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2016 List of Not Otherwise Classified HCPCS Codes


A4335 Incontinence supply; miscellaneous

A4421 Ostomy supply; miscellaneous

A4641 Radiopharmaceutical, diagnostic, not otherwise classified

A4649 Surgical supply; miscellaneous

A4913 Miscellaneous dialysis supplies, not otherwise specified

A5507 For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe

A6261 Wound filler, gel/paste, per fluid ounce, not otherwise specified

A6262 Wound filler, dry form, per gram, not otherwise specified

A6512 Compression burn garment, not otherwise classified

A6549 Gradient compression stocking/sleeve, not otherwise specified

A9152 Single vitamin/mineral/trace element, oral, per dose, not otherwise specified

A9153 Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified

A9279 Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified

A9280 Alert or alarm device, not otherwise classified

A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml

A9580 Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries

A9698 Non-radioactive contrast imaging material, not otherwise classified, per study

A9699 Radiopharmaceutical, therapeutic, not otherwise classified

A9999 Miscellaneous dme supply or accessory, not otherwise specified

B9998 Noc for enteral supplies

B9999 Noc for parenteral supplies

C2698 Brachytherapy source, stranded, not otherwise specified, per source

C2699 Brachytherapy source, non-stranded, not otherwise specified, per source

E0446 Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories

E0625 Patient lift, bathroom or toilet, not otherwise classified

E0676 Intermittent limb compression device (includes all accessories), not otherwise specified

E0769 Electrical stimulation or electromagnetic wound treatment device, not otherwise classified

E0770 Functional electrical stimulator, transcutaneous stimulation of nerve and/or muscle groups, any type, complete system, not otherwise specified

E1229 Wheelchair, pediatric size, not otherwise specified

E1239 Power wheelchair, pediatric size, not otherwise specified

E1399 Durable medical equipment, miscellaneous

E1699 Dialysis equipment, not otherwise specified

E2599 Accessory for speech generating device, not otherwise classified

G0235 Pet imaging, any site, not otherwise specified

G8701 Rehabilitation services were not ordered, reason not otherwise specified

G9055 Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)

G9213 Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified

G9282 Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)

G9283 Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation

G9284 Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation

G9288 Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)

G9289 Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation

G9290 Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation

G9291 Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos

G9418 Primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation

G9419 Documentation of medical reason(s) for not including the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of primary non-small cell lung cancer or other documented medical reasons) 

G9421 Primary non-small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation

G9422 Primary lung carcinoma resection report documents pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma and not nsclc-nos)

G9424 Specimen site other than anatomic location of lung or classified as nsclc-nos

G9425 Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma) 

G9611 Order for anti-platelet agents or p2y12 antagonists was not documented, reason not otherwise specified

H0046 Mental health services, not otherwise specified

H0047 Alcohol and/or other drug abuse services, not otherwise specified

J0220 Injection, alglucosidase alfa, 10 mg, not otherwise specified

J0256 Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg

J0833 Injection, cosyntropin, not otherwise specified, 0.25 mg

J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg

J7192 Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified

J7195 Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified

J7199 Hemophilia clotting factor, not otherwise classified

J7599 Immunosuppressive drug, not otherwise classified

J7699 Noc drugs, inhalation solution administered through dme

J7799 Noc drugs, other than inhalation drugs, administered through dme

J7999 Compounded drug, not otherwise classified

J8498 Antiemetic drug, rectal/suppository, not otherwise specified

J8499 Prescription drug, oral, non chemotherapeutic, nos

J8597 Antiemetic drug, oral, not otherwise specified

J8999 Prescription drug, oral, chemotherapeutic, nos

J9020 Injection, asparaginase, not otherwise specified, 10,000 units

J9999 Not otherwise classified, antineoplastic drugs

K0108 Wheelchair component or accessory, not otherwise specified

K0812 Power operated vehicle, not otherwise classified

K0898 Power wheelchair, not otherwise classified

L0999 Addition to spinal orthosis, not otherwise specified

L1499 Spinal orthosis, not otherwise specified

L2999 Lower extremity orthoses, not otherwise specified

L3649 Orthopedic shoe, modification, addition or transfer, not otherwise specified

L3999 Upper limb orthosis, not otherwise specified

L5999 Lower extremity prosthesis, not otherwise specified

L7499 Upper extremity prosthesis, not otherwise specified

L8039 Breast prosthesis, not otherwise specified

L8499 Unlisted procedure for miscellaneous prosthetic services

L8699 Prosthetic implant, not otherwise specified

Q2039 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (not otherwise specified)

Q2050 Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg

Q2051 Injection, zoledronic acid, not otherwise specified, 1mg

Q4050 Cast supplies, for unlisted types and materials of casts

Q4051 Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)

Q4082 Drug or biological, not otherwise classified, part b drug competitive acquisition program (cap)

Q4100 Skin substitute, not otherwise specified

Q5009 Hospice or home health care provided in place not otherwise specified (nos)

Q9977 Compounded drug, not otherwise classified

S0590 Integral lens service, miscellaneous services reported separately

S4015 Complete in vitro fertilization cycle, not otherwise specified, case rate

S5130 Homemaker service, nos; per 15 minutes

S5131 Homemaker service, nos; per diem

S5181 Home health respiratory therapy, nos, per diem

S5199 Personal care item, nos, each

S5497 Home infusion therapy, catheter care / maintenance, not otherwise classified; includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem 

S8189 Tracheostomy supply, not otherwise classified

S8301 Infection control supplies, not otherwise specified

S9379 Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem 

S9445 Patient education, not otherwise classified, non-physician provider, individual, per session

S9446 Patient education, not otherwise classified, non-physician provider, group, per session

S9542 Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem 

S9810 Home therapy; professional pharmacy services for provision of infusion, specialty drug administration, and/or disease state management, not otherwise classified, per hour (do not use this code with any per diem code)

S9976 Lodging, per diem, not otherwise classified

S9977 Meals, per diem, not otherwise specified

T1505 Electronic medication compliance management device, includes all components and accessories, not otherwise classified

T1999 Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in “remarks”

T2025 Waiver services; not otherwise specified (nos)

T2028 Specialized supply, not otherwise specified, waiver

T2029 Specialized medical equipment, not otherwise specified, waiver

T2032 Residential care, not otherwise specified (nos), waiver; per month

T2033 Residential care, not otherwise specified (nos), waiver; per diem

T5999 Supply, not otherwise specified

V2199 Not otherwise classified, single vision lens

V2799 Vision item or service, miscellaneous

V5090 Dispensing fee, unspecified hearing aid

V5267 Hearing aid or assistive listening device/supplies/accessories, not otherwise specified

V5274 Assistive listening device, not otherwise specified

V5287 Assistive listening device, personal fm/dm receiver, not otherwise specified

V5298 Hearing aid, not otherwise classified

V5299 Hearing service, miscellaneous


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