| T4529 | Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
| Q4008 | Cast supplies, long arm cast, pediatric (0-10 years), fiberglass |
| Q4020 | Cast supplies, long arm splint, pediatric (0-10 years), fiberglass |
| Q4032 | Cast supplies, long leg cast, pediatric (0-10 years), fiberglass |
| Q4044 | Cast supplies, long leg splint, pediatric (0-10 years), fiberglass |
| Q4036 | Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass |
| Q4016 | Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass |
| Q4015 | Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster |
| E0455 | Oxygen tent, excluding croup or pediatric tents |
| E1011 | Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair) |
| G0047 | Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed |
| G9593 | Pediatric patient with minor blunt head trauma classified as low risk according to the pecarn prediction rules |
| G9597 | Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules |
| Q4012 | Cast supplies, short arm cast, pediatric (0-10 years), fiberglass |
| Q4024 | Cast supplies, short arm splint, pediatric (0-10 years), fiberglass |
| Q4040 | Cast supplies, short leg cast, pediatric (0-10 years), fiberglass |
| Q4048 | Cast supplies, short leg splint, pediatric (0-10 years), fiberglass |
| T4530 | Pediatric sized disposable incontinence product, brief/diaper, large size, each |
| T4532 | Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
| T4531 | Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
| E1037 | Transport chair, pediatric size |
