HCPCS code L8604 — Dextranomer/hyaluronic acid. Status: Active. Effective Jan 1, 2009. Source: CMS HCPCS Level II.

L8604

Active

Dextranomer/hyaluronic acid

Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies

Category: Orthotics & Prosthetics
Section: L-codes: Orthotic and Prosthetic Procedures
Effective: Jan 1, 2009
Code type: alphanumeric
OPPS Status: N — Items / services packaged into APC rates

MUE — Medically Unlikely Edits

Maximum units of L8604 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
Outpatient Hospital 3
Practitioner Services 3

Source: CMS Medicare NCCI Medically Unlikely Edits