Coding: Browse HCPCS Level II 2020 Edition

Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

A7501 - A7527 Tracheostomy Supplies

A7501

Tracheostoma valve, including diaphragm, each

short

Tracheostoma valve w diaphra

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	3.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7502

Replacement diaphragm/faceplate for tracheostoma valve, each

short

Replacement diaphragm/fplate

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	3.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7503

Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each

short

Hmes filter holder or cap

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	1.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7504

Filter for use in a tracheostoma heat and moisture exchange system, each

short

Tracheostoma hmes filter

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	180.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	200.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7505

Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each

short

Hmes or trach valve housing

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	2.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7506

Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each

short

Hmes/trachvalve adhesivedisk

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	0.0	3 Date of Service Edit: Clinical	CMS Policy
DME	200.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7507

Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each

short

Integrated filter & holder

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	200.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	200.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7508

Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each

short

Housing & integrated adhesiv

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	0.0	3 Date of Service Edit: Clinical	CMS Policy
DME	200.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7509

Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each

short

Heat & moisture exchange sys

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	0.0	3 Date of Service Edit: Clinical	CMS Policy
DME	200.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7520

Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each

short

Trach/laryn tube non-cuffed

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	1.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7521

Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each

short

Trach/laryn tube cuffed

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	1.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7522

Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each

short

Trach/laryn tube stainless

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	0.0	3 Date of Service Edit: Clinical	CMS Policy
DME	1.0	2 Date of Service Edit: Policy	Published Contractor Policy

A7523

Tracheostomy shower protector, each

short

Tracheostomy shower protect

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Ajudication Indicator	Rationale
PRA	3 Date of Service Edit: Clinical	CMS Policy
OPH	3 Date of Service Edit: Clinical	CMS Policy
DME	3 Date of Service Edit: Clinical	Published Contractor Policy

A7524

Tracheostoma stent/stud/button, each

short

Tracheostoma stent/stud/bttn

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	1.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7525

Tracheostomy mask, each

short

Tracheostomy mask

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	0.0	3 Date of Service Edit: Clinical	CMS Policy
DME	3.0	2 Date of Service Edit: Policy	Published Contractor Policy

A7526

Tracheostomy tube collar/holder, each

short

Tracheostomy tube collar

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	0.0	3 Date of Service Edit: Clinical	CMS Policy
DME	100.0	3 Date of Service Edit: Clinical	Published Contractor Policy

A7527

Tracheostomy/laryngectomy tube plug/stop, each

short

Trach/laryn tube plug/stop

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	CMS Policy
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	2.0	3 Date of Service Edit: Clinical	Published Contractor Policy