KVÅKVÅ5A09557 — Assistance with Respiratory Ventilation, Greater than 96 Consecutive Hours, Continuous Positive Airway Pressure
KVÅKVÅ5A09558 — Assistance with Respiratory Ventilation, Greater than 96 Consecutive Hours, Intermittent Positive Airway Pressure
KVÅKVÅ5A09559 — Assistance with Respiratory Ventilation, Greater than 96 Consecutive Hours, Continuous Negative Airway Pressure
KVÅKVÅ5A0955A — Assistance with Respiratory Ventilation, Greater than 96 Consecutive Hours, High Flow/Velocity Cannula
KVÅKVÅ5A0955B — Assistance with Respiratory Ventilation, Greater than 96 Consecutive Hours, Intermittent Negative Airway Pressure
KVÅKVÅ5A09D5K — Assistance with Respiratory Ventilation, Greater than 24 Consecutive Hours, Intubated Prone Positioning
KVÅKVÅB4178 — Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix
KVÅKVÅB4180 — Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix
KVÅKVÅA4720 — Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
KVÅKVÅA4721 — Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
KVÅKVÅA4722 — Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis
KVÅKVÅA4723 — Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis
KVÅKVÅA4724 — Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis
KVÅKVÅA4725 — Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis
KVÅKVÅA4726 — Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis
KVÅKVÅA6232 — Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing
KVÅKVÅA6441 — Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard
KVÅKVÅA6443 — Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard
KVÅKVÅA6444 — Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard
KVÅKVÅA6446 — Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard
KVÅKVÅA6447 — Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard
KVÅKVÅA6449 — Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard
KVÅKVÅA6450 — Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard
KVÅKVÅA6452 — High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard
KVÅKVÅA6454 — Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard
KVÅKVÅA6455 — Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard
KVÅKVÅA6456 — Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard
KVÅKVÅB4152 — Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
KVÅKVÅC2634 — Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mci (nist), per source
KVÅKVÅC2635 — Brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mci (nist), per source
KVÅKVÅE0301 — Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress
KVÅKVÅE0302 — Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress
KVÅKVÅE0303 — Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress
KVÅKVÅE0304 — Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress
KVÅKVÅE0911 — Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar
KVÅKVÅE0912 — Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar
KVÅKVÅE1039 — Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds
KVÅKVÅE1225 — Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each
KVÅKVÅE1226 — Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
KVÅKVÅE2201 — Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches
KVÅKVÅE2502 — Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time
KVÅKVÅE2504 — Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time
KVÅKVÅE2506 — Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time
KVÅKVÅB4160 — Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
KVÅKVÅA6451 — Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard
KVÅKVÅE1036 — Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs
KVÅKVÅA6561 — Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each
