots
Long description: Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Code added date: 20141001.
Code effective date: 20170101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0902 - Ko double upright pre ots
Long description: Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Code added date: 20141001.
Code effective date: 20170101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0903 - Mult den insert dir carv/cam
Long description: For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
Code added date: 20180401.
Code effective date: 20190101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1 - Lwr ext prost functnl lvl 1
Long description: Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator.
Code added date: 19930101.
Code effective date: 19970101.
Coverage Code: C (A code denoting Medicare coverage status).
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K1001 - Electronic posa treatment
Long description: Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
Code added date: 20200101.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1002 - Ces system
Long description: Cranial electrotherapy stimulation (ces) system, any type
Code added date: 20200101.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1003 - Whirlpool tub walkin portabl
Long description: Whirlpool tub, walk-in, portable
Code added date: 20200101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: M (A code denoting Medicare coverage status).
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K1004 - Lo freq us diathermy device
Long description: Low frequency ultrasonic diathermy treatment device for home use
Code added date: 20200101.
Code effective date: 20231001.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: S (A code denoting Medicare coverage status).
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K1005 - Disp col sto bag breast milk
Long description: Disposable collection and storage bag for breast milk, any size, any type, each
Code added date: 20200101.
Code effective date: 20240101.
Pricing Indicator Code(s): 46 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1006 - Suct pum ext urine mgmt sys
Long description: Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system
Code added date: 20201001.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1007 - Bil hkaf pc s/d micro sensor
Long description: Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors
Code added date: 20201001.
Code effective date: 20240101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1009 - Speech volume modulation sys
Long description: Speech volume modulation system, any type, including all components and accessories
Code added date: 20201001.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1010 - Intraurethral drainag device
Long description: Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
Code added date: 20201001.
Code effective date: 20210401.
Pricing Indicator Code(s): 99 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1011 - Acti intraurethral drainage
Long description: Activation device for intraurethral drainage device with valve, replacement only, each
Code added date: 20201001.
Code effective date: 20210401.
Pricing Indicator Code(s): 99 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1012 - Charger base station intraur
Long description: Charger and base station for intraurethral activation device, replacement only
Code added date: 20201001.
Code effective date: 20210401.
Pricing Indicator Code(s): 99 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1013 - Enema tube any type repl
Long description: Enema tube, with or without adapter, any type, replacement only, each
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: S (A code denoting Medicare coverage status).
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K1014 - Ak 4 bar link hydl swg/stanc
Long description: Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1015 - Foot, adductus position, adj
Long description: Foot, adductus positioning device, adjustable
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 46 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1016 - Trans elec nerv for trigemin
Long description: Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1017 - Monthly supp use with k1016
Long description: Monthly supplies for use of device coded at k1016
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 34 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1018 - Ext up limb tremor stim wris
Long description: External upper limb tremor stimulator of the peripheral nerves of the wrist
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1019 - Supp ext up limb tremor stim
Long description: Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 34 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1020 - Non-invasive vagus nerv stim
Long description: Non-invasive vagus nerve stimulator
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1021 - Exsuff belt incl all sup acc
Long description: Exsufflation belt, includes all supplies and accessories
Code added date: 20211001.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: S (A code denoting Medicare coverage status).
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K1022 - Endoskel posit rotat unit
Long description: Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type
Code added date: 20211001.
Code effective date: 20240101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1023 - Trans elec nerv periph nerv
Long description: Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
Code added date: 20211001.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: S (A code denoting Medicare coverage status).
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K1024 - Non pneum comp control cal
Long description: Non-pneumatic compression controller with sequential calibrated gradient pressure
Code added date: 20211001.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1025 - Non pneum compress full arm
Long description: Non-pneumatic sequential compression garment, full arm
Code added date: 20211001.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1026 - Mech allergen parti barrier
Long description: Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical
Code added date: 20211001.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: S (A code denoting Medicare coverage status).
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K1027 - Oral dev without fix mech
Long description: Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment
Code added date: 20211001.
Code effective date: 20211001.
Pricing Indicator Code(s): 99 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1028 - Control unit nm stim w phone
Long description: Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application
Code added date: 20220401.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: S (A code denoting Medicare coverage status).
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