Listing of 2008 Discontinued HCPCS Codes
K0553 Combination oral/nasal mask, used with continuous positive airway pressure device, each
K0554 Oral cushion for combination oral/nasal mask, replacement only, each
K0555 Nasal pillows for combination oral/nasal mask, replacement only, pair
L1855 Knee orthosis, molded plastic, thigh and calf sections, with double upright knee joints, custom-fabricated
L1858 Knee orthosis, molded plastic, polycentric knee joints, pneumatic knee pads (CTI), custom-fabricated
L1870 Knee orthosis, double upright, thigh and calf lacers with knee joints, custom-fabricated
L1880 Knee orthosis, double upright, non-molded thigh and calf cuffs/lacers with knee joints, custom-fabricated
Q4087 Injection, immune globulin, (Octogam), intravenous, non-lyophilized (e.g. liquid), 500 mg
Q4088 Injection, immune globulin, (Gammagard liquid), intravenous, non-lyophilized, (e.g. liquid), 500 mg
Q4091 Injection, immune globulin, (Flebogamma), intravenous, non-lyophilized, (e.g. liquid), 500 mg
Q4092 Injection, immune globulin, (Gamunex), intravenous, non-lyophilized (e.g. liquid), 500 mg
Q4093 Albuterol, all formulations including separated isomers, inhalation solution, FDA-approved final product, non-compounded, administered through DME, concentrated form, per 1 mg (Albuterol) or per 0.5 mg (Levalbuterol)
Q4094 Albuterol, all formulations including separated isomers, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose, per 1 mg (Albuterol) or per 0.5 mg (Levalbuterol)
L3800 Wrist hand finger orthosis, short opponens, no attachments, custom-fabricated
L3805 Wrist hand finger orthosis, long opponens, no attachment, custom-fabricated
L3810 WHFO, addition to short and long opponens, thumb abduction (C) bar
L3815 WHFO, addition to short and long opponens, second M.P. abduction assist
L3820 WHFO, addition to short and long opponens, I.P. extension assist, with M.P. extension stop
L3825 WHFO, addition to short and long opponens, M.P. extension stop
L3938 Wrist hand finger orthosis, dorsal wrist, prefabricated, includes fitting and adjustment
L3940 Wrist hand finger orthosis, dorsal wrist, with outrigger attachment, prefabricated, includes fitting and adjustment
L3942 Hand finger orthosis, reverse knuckle bender, prefabricated, includes fitting and adjustment
L3944 Hand finger orthosis, reverse knuckle bender, with outrigger, prefabricated, includes fitting and adjustment
L3946 Hand finger orthosis, composite elastic, prefabricated, includes fitting and adjustment
L3948 Finger orthosis, finger knuckle bender, prefabricated, includes fitting and adjustment
L3950 Wrist hand finger orthosis, combination Oppenheimer with knuckle bender and two attachments, prefabricated, includes fitting and adjustment
L3952 Wrist hand finger orthosis, combination Oppenheimer, with reverse knuckle and two attachments, prefabricated, includes fitting and adjustment
L3954 Hand finger orthosis, spreading hand, prefabricated, includes fitting and adjustment
L3985 Upper extremity fracture orthosis, forearm, hand with wrist hinge, custom-fabricated
L3986 Upper extremity fracture orthosis, combination of humeral, radius/ulnar, wrist, custom fabricated
E2618 Wheelchair accessory, solid seat support base (replaces sling seat), for use with manual wheelchair or lightweight power wheelchair, includes any type mounting hardware
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