HCPCS A-Codes
Transportation Services Including Ambulance, Medical & Surgical Supplies

This section covers a wide variety of medical and surgical supplies, as well as some DME-related supplies and accessories. Medicare generally covers DME-related supplies, accessories, maintenance, and repair under the prosthetic devices provision.

  • A4890

    Contracts, repair and maintenance, for hemodialysis equipment

  • A4911

    Drain bag/bottle, for dialysis, each

  • A4913

    Miscellaneous dialysis supplies, not otherwise specified

  • A4918

    Venous pressure clamp, for hemodialysis, each

  • A4927

    Gloves, non-sterile, per 100

  • A4928

    Surgical mask, per 20

  • A4929

    Tourniquet for dialysis, each

  • A4930

    Gloves, sterile, per pair

  • A4931

    Oral thermometer, reusable, any type, each

  • A4932

    Rectal thermometer, reusable, any type, each
  • Continued

  • A5051

    Ostomy pouch, closed; with barrier attached (1 piece), each

  • A5052

    Ostomy pouch, closed; without barrier attached (1 piece), each

  • A5053

    Ostomy pouch, closed; for use on faceplate, each

  • A5054

    Ostomy pouch, closed; for use on barrier with flange (2 piece), each

  • A5055

    Stoma cap

  • A5056

    Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each

  • A5057

    Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each

  • A5061

    Ostomy pouch, drainable; with barrier attached, (1 piece), each

  • A5062

    Ostomy pouch, drainable; without barrier attached (1 piece), each

  • A5063

    Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each

  • A5071

    Ostomy pouch, urinary; with barrier attached (1 piece), each

  • A5072

    Ostomy pouch, urinary; without barrier attached (1 piece), each

  • A5073

    Ostomy pouch, urinary; for use on barrier with flange (2 piece), each

  • A5081

    Stoma plug or seal, any type

  • A5082

    Continent device; catheter for continent stoma

  • A5083

    Continent device, stoma absorptive cover for continent stoma

  • A5093

    Ostomy accessory; convex insert

  • A5102

    Bedside drainage bottle with or without tubing, rigid or expandable, each

  • A5105

    Urinary suspensory with leg bag, with or without tube, each

  • A5112

    Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each
  • Continued

  • A5113

    Leg strap; latex, replacement only, per set

  • A5114

    Leg strap; foam or fabric, replacement only, per set

  • A5120

    Skin barrier, wipes or swabs, each

  • A5121

    Skin barrier; solid, 6 x 6 or equivalent, each

  • A5122

    Skin barrier; solid, 8 x 8 or equivalent, each

  • A5126

    Adhesive or non-adhesive; disk or foam pad

  • A5131

    Appliance cleaner, incontinence and ostomy appliances, per 16 oz.

  • A5200

    Percutaneous catheter/tube anchoring device, adhesive skin attachment

  • A5500

    For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe

  • A5501

    For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe

  • A5503

    For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe

  • A5504

    For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe

  • A5505

    For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe

  • A5506

    For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe

  • A5507

    For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe

  • A5508

    For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe

  • A5510

    For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe

  • A5512

    For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each

  • A5513

    For diabetics only, multiple density insert, custom molded from model of patient's foot, 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

  • A5514

    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