Table of content for "Variable concentration mask" (HCPCS A4620)
General information on the “A4620” code
HCPCS Code: A4620
Long Description: Variable concentration mask
Short Description: Variable concentration mask
Original information is taken from A4620 page
Pricing indicators
Pricing Indicator Code 1: 00 – Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)
Multiple Pricing Indicator Code 9 : Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Certification and additional reference information
Coverage Issues Manual Reference Section Number 1: 60-4
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): D1C – Oxygen and supplies
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 19900101
Code Effective Date: 20090101
Action Code: N – No maintenance for this code