| HCPCS Code: |
A4255 |
| Long Description: |
Platforms for home blood glucose monitor, 50 per box |
| Short Description: |
Glucose monitor platforms |
| Pricing Indicator 1: |
34 (DME supplies (price subject to floors and ceilings)) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Coverage Issues Manual 1: |
60-11 |
| Statute Number: |
|
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
D1E (Other DME) |
| Type of Service Code 1: |
P (Lump sum purchase of DME, prosthetics, orthotics) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-1997 |
| Action Effective Date: |
01-01-2002 |
| Action Code: |
N (No maintenance for this code) |
