2024 Jurisdiction List - JA DME
2024 Jurisdiction List
NOTE: Deleted codes are valid for dates of service on or before the date of deletion.
NOTE: Updated codes are in bold.
NOTE: The jurisdiction list includes codes that are not payable by Medicare. Please consult the Medicare contractor in whose jurisdiction a claim would be filed in order to determine coverage under Medicare.
NOTE: All HCPCs code listed have DME or joint MAC Jurisdiction. Any other codes not listed as DME MAC only or dual DME MAC/Part B MAC jurisdiction shall be considered to be A/B MAC (Part B) only jurisdiction.
SEARCH TIP: Enter only the first two or three digits of the HCPCS code in the search box to display range of codes, then scroll down page to find specific code.
| HCPCS | DESCRIPTION | JURISDICTION | COMMENT |
|---|---|---|---|
| A4206 - A4209 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4210 | Needle Free Injection Device | DME MAC | |
| A4211 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4213 - A4215 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4216 - A4218 | Saline | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4221 - A4239 | Self-Administered Injection and Diabetic Supplies | DME MAC | |
| A4244 - A4250 | Medical, Surgical, and Self-Administered Injection Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4252 - A4259; A4271 | Diabetic Supplies | DME MAC | |
| A4265 | Paraffin | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC | |
| A4280 | Accessory for Breast Prosthesis | DME MAC | |
| A4281 - A4287 | Accessory for Breast Pump | DME MAC | |
| A4305 - A4306 | Disposable Drug Delivery System | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4310 - A4340 | Incontinence Supplies/ Urinary Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A4341 - A4342 | Urinary Supplies | DME MAC | |
| A4344 - A4358 | Incontinence Supplies/ Urinary Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A4360 - A4437 | Urinary Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A4450 - A4452 | Tape; Adhesive Remover | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device. If other, DME MAC. | |
| A4453 | Enema Catheter | DME MAC | |
| A4455 - A4456 | Tape; Adhesive Remover | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device. If other, DME MAC. | |
| A4457 | Enema Tube | Part B MAC if a supply for or inserted by a licensed healthcare provider. If other, DME MAC | |
| A4458 - A4459 | Enema Bag/System | DME MAC | |
| A4461 - A4463 | Surgical Dressing Holders | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4465 - A4468 | Non-elastic Binder and Garment, Strap, Covering, Exsufflation Belt | DME MAC | |
| A4481 | Tracheostomy Supply | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4483 | Moisture Exchanger | DME MAC | |
| A4490 - A4510 | Surgical Stockings | DME MAC | |
| A4520 | Diapers | DME MAC | |
| A4540 - A4545 | Stimulator and Supplies | DME MAC | |
| A4553 - A4554 | Underpads | DME MAC | |
| A4555 - A4558 | Electrodes; Lead Wires; Conductive Paste | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4559 | Coupling Gel | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4560 | Disposable NMES | DME MAC | |
| A4575 | Topical Hyperbaric Oxygen Chamber, Disposable | DME MAC | |
| A4593 - A4594 | Stimulator and Supplies | DME MAC | |
| A4595 | TENS Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4596 | Electrical Stimulator Supplies | DME MAC | |
| A4600 | Sleeve for Intermittent Limb Compression Device | DME MAC | |
| A4601 - A4602 | Lithium Replacement Batteries | DME MAC | |
| A4604 | Tubing for Positive Airway Pressure Device | DME MAC | |
| A4605 | Tracheal Suction Catheter | DME MAC | |
| A4606 | Oxygen Probe for Oximeter | DME MAC | |
| A4608 | Transtracheal Oxygen Catheter | DME MAC | |
| A4611 - A4613 | Oxygen Equipment Batteries and Supplies | DME MAC | |
| A4614 | Peak Flow Rate Meter | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4615 - A4629 | Oxygen & Tracheostomy Supplies | Part B MAC if incident to a physician's service (not separately payable). If other, DME MAC. | |
| A4630 - A4640 | DME Supplies | DME MAC | |
| A4649 | Miscellaneous Surgical Supplies | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A4651 - A4932 | Supplies for ESRD | DME MAC (not separately payable) | |
| A5051 - A5093 | Additional Ostomy Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A5102 - A5200 | Additional Incontinence and Ostomy Supplies | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| A5500 - A5514 | Therapeutic Shoes | DME MAC | |
| A6000 | Non-Contact Wound Warming Cover | DME MAC | |
| A6010 - A6024 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6025 | Silicone Gel Sheet | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6154 - A6411 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6412 | Eye Patch | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6413 | Adhesive Bandage | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6441 - A6457 | Surgical Dressings | Part B MAC if incident to a physician's service (not separately payable), or if supply for implanted prosthetic device or implanted DME. If other, DME MAC. | |
| A6501 - A6512 | Surgical Dressing | Part B MAC if incident to a physician's service (not separately payable) or if supply for implanted prosthetic device or implanted DME. If other, DME MAC | |
| A6513 | Compression Burn Mask | DME MAC | |
| A6520 - A6549 | Gradient Compression Garments | DME MAC | |
| A6550 | Supplies for Negative Pressure Wound Therapy Electrical Pump | DME MAC | |
| A6552 - A6589; A6593 - A6610 | Lymphedema Compression Items | DME MAC | |
| A6590 - A7002 | Accessories for Suction Pumps | DME MAC | |
| A7003 - A7039 | Accessories for Nebulizers, Aspirators and Ventilators | DME MAC | |
| A7044 - A7047 | Respiratory Accessories | DME MAC | |
| A7049 | Respiratory Item | DME MAC | |
| A7501 - A7527 | Tracheostomy Supplies | DME MAC | |
| A8000 - A8004 | Protective Helmets | DME MAC | |
| A9156; A9268 - A9269 | Mucoadhesive and Programable oral capsule | DME MAC | |
| A9270 | Noncovered Items or Services | DME MAC | |
| A9272 | Disposable Wound Suction Pump | DME MAC | |
| A9273 | Hot Water Bottles, Ice Caps or Collars, and Heat and/or Cold Wraps | DME MAC | |
| A9274 - A9278 | Glucose Monitoring | DME MAC | |
| A9279 | Monitoring Feature/Device | DME MAC | |
| A9280 | Alarm Device | DME MAC | |
| A9281 | Reaching/Grabbing Device | DME MAC | |
| A9282 | Wig | DME MAC | |
| A9283 | Foot Off Loading Device | DME MAC | |
| A9284 - A9286 | Non-electric Spirometer, Inversion Devices and Hygienic Items | DME MAC | |
| A9300 | Exercise Equipment | DME MAC | |
| A9900 | Miscellaneous DME Supply or Accessory | Part B MAC if used with implanted DME. If other, DME MAC. | |
| A9901 | Delivery | DME MAC | |
| A9999 | Miscellaneous DME Supply or Accessory | Part B MAC if used with implanted DME. If other, DME MAC. | |
| B4034 - B9999 | Enteral and Parenteral Therapy | DME MAC | |
| E0100 - E0105 | Canes | DME MAC | |
| E0110 - E0118 | Crutches | DME MAC | |
| E0130 - E0159 | Walkers | DME MAC | |
| E0160 - E0175 | Commodes | DME MAC | |
| E0181 - E0199 | Decubitus Care Equipment | DME MAC | |
| E0200 - E0239 | Heat/Cold Applications | DME MAC | |
| E0240 - E0248 | Bath and Toilet Aids | DME MAC | |
| E0249 | Pad for Heating Unit | DME MAC | |
| E0250 - E0304 | Hospital Beds | DME MAC | |
| E0305 - E0326 | Hospital Bed Accessories | DME MAC | |
| E0328 - E0329 | Pediatric Hospital Beds | DME MAC | |
| E0350 - E0352 | Electronic Bowel Irrigation System | DME MAC | |
| E0370 | Heel Pad | DME MAC | |
| E0371 - E0373 | Decubitus Care Equipment | DME MAC | |
| E0424 - E0484 | Oxygen and Related Respiratory Equipment | DME MAC | |
| E0485 - E0486 | Oral Device to Reduce Airway Collapsibility | DME MAC | |
| E0487 | Electric Spirometer | DME MAC | |
| E0490 - E0493 | Oral Neuromuscular Stimulator | DME MAC | |
| E0500 | IPPB Machine | DME MAC | |
| E0530 | Electric Sleep Apnea Treatment | DME MAC | |
| E0550 - E0585 | Compressors/Nebulizers | DME MAC | |
| E0600 | Suction Pump | DME MAC | |
| E0601 | CPAP Device | DME MAC | |
| E0602 - E0604 | Breast Pump | DME MAC | |
| E0605 | Vaporizer | DME MAC | |
| E0606 | Drainage Board | DME MAC | |
| E0607 | Home Blood Glucose Monitor | DME MAC | |
| E0610 - E0615 | Pacemaker Monitor | DME MAC | |
| E0617 | External Defibrillator | DME MAC | |
| E0618 - E0619 | Apnea Monitor | DME MAC | |
| E0620 | Skin Piercing Device | DME MAC | |
| E0621 - E0636 | Patient Lifts | DME MAC | |
| E0637 - E0642 | Standing Devices/Lifts | DME MAC | |
| E0650 - E0683 | Pneumatic/ Non-Pneumatic Devices and Appliances | DME MAC | |
| E0691 - E0694 | Ultraviolet Light Therapy Systems | DME MAC | |
| E0700 | Safety Equipment | DME MAC | |
| E0705 | Transfer Board | DME MAC | |
| E0710 - E0716 | Restraints/Enclosures; Pelvic Device | DME MAC | |
| E0720 - E0745 | Electrical Nerve Stimulators; Rehab System | DME MAC | |
| E0747 - E0748 | Osteogenic Stimulators | DME MAC | |
| E0755 - E0770 | Stimulation Devices | DME MAC | |
| E0776 | IV Pole | DME MAC | |
| E0779 - E0780 | External Infusion Pumps | DME MAC | |
| E0781 | Ambulatory Infusion Pump | DME MAC | |
| E0784 | Infusion Pumps, Insulin | DME MAC | |
| E0791 | Parenteral Infusion Pump | DME MAC | |
| E0830 | Ambulatory Traction Device | DME MAC | |
| E0840 - E0900 | Traction Equipment | DME MAC | |
| E0910 - E0930 | Trapeze/Fracture Frame | DME MAC | |
| E0935 - E0936 | Passive Motion Exercise Device | DME MAC | |
| E0940 | Trapeze Equipment | DME MAC | |
| E0941 | Traction Equipment | DME MAC | |
| E0942 - E0945 | Orthopedic Devices | DME MAC | |
| E0946 - E0948 | Fracture Frame | DME MAC | |
| E0950 - E1298 | Wheelchairs | DME MAC | |
| E1300 - E1310 | Whirlpool Equipment | DME MAC | |
| E1352 - E1392 | Additional Oxygen Related Equipment | DME MAC | |
| E1399 | Miscellaneous DME | Part B MAC if implanted DME. If other, DME MAC. | |
| E1405 - E1406 | Additional Oxygen Equipment | DME MAC | |
| E1500 - E1625 | Artificial Kidney Machines and Accessories | DME MAC (not separately payable) | |
| E1630 - E1699 | Artificial Kidney Machines and Accessories | DME MAC (not separately payable) | |
| E1700 - E1702 | TMJ Device and Supplies | DME MAC | |
| E1800 - E1841 | Dynamic Flexion Devices | DME MAC | |
| E1902 | Communication Board | DME MAC | |
| E1905 | CBT Device | DME MAC | |
| E2000 - E2001 | Suction Pump | DME MAC | |
| E2100 - E2104 | Blood Glucose Monitors with special Features: Continuous Glucose Monitor | DME MAC | |
| E2120 | Pulse Generator for Tympanic Treatment of Inner Ear | DME MAC | |
| E2201 - E2299 | Wheelchair Accessories | DME MAC | |
| E2301 - E2398 | Wheelchair Accessories | DME MAC | |
| E2402 | Negative Pressure Wound Therapy Pump | DME MAC | |
| E2500 - E2599 | Speech Generating Device | DME MAC | |
| E2601 - E2633 | Wheelchair Cushions and Accessories | DME MAC | |
| E3000 - E3200 | Devices | DME MAC | |
| E8000 - E8002 | Gait Trainers | DME MAC | |
| G0333 | Dispensing Fee | DME MAC | |
| J0120 - J0575 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0577 - J0749 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0750 - J0751 | Oral | Part B MAC or DME MAC | |
| J0752 - J0798 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J0799 | NOC Drugs | Part B MAC or DME MAC | |
| J0800 - J1019 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1021 - J1029 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1031 - J1039 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1041 - J1094 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1100 - J1104 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1105 | Oral | Part B MAC if incident to a physician's service If other, DME MAC. | |
| J1106 - J1169 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J1170 has been terminated |
| J1171 - J1839 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1841 - J1849 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J1851 - J2000 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | J2001 has been terminated |
| J2002 - J2402 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2403 | Miscellaneous Drug and Solutions | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC | |
| J2404 - J2779 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2781 - J2786 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2788 - J2919 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2921 - J2929 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J2931 - J3400 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J3401 | Topical | Part B MAC if incident to a physician's service If other, DME MAC. | |
| J3410 - J3570 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7030 - J7131 | Miscellaneous Drugs and Solutions | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7165 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7171 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7340 | Carbidopa/Levodopa | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7500 - J7599 | Immunosuppressive Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J7604 - J7699 | Inhalation Solutions | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| J7799 - J7999 | NOC Drugs, Other than Inhalation Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| J8498 | Anti-emetic Drug | DME MAC | |
| J8499 | Prescription Drug, Oral, Non-Chemotherapeutic | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| J8501 - J8519 | Oral Anti-Cancer Drugs | DME MAC | J8520 and J8521 has been terminated |
| J8522 - J8999 | Oral Anti-Cancer Drugs | DME MAC | |
| J9000 - J9069 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC | |
| J9071 - J9249 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC | |
| J9251 - J9257 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC | J9258 has been terminated |
| J9259 - J9370 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC | |
| J9372 - J9999 | Chemotherapy Drugs | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC | |
| K0001 - K0108 | Wheelchairs | DME MAC | |
| K0195 | Elevating Leg Rests | DME MAC | |
| K0455 | Infusion Pump used for Uninterrupted Administration of Epoprostenal | DME MAC | |
| K0462 | Loaner Equipment | DME MAC | |
| K0552 | External Infusion Pump Supplies | DME MAC | |
| K0555 - K0605 | External Infusion Pump Supplies | DME MAC | |
| K0606 - K0609 | Defibrillator Accessories | DME MAC | |
| K0669 | Wheelchair Cushion | DME MAC | |
| K0672 | Soft Interface for Orthosis | DME MAC | |
| K0730 | Inhalation Drug Delivery System | DME MAC | |
| K0733 | Power Wheelchair Accessory | DME MAC | |
| K0738 | Oxygen Equipment | DME MAC | |
| K0739 | Repair or Nonroutine Service for DME | Part B MAC if implanted DME. If other, DME MAC | |
| K0740 | Repair or Nonroutine Service for Oxygen Equipment | DME MAC | |
| K0743 - K0746 | Suction Pump and Dressings | DME MAC | |
| K0800 - K0899 | Power Mobility Devices | DME MAC | |
| K0900 | Custom DME, other than Wheelchair | DME MAC | |
| K1004 | Devices | DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (e.g., supplies furnished incident to the professional service of a physician) | |
| K1007 | Devices | DME MAC | |
| K1027 | Devices | DME MAC when the supplier considers the item DMEPOS. Part B MAC if the supplier considers the item something other than DMEPOS (e.g., supplies furnished incident to the professional service of a physician) | |
| K1035 - K1037 | Devices | DME MAC | |
| L0112 - L4631 | Orthotics & Devices | DME MAC | |
| L5000 - L5999 | Lower Limb Prosthetics | DME MAC | |
| L6000 - L7499 | Upper Limb Prosthetics | DME MAC | |
| L7510 - L7520 | Repair of Prosthetic Device | Part B MAC if repair of implanted prosthetic device. If other, DME MAC. | |
| L7600 - L8485 | Prosthetics | DME MAC | |
| L8499 | Unlisted Procedure for Miscellaneous Prosthetic Services | Part B MAC if implanted prosthetic device. If other, DME MAC. | |
| L8500 - L8501 | Artificial Larynx; Tracheostomy Speaking Valve | DME MAC | |
| L8505 | Artificial Larynx Accessory | DME MAC | |
| L8507 | Voice Prosthesis, Patient Inserted | DME MAC | |
| L8509 | Voice Prosthesis, Inserted by a Licensed Health Care Provider | Part B MAC for dates of service on or after 10/01/2010. DME MAC for dates of service prior to 10/01/2010 | |
| L8510 | Voice Prosthesis | DME MAC | |
| L8511 - L8515 | Voice Prosthesis | Part B MAC if used with tracheoesophageal voice prostheses inserted by a licensed health care provider. If other, DME MAC | |
| L8701 - L8721 | Devices | DME MAC | |
| L9900 | Miscellaneous Orthotic or Prosthetic Component or Accessory | Part B MAC if used with implanted prosthetic device. If other, DME MAC. | |
| Q0144 | Azithromycin Dihydrate | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| Q0161 - Q0181 | Anti-emetic | DME MAC | |
| Q0510 - Q0514 | Drug Dispensing Fees | DME MAC | |
| Q0516 - Q0520 | Supply fee HIV prep | Part B MAC if incident to a physician's Service, If other, DME MAC | |
| Q2049 - Q2050 | Doxorubicin | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| Q2052 | IVIG | DME MAC | |
| Q4074 | Inhalation Drug | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| Q5101 - Q5138 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| Q9991 - Q9992 | Injection | Part B MAC if incident to a physician's service or used in an implanted infusion pump. If other, DME MAC. | |
| V2020 - V2025 | Frames | DME MAC | |
| V2100 - V2513 | Lenses | DME MAC | |
| V2520 - V2523 | Hydrophilic Contact Lenses | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| V2524 - V2526 | Hydrophilic Contact Lenses | DME MAC | |
| V2530 - V2531 | Contact Lenses, Scleral | DME MAC | |
| V2599 | Contact Lens, Other Type | Part B MAC if incident to a physician's service. If other, DME MAC. | |
| V2600 - V2615 | Low Vision Aids | DME MAC | |
| V2623 - V2629 | Prosthetic Eyes | DME MAC | |
| V2700 - V2780 | Miscellaneous Vision Service | DME MAC | |
| V2781 | Progressive Lens | DME MAC | |
| V2782 - V2784 | Lenses | DME MAC | |
| V2786 | Lens | DME MAC | |
| V2797 | Vision Supply | DME MAC | |
| V2799 | Miscellaneous Vision Service | Part B MAC if supply for an implanted prosthetic device. If other, DME MAC | |
| V5336 | Repair/Modification of Augmentative Communicative System or Device | DME MAC |
Last Updated $dateUtil.getDate( $modifieddate , "MMM dd , yyyy" , $locale , $tzone )
