Table of content for "Drainable plstic pch w/o fp" (HCPCS A4377)
General information on the “A4377” code
HCPCS Code: A4377
Long Description: Ostomy pouch, drainable, for use on faceplate, plastic, each
Short Description: Drainable plstic pch w/o fp
Original information is taken from A4377 page
Pricing indicators
Pricing Indicator Code 1: 37 – Ostomy, tracheostomy and urological supplies (price subject to floors and ceilings). Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): D1F – Prosthetic/Orthotic devices
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20000101
Code Effective Date: 20030101
Action Code: N – No maintenance for this code