2024 HCPCS Code A4220

Refill kit for implantable infusion pump

Short Description	Infusion pump refill kit
Product Note	0050
HCPCS Coverage Code	D - Special coverage instructions apply
HCPCS Action Code	N - No maintenance for this code
HCPCS Action Effective Date	March 03, 1998
HCPCS Code Added Date	January 01, 1994
HCPCS Pricing Indicator Code	57 - Other carrier priced
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Issues Manual Reference Section Number	60-14
HCPCS Type Of Service Code	P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Anesthesia Base Unit Quantity	0