Coding: Browse HCPCS Level II 2020 Edition

Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

Q0477 - Q0509 Ventricular Assist Devices (CMS Temporary Codes)

Q0477

Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Pwr module pt cable lvad rpl

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	1.0	1 Line Edit	Nature of Equipment
OPH	1.0	1 Line Edit	Nature of Equipment

Q0478

Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type

short

Power adapter, combo vad

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	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0479

Power module for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Power module combo vad, rep

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	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0480

Driver for use with pneumatic ventricular assist device, replacement only

short

Driver pneumatic vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: CMS Workgroup
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: CMS Workgroup
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0481

Microprocessor control unit for use with electric ventricular assist device, replacement only

short

Microprcsr cu elec vad, rep

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	1.0	2 Date of Service Edit: Policy	Clinical: Data
OPH	1.0	2 Date of Service Edit: Policy	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0482

Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only

short

Microprcsr cu combo vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0483

Monitor/display module for use with electric ventricular assist device, replacement only

short

Monitor elec vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0484

Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Monitor elec or comb vad rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0485

Monitor control cable for use with electric ventricular assist device, replacement only

short

Monitor cable elec vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0486

Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only

short

Mon cable elec/pneum vad rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0487

Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only

short

Leads any type vad, rep only

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0488

Power pack base for use with electric ventricular assist device, replacement only

short

Pwr pack base elec vad, rep

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	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
OPH	1.0	3 Date of Service Edit: Clinical	Nature of Equipment
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0489

Power pack base for use with electric/pneumatic ventricular assist device, replacement only

short

Pwr pck base combo vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0490

Emergency power source for use with electric ventricular assist device, replacement only

short

Emr pwr source elec vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: CMS Workgroup
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: CMS Workgroup
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0491

Emergency power source for use with electric/pneumatic ventricular assist device, replacement only

short

Emr pwr source combo vad rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0492

Emergency power supply cable for use with electric ventricular assist device, replacement only

short

Emr pwr cbl elec vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0493

Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only

short

Emr pwr cbl combo vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0494

Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Emr hd pmp elec/combo, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0495

Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Charger elec/combo vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0496

Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Battery elec/combo vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0497

Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Bat clps elec/comb vad, rep

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	2.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	2.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0498

Holster for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Holster elec/combo vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0499

Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only

short

Belt/vest elec/combo vad rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0500

Filters for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Filters elec/combo vad, rep

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
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0501

Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Shwr cov elec/combo vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0502

Mobility cart for pneumatic ventricular assist device, replacement only

short

Mobility cart pneum vad, rep

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0503

Battery for pneumatic ventricular assist device, replacement only, each

short

Battery pneum vad replacemnt

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	3.0	3 Date of Service Edit: Clinical	Clinical: CMS Workgroup
OPH	3.0	3 Date of Service Edit: Clinical	Clinical: CMS Workgroup
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0504

Power adapter for pneumatic ventricular assist device, replacement only, vehicle type

short

Pwr adpt pneum vad, rep veh

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data
DME	0.0	3 Date of Service Edit: Clinical	CMS Policy

Q0506

Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only

short

Lith-ion batt elec/pneum vad

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	8.0	3 Date of Service Edit: Clinical	Nature of Equipment
OPH	8.0	3 Date of Service Edit: Clinical	Nature of Equipment

Q0507

Miscellaneous supply or accessory for use with an external ventricular assist device

short

Misc sup/acc ext vad

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	1.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	1.0	3 Date of Service Edit: Clinical	Clinical: Data

Q0508

Miscellaneous supply or accessory for use with an implanted ventricular assist device

short

Mis sup/acc imp vad

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	4.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	24.0	3 Date of Service Edit: Clinical	Clinical: Data

Q0509

Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a

short

Mis sup/ac imp vad nopay med

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	2.0	3 Date of Service Edit: Clinical	Clinical: Data
OPH	2.0	3 Date of Service Edit: Clinical	Clinical: Data