Surgical NOTE #1: For Medicare Outpatient Hospital procedures, C1776 [Joint device (implantable)] and C1713 [Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)] might be allowable for purposes of billing for Zimmer implantable devices and products. Please check with your Payer(s) for complete billing and reimbursement details. NOTE #2: For implantable devices and products in the Zimmer Catalog, there are no separately reportable HCPCS codes for billing Inpatient Hospital Medicare procedures on the UB-04 Claim Form. These implantable devices and products are considered integral to the procedure performed, and the Medicare MS-DRG payment includes their costs in the total facility payment. Revenue Code(s) in the 027X range could be appended on the UB-04 claim form to track facility charges for such implantable devices and products. Please check with your Payer(s) for complete billing and reimbursement details. # EDI Item # Item Header 1 Header 2 Type 60-3000-101-00 60300010100 ATS 3000 TOURNIQUET W/HOSES AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 3000 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-3000-102-00 60300010200 ATS 3000 TOURNIQUET W/HOSES & AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 3000 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS 60-3000-103-00 60300010300 ATS 3000 TOURNIQUET W/HOSES, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 3000 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS, STD, BSKT 60-3000-104-00 60300010400 ATS 3000 TOURNIQUET W/HOSES, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 3000 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A STAND, BASKET 62-2100-096-00 62210009600 MANUAL, ATS3000 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 3000 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-1200-101-00 60120010100 ATS1200 TOURNIQUET W/HOSES AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 1200 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-1200-102-00 60120010200 ATS1200 TOURNIQUET W/HOSES & AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 1200 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS 60-1200-103-00 60120010300 ATS 1200 TOURNIQUET W/HOSES, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 1200 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS, STD, BSKT 60-1200-104-00 60120010400 ATS 1200 TOURNIQUET W/HOSES, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 1200 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A STAND, BASKET 62-8000-015-00 62800001500 MANUAL, ATS1200 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 1200 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-101-00 60075010100 ATS 750 TOURNIQUET W/HOSE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 750 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-102-00 60075010200 ATS 750 TOURNIQUET W/HOSE & AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 750 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS 60-0750-103-00 60075010300 ATS 750 TOURNIQUET W/HOSE, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 750 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS, STD, BSKT 60-0750-104-00 60075010400 ATS 750 TOURNIQUET W/HOSE, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 750 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A STAND, BASKET 60-2000-110-00 60200011000 ATS 2000 CALIBRATION KIT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 2000 TOURNIQUET SYSTEM Tourniquets Tourniquets (Extremity) N/A N/A N/A ACCESSORIES 62-2000-101-00 62200010100 ATS 2000 MANUAL W/CUFF ALERT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 2000 TOURNIQUET SYSTEM Tourniquets Tourniquets (Extremity) N/A N/A N/A ACCESSORIES 60-7070-053-00 60707005300 18 DPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7070-056-00 60707005600 34 DPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7070-152-00 60707015200 12 DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7070-153-00 60707015300 18 DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7070-154-00 60707015400 24 DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7070-155-00 60707015500 30 DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7070-156-00 60707015600 34 DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7070-157-00 60707015700 42 DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 1
# EDI Item # Item Header 1 Header 2 60-7075-052-00 60707505200 12 SPSB STER DISP CUFF LUER LOCK W/SLEEVE Type AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-053-00 60707505300 18 SPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-054-00 60707505400 24 SPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-055-00 60707505500 30 SPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-056-00 60707505600 34 SPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-152-00 60707515200 12 SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-153-00 60707515300 18 SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-154-00 60707515400 24 SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-155-00 60707515500 30 SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-156-00 60707515600 34 SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7075-157-00 60707515700 42 SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7080-152-00 60708015200 18 DPDB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 60-7080-153-00 60708015300 24 DPDB STER DISP CUFF PLC WSLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 2
# EDI Item # Item Header 1 Header 2 60-7070-001-00 60707000100 8 DPSB STER DISP CUFF LUER LOCK Type AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-002-00 60707000200 12 DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-003-00 60707000300 18 DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-004-00 60707000400 24 DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-005-00 60707000500 30 DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-006-00 60707000600 34 DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-007-00 60707000700 42 DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-101-00 60707010100 8 DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-102-00 60707010200 12 DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-103-00 60707010300 18 DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-104-00 60707010400 24 DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-105-00 60707010500 30 DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7070-106-00 60707010600 34 DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 3
# EDI Item # Item Header 1 Header 2 Type 60-7070-107-00 60707010700 42 DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-001-00 60707500100 8 SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-002-00 60707500200 12 SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-003-00 60707500300 18 SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-004-00 60707500400 24 SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-005-00 60707500500 30 SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-006-00 60707500600 34 SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-007-00 60707500700 42 SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-101-00 60707510100 8 SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-102-00 60707510200 12 SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-103-00 60707510300 18 SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-104-00 60707510400 24 SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-105-00 60707510500 30 SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 4
# EDI Item # Item Header 1 Header 2 Type 60-7075-106-00 60707510600 34 SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7075-107-00 60707510700 42 SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7080-001-00 60708000100 12 DPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7080-002-00 60708000200 18 DPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7080-003-00 60708000300 24 DPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7080-101-00 60708010100 12 DPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7080-102-00 60708010200 18 DPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7080-103-00 60708010300 24 DPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7085-001-00 60708500100 12 SPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7085-002-00 60708500200 18 SPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7085-003-00 60708500300 24 SPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7085-101-00 60708510100 12 SPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7085-102-00 60708510200 18 SPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 5
# EDI Item # Item Header 1 Header 2 Type 60-7085-103-00 60708510300 24 SPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 60-7500-001-00 60750000100 8 DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7500-002-00 60750000200 12 DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7500-003-00 60750000300 18 DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7500-004-00 60750000400 24 DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7500-005-00 60750000500 30 DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7500-006-00 60750000600 34 DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7500-007-00 60750000700 42 DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7555-001-00 60755500100 12 DPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7555-002-00 60755500200 18 DPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7555-003-00 60755500300 24 DPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7600-001-00 60760000100 8 SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7600-002-00 60760000200 12 SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 6
# EDI Item # Item Header 1 Header 2 60-7600-003-00 60760000300 18 SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Type Tourniquets Tourniquets (Extremity) 60-7600-004-00 60760000400 24 SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7600-005-00 60760000500 30 SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7600-006-00 60760000600 34 SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7600-007-00 60760000700 42 SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7666-001-00 60766600100 12 SPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7666-002-00 60766600200 18 SPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7666-003-00 60766600300 24 SPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7350-002-00 60735000200 SPSB CONTOUR UPPER LIMB CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-7350-003-00 60735000300 SPSB CONTOUR THIGH CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-7350-004-00 60735000400 SPSB CONTOUR LOWER LEG CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-7350-011-00 60735001100 SPDB CONTOUR UPPPER LIMB IVRA CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-7450-002-00 60745000200 DPSB CONTOUR UPPER LIMB CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 7
# EDI Item # Item Header 1 Header 2 60-7450-003-00 60745000300 DPSB CONTOUR THIGH CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Type Tourniquets Tourniquets (Extremity) 60-7450-004-00 60745000400 DPSB CONTOUR LOWER LEG CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-7450-011-00 60745001100 DPDB CONTOUR UPPER LIMB IVRA CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-7500-008-00 60750000800 DPSB CONTOUR CUFF - XL (30 IN-39 IN) AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) XL CONTOUR CUFFS (REUSABLE, NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7600-008-00 60760000800 SPSB CONTOUR CUFF - XL (30 IN-39 IN) AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) XL CONTOUR CUFFS (REUSABLE, NON- STERILE) Tourniquets Tourniquets (Extremity) 60-7920-001-00 60792000100 PROT.SLEEVE/CONT.ARM CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFF SLEEVES Tourniquets Tourniquets (Extremity) 60-7920-002-00 60792000200 PROT.SLEEVE/CONT.THIGHCUF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFF SLEEVES Tourniquets Tourniquets (Extremity) 60-7920-003-00 60792000300 PROT.SLEEVE/CONT.LEG CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFF SLEEVES Tourniquets Tourniquets (Extremity) 60-8000-001-00 60800000100 SPSB EXTRA SMALL ADULT CUFF 3 IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-8000-002-00 60800000200 SPSB SMALL ADULT CUFF 3.5 IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-8100-001-00 60810000100 DPSB EXTRA SMALL ADULT CUFF 3 IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-8100-002-00 60810000200 DPSB SMALL ADULT CUFF 3.5 IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 60-7910-001-00 60791000100 PROT. SLEEVE/ X-SM ADULT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT SLEEVES Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 8
# EDI Item # Item Header 1 Header 2 Type 60-7910-002-00 60791000200 PROT. SLEEVE/ SM ADULT 10 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT SLEEVES Tourniquets Tourniquets (Extremity) 60-8000-008-00 60800000800 8 INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) 60-8000-012-00 60800001200 12 INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) 60-8000-018-00 60800001800 18 INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) 60-8000-024-00 60800002400 24 INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) 60-8000-030-00 60800003000 30 INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) 60-8000-034-00 60800003400 34 INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) 60-8000-042-00 60800004200 42 INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-001-00 60269400100 ESMARK BANDAGES, DISP, 3IN X 9FT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) STER 60-2694-002-00 60269400200 ESMARK BANDAGES, DISP 4INX 9FT STER AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-003-00 60269400300 ESMARK BANDAGES, DISP, 6IN X 9FT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) STER 60-2694-004-00 60269400400 ESMARK BANDAGES, DISP, 3IN X 12FT STER AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-005-00 60269400500 ESMARK BANDAGES, DISP, 4IN X 12FT STER AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 9
# EDI Item # Item Header 1 Header 2 60-2694-006-00 60269400600 ESMARK BANDAGES, DISP, 6IN X 12FT STER Type AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-011-00 60269401100 LATEX FREE ESMARK 3IN. X 9FT. AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-012-00 60269401200 LATEX FREE ESMARK 4IN. X 9FT. AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-013-00 60269401300 LATEX FREE ESMARK 5.5IN X 9FT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-014-00 60269401400 LATEX FREE ESMARK 3IN. X 12FT. AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-015-00 60269401500 LATEX FREE ESMARK 4IN. X 12FT. AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-2694-016-00 60269401600 LATEX FREE ESMARK 5.5IN X 12FT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 60-1812-001-00 60181200100 DUAL STERILE EXTENSION HOSE W/LUER LOCK CONNECTOR AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) 60-1812-101-00 60181210100 DUAL STERILE EXTENSION HOSE W/PLC CONNECTOR AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) 60-2790-001-00 60279000100 ATS 500/750/1200 HOSE, RED/WE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-2790-002-00 60279000200 ATS 500/750/1200 HOSE, BLUE/W AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-4009-001-00 60400900100 SINGLE STERILE EXTENSION HOSE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) W/LUER LOCK CONNECTR 60-4009-101-00 60400910100 SINGLE STERILE EXTENSION HOSE W/PLC CONNECTOR AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) 60-4017-001-00 60401700100 ATS 1500/2000 DUAL HOSE, BLU/W AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-4018-001-00 60401800100 ATS 1500/2000 DUAL HOSE, RED/W AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-7300-105-00 60730010500 CPC-TO-LUER ADAPTORS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-7500-100-00 60750010000 A.T.S. DUAL HOSE RETROFIT KIT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-7600-100-00 60760010000 A.T.S. 500 HOSE RETROFIT KIT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-7600-300-00 60760030000 RED UNIVERSAL HOSE ADAPTERS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-7600-400-00 60760040000 BLUE UNIVERSAL HOSE ADAPTERS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 61-7308-000-00 61730800000 O-RINGS FOR TOURNIQUET CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A 06-0015-012-63 06001501263 CALIBRATION HOSE ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 06-0020-013-70 06002001370 PLUMBING ASSY ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-01 60075000001 CONTROL BOARD ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-02 60075000002 BATTERY ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-03 60075000003 MEMBRANE CONTROL PANEL ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 10
# EDI Item # Item Header 1 Header 2 Type 60-0750-000-04 60075000004 12 VOLT PUMP ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-05 60075000005 CASE BASE ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-06 60075000006 CASE LID ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-07 60075000007 ROTARY KNOB ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-08 60075000008 BATTERY BRACKET ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-09 60075000009 DEFLATE VALVE ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-10 60075000010 POWER ENTRY MODULE ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-11 60075000011 MAIN WIRE HARNESS ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-12 60075000012 BATTERY HARNESS ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-13 60075000013 OVERPRESSURE SWITCH HARNESS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-0750-000-14 60075000014 OVERPRESSURE SWITCH ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-2000-000-03 60200000003 PUMP W/O TUBING ATS2000 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-2000-000-06 60200000006 VALVE 24VOLT CLIPPARD SLOW AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-2000-000-07 60200000007 VALVE 24VOLT BURKERT:FAST AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-2000-000-08 60200000008 FUSE 1A 5X20MM AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1131-001-00 62113100100 ALARM SILENCE SWITCH W/O LAMP AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1132-001-00 62113200100 ALARM SILENCE LAMP AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1133-001-00 62113300100 ALARM SILENCE LENS RED AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1134-001-00 62113400100 FEET W/O SCREWS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1137-001-00 62113700100 FUSE DRAWER 1/4IN X 1 1/4IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1138-001-00 62113800100 FUSE DRAWER 5X20 CM AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1168-001-00 62116800100 ALARM SILENCE HARNESS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1169-001-00 62116900100 SPEAKER HARNESS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1175-001-00 62117500100 8 OHM SPEAKER AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1179-001-00 62117900100 1 AMPTIME DELAY 1 1/4IN (3.2 CM) AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A GLASS FUSE 62-1180-001-00 62118000100 PUMP GASKET AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-1184-001-00 62118400100 GRAY POWER CORD AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-8000-018-00 62800001800 MAINS WIRING HARNESS, ATS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 62-8000-019-00 62800001900 CORD CLIP, ATS1200 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-1908-001-00 60190800100 TOURNIQUET ACCESSORY BASKET AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. ACCESSORIES Tourniquets Tourniquets (Extremity) N/A N/A N/A 60-4022-001-00 60402200100 TOURNIQUET STAND, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. ACCESSORIES Tourniquets Tourniquets (Extremity) N/A N/A N/A TELESCOPING, W/28 BASE 00-5150-420-01 00515042001 PULSAVAC PLUS COMPONENT KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 00-5150-475-01 00515047501 PULSAVAC PLUS FAN SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 00-5150-482-01 00515048201 PULSAVAC PLUS HIP KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 00-5150-495-01 00515049501 PULSAVAC PLUS SHOWER SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 00-5150-420-00 00515042000 PULSAVAC PLUS COMPONENT KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 00-5150-475-00 00515047500 PULSAVAC PLUS FAN KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 00-5150-482-00 00515048200 PULSAVAC PLUS HIP KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 11
Type # EDI Item # Item Header 1 Header 2 00-5150-495-00 00515049500 PULSAVAC PLUS SHOWER KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 00-5150-350-00 00515035000 PULSAVAC PLUS AC POWER SUPPLY WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( US Debridement Debridement) 00-5150-426-01 00515042601 PULSAVAC PLUS A/C COMPONENT KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( Debridement Debridement) 00-5150-476-01 00515047601 PULSAVAC PLUS AC FAN SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( Debridement Debridement) 00-5150-486-01 00515048601 PULSAVAC PLUS AC HIP KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( Debridement Debridement) 00-5150-496-01 00515049601 PULSAVAC PLUS AC SHOWER SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( Debridement Debridement) 00-5150-920-00 00515092000 PULSAVAC PLUS (LOW PRESSURE) COMPONENT KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS LOW PRESSURE Pulsavac ( Debridement Debridement) 00-5150-975-00 00515097500 PULSAVAC PLUS (LOW PRESSURE) FAN SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS LOW PRESSURE Pulsavac ( Debridement Debridement) 00-5150-995-00 00515099500 PULSAVAC PLUS (LOW PRESSURE) SHOWER SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS LOW PRESSURE Pulsavac ( Debridement Debridement) 00-5150-145-00 00515014500 ADJUSTABLE LENGTH IM TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-155-00 00515015500 SINGLE STREAM TIP W/SPLASH SHIELD HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-175-00 00515017500 FAN SPRAY TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-176-00 00515017600 FAN SPRAY TIP W/FILTER HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-181-00 00515018100 FOUR ORIFICES IM TIP HI-CAP 20.32CM X 1.27CM WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 12
# EDI Item # Item Header 1 Header 2 00-5150-182-00 00515018200 RADIAL SPRAY IM TIP HI-CAP 22.86CM X.89 CM Type WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-183-00 00515018300 FEMORAL BRUSH TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-184-00 00515018400 HIP REVISION TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-185-00 00515018500 FOUR ORIFICES IM TIP HI-CAP 30.48CM X 1.27CM WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-187-00 00515018700 TIBIAL PLATEAU BRUSH TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-195-00 00515019500 SHOWER SPRAY TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 00-5150-188-00 00515018800 7IN SPLASH SHIELD WOUND DEBRIDEMENT PRODUCTS SPLASH SHIELDS Pulsavac ( Debridement Debridement) N/A N/A N/A 00-5150-189-00 00515018900 9IN SPLASH SHIELD WOUND DEBRIDEMENT PRODUCTS SPLASH SHIELDS Pulsavac ( Debridement Debridement) N/A N/A N/A 00-5150-375-00 00515037500 SHIELDLESS FAN SPRAY TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS SHIELDLESS TIPS Pulsavac ( Debridement Debridement) 00-5150-395-00 00515039500 SHIELDLESS SHOWER SPRAY TIP HI- WOUND DEBRIDEMENT PRODUCTS SHIELDLESS TIPS Pulsavac ( CAP Debridement Debridement) 00-5150-065-00 00515006500 WIDE SINGLE STREAM IM TIP WOUND DEBRIDEMENT PRODUCTS MISCELLANEOUS TIPS Pulsavac ( Debridement Debridement) 00-5150-186-00 00515018600 FLEXIBLE TIP WOUND DEBRIDEMENT PRODUCTS MISCELLANEOUS TIPS Pulsavac ( Debridement Debridement) 00-5150-042-00 00515004200 DUAL SPIKE Y-CONNECTOR WOUND DEBRIDEMENT PRODUCTS MISCELLANEOUS Pulsavac ( Debridement Debridement) 00-1500-050-10 00150005010 HEMOVAC INFECTION CONTROL BAG PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 00-2550-001-10 00255000110 HEMOVAC INFECTION CONTROLKIT, 3/32 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 13
# EDI Item # Item Header 1 Header 2 00-2550-002-10 00255000210 HEMOVAC INFECTION CONTROLKIT, 1/8 PVC DRAIN Type PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 00-2550-003-10 00255000310 HEMOVAC INFECTION CONTROLKIT, 3/16 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 00-2550-004-10 00255000410 HEMOVAC INFECTION CONTROLKIT, 1/4 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 00-2550-050-10 00255005010 400ML HEMOVAC INFECTION CONTROL COMPONENT KIT PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 00-2550-702-10 00255070210 BONDED HEMOVAC INF CTRL, 1/8 PVC W/TROCAR DRN CLMP PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 00-2550-703-10 00255070310 BONDED HEMOVAC INF CTRL, 3/16 PVC W/TROCR DRN CLMP PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 00-2550-704-10 00255070410 BONDED HEMOVAC INF CTRL, 1/4 PVC W/TROCAR DRN CLMP PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 00-2500-700-10 00250070010 400ML HEMOVAC KIT 1/8 IN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC 00-2505-700-10 00250570010 400ML HEMOVAC KIT 3/16 IN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC 00-2590-700-10 00259070010 400ML HEMOVAC KIT 1/4 IN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC 00-2500-000-10 00250000010 400ML HEMOVAC KIT, 1/8 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC 00-2500-004-10 00250000410 400ML HEMOVAC COMPONENT KIT PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC 00-2505-000-10 00250500010 400ML HEMOVAC KIT, 3/16 SOFT PVC PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed DRAIN PVC 00-2590-000-10 00259000010 400ML HEMOVAC KIT, 1/4 PVC DRAIN, PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed 4 IN TROCAR PVC 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 14
# EDI Item # Item Header 1 Header 2 00-2590-040-10 00259004010 400ML HEMOVAC KIT, 1/4 PVC DRAIN, PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed 5 IN TROCAR Type PVC 00-2595-000-10 00259500010 400ML HEMOVAC KIT, 3/32 IN PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC 00-2500-900-10 00250090010 HYDROCOAT PVC KIT, 1/8 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS - HYDROCOAT Closed PVC 00-2505-900-10 00250590010 HYDROCOAT PVC KIT, 3/16 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS - HYDROCOAT Closed PVC 00-2590-900-10 00259090010 HYDROCOAT PVC KIT, 1/4 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS - HYDROCOAT Closed PVC 00-5300-000-10 00530000010 400ML SURGIVAC KIT, 1/8 IN PVC DRAIN PVC CLOSED WOUND DRAINAGE SURGIVAC KITS Closed PVC 00-5300-004-10 00530000410 400ML SURGIVAC COMPONENT KIT PVC CLOSED WOUND DRAINAGE SURGIVAC KITS Closed PVC 00-5305-000-10 00530500010 400ML SURGIVAC KIT, 3/16 IN PVC DRAIN PVC CLOSED WOUND DRAINAGE SURGIVAC KITS Closed PVC 00-5390-040-10 00539004010 400ML SURGIVAC KIT, 1/4 PVC DRAIN PVC CLOSED WOUND DRAINAGE SURGIVAC KITS Closed W/TROCAR, LARGE PVC 00-1500-021-10 00150002110 3/32 IN PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC 00-1500-022-10 00150002210 1/8 IN PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC 00-1500-023-10 00150002310 3/16 IN SOFT PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC 00-1500-024-10 00150002410 3/16 IN FIRM PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC 00-1500-025-10 00150002510 1/4 IN PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 15
# EDI Item # Item Header 1 Header 2 00-1500-032-10 00150003210 1/8 IN PVC DRAIN, DUAL TROCARS PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed Type PVC 00-1500-033-10 00150003310 3/16 IN PVC DRAIN, DUAL TROCARS PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC 00-1500-035-10 00150003510 1/4 PVC DRAIN, DUAL TROCARS PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC 00-1500-028-10 00150002810 1/8 IN PVC DRAIN, END- PERFORATED PVC CLOSED WOUND DRAINAGE END PERFORATED PVC DRAINS Closed PVC 00-1500-005-10 00150000510 5 IN TROCARS, 1/8 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC 00-1500-011-10 00150001110 5 IN TROCARS, 3/32 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC 00-1500-014-10 00150001410 4 IN TROCARS, 1/4 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC 00-1500-020-10 00150002010 5 IN TROCARS, 1/4 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC 00-1509-014-10 00150901410 5 IN TROCARS, 3/16 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC 00-1500-002-10 00150000210 EVACUATOR TUBING PVC CLOSED WOUND DRAINAGE ACCESSORIES Closed PVC 00-1500-015-10 00150001510 UNIVERSAL Y-CONNECTOR PVC CLOSED WOUND DRAINAGE ACCESSORIES Closed PVC 00-1500-060-10 00150006010 SUCTION ADAPTER PVC CLOSED WOUND DRAINAGE ACCESSORIES Closed PVC 00-1535-000-10 00153500010 DIRECTIONAL FLOW CONTROL PVC CLOSED WOUND DRAINAGE ACCESSORIES Closed PVC 00-2540-000-10 00254000010 400ML HEMOVAC,1/8 SILICONE ROUND DRAIN W/TROCAR SILICONE CLOSED WOUND DRAINAGE HEMOVAC KITS Closed Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 16
# EDI Item # Item Header 1 Header 2 00-2541-000-10 00254100010 400ML HEMOVAC 3/16 SILICONE ROUND DRAIN W/TROCAR Type SILICONE CLOSED WOUND DRAINAGE HEMOVAC KITS Closed Silicone 00-2545-000-10 00254500010 400ML HEMOVAC, 1/4 SILICONE ROUND DRAIN W/TROCAR SILICONE CLOSED WOUND DRAINAGE HEMOVAC KITS Closed Silicone 00-2535-000-10 00253500010 100ML HEMOVAC 3/32 ROUND W/TROCAR, SMALL STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2536-000-10 00253600010 100ML HEMOVAC, 1/8 ROUND W/TROCAR, MEDIUM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2537-000-10 00253700010 100ML HEMOVAC 3/16 ROUND W/TROCAR, SOFT STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2538-000-10 00253800010 100ML MINI-BULB, 1/4 SILICONE ROUND W/TROCAR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2560-000-10 00256000010 100ML HEMOVAC FULL PERF FLAT W/TROC 7MMX20CM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2561-000-10 00256100010 100ML HEMOVAC FULL PERF FLT W/TROC 10MMX20CM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2562-000-10 00256200010 100ML HEMOVAC 3/4 PERF FLAT W/TROC 7MMX20CM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2563-000-10 00256300010 100ML HEMOVAC 3/4 PERF FLAT W/TROC 10MMX20CM STR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2564-000-10 00256400010 100ML HEMOVAC FULL PERF W/O TROCAR 7MM X 20CM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2565-000-10 00256500010 100ML HEMOVAC FULL PERF FLT W/OTROC 10MMX20CM STR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2566-000-10 00256600010 100ML HEMOVAC 3/4 PERF FLT W/O TROC 7MMX20CM STR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 00-2567-000-10 00256700010 100ML HEMOVAC 3/4 PERF FLT W/OTROC 10MMX20CM STR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 17
# EDI Item # Item Header 1 Header 2 00-2568-000-10 00256800010 100ML MINI-HEMOVAC BULB SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Type Silicone 00-2557-000-10 00255700010 100ML MINI-HEMOVAC INFECTION CONTROL KIT SILICONE CLOSED WOUND DRAINAGE MINI-HEMOVAC INFECTION CONTROL KITS Closed Silicone 00-2558-000-10 00255800010 150ML COLLECTION BAG FOR MINI- HEMOVAC BULB SILICONE CLOSED WOUND DRAINAGE MINI-HEMOVAC INFECTION CONTROL KITS Closed Silicone 00-5340-000-10 00534000010 400ML SURGIVAC 1/8 DRAIN ROUND W/TROCAR SILICONE CLOSED WOUND DRAINAGE SURGIVAC KITS Closed Silicone 00-5341-000-10 00534100010 400ML SURGIVAC 3/16 DRAINROUND SILICONE CLOSED WOUND DRAINAGE SURGIVAC KITS Closed W/TROCAR, SOFT Silicone 00-5345-000-10 00534500010 400ML SURGIVAC 1/4 DRAIN ROUND W/TROCAR SILICONE CLOSED WOUND DRAINAGE SURGIVAC KITS Closed Silicone 00-2540-069-10 00254006910 SILICONE FLAT DRAIN W/TROCAR, FULL PERF, 7MMX20CM SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 00-2540-070-10 00254007010 SILICONE FLAT DRAIN W/TROCAR, FULL PERF, 10MMX20CM SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 00-2540-071-10 00254007110 SILICONE FLAT DRAIN W/TROCAR, 3/4 PERF, 7MM X 20CM SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 00-2540-072-10 00254007210 SILICONE FLAT DRAIN W/TROCAR, 3/4 PERF, 10MMX20CM SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 00-2569-000-10 00256900010 7MM X 20CM SILICONE FLAT DRAIN, FULL-PERFORATED SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 00-2570-000-10 00257000010 10MM X 20CM SILICONE FLAT DRAIN, SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed FULL-PERFORATED Silicone 00-2571-000-10 00257100010 7MM X 20CM SILICONE FLAT DRAIN, 3/4-PERFORATED SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 00-2572-000-10 00257200010 10MM X 20CM 3/4-PERFORATED SILICONE FLAT DRAIN SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 18
# EDI Item # Item Header 1 Header 2 00-2573-000-10 00257300010 7MMX 30CM FULL PERF SILICONE FLAT DRAIN Type SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 00-2574-000-10 00257400010 10MM X 30CM SILICONE FLATDRAIN, FULL-PERFORATED SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 00-2540-001-10 00254000110 3/32 IN SILICONE ROUND DRAIN, END-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-002-10 00254000210 1/8 IN SILICONE ROUND DRAIN, END- SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed PERFORATED Silicone 00-2540-003-10 00254000310 1/8 IN SILICONE ROUND DRAIN, MIDDLE-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-004-10 00254000410 3/16 IN SILICONE ROUND DRAIN, MIDDLE-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-007-10 00254000710 3/16 IN SILICONE ROUND DRAIN, END-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-008-10 00254000810 1/4 IN SILICONE ROUND DRAIN, END- SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed PERFORATED Silicone 00-2540-010-10 00254001010 3/32 IN SILICONE ROUND DRAIN, MIDDLE-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-013-10 00254001310 1/4 IN SILICIONE ROUND DRAIN, MIDDLE-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-021-10 00254002110 3/32 IN SILICONE ROUND DRAIN, END-PERFORATED W/TRO SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-022-10 00254002210 1/8 IN SLICONE ROUND DRAIN, END- PERFORATED W/TROCA SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-023-10 00254002310 3/16 IN SILICONE ROUND DRAIN, END-PERFORATED W/TRO SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-024-10 00254002410 1/4 IN SILICONE ROUND DRAIN, END- SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed PERFORATED W/TROC Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 19
# EDI Item # Item Header 1 Header 2 00-2540-025-10 00254002510 SILICONE DRAIN, 3/32 DRAIN W/TROCAR MIDDLE PERF Type SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-026-10 00254002610 SILICONE DRAIN, 1/8 DRAIN W/TROCAR, MIDDLE PERF SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-027-10 00254002710 SILICONE DRAIN, 3/16 DRAIN W/TROCAR, MIDDLE PERF SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-028-10 00254002810 SILICONE DRAIN, 1/4 DRAIN W/TROCAR, MIDDLE PERF SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone 00-2540-922-10 00254092210 HEMOVAC HYDROCOAT, 1/8 RND, END PERF W/TROCAR STER SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2540-923-10 00254092310 HEMOVAC HYDROCOAT, 3/16 ROUND, END PERF W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2540-924-10 00254092410 HEMOVAC HYDROCOAT, 1/4 ROUND, END PERF W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2540-926-10 00254092610 HEMOVAC HYDROCOAT, 1/8 ROUND, MIDDLE PERF W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2540-927-10 00254092710 HEMOVAC HYDROCOAT, 3/16 RND, MDL PERF W/TROCR STER SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2540-928-10 00254092810 HEMOVAC HYDROCOAT, 1/4 ROUND, MIDDLE PERF W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2569-900-10 00256990010 HEMOVAC HYDROCOAT FLAT DRAIN FULL PERF 7MM X 20CM SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2570-900-10 00257090010 10MM X 20CM FULLY PERF HEMOVAC HYROCOAT FLT DRN SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2571-900-10 00257190010 7MM X 20CM 3/4 PERF HEMOVAC HYDROCOAT FLT DRN SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 00-2572-900-10 00257290010 10MM X 20CM 3/4 PERF HEMOVAC HYDROCOAT FLT DRN SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 20
# EDI Item # Item Header 1 Header 2 00-2540-950-10 00254095010 1/8 IN HYDROCOAT QUAD-LUMEN DRAIN W/TROCAR Type SILICONE CLOSED WOUND DRAINAGE HYDROCOAT QUAD-LUMEN DRAINS Closed Silicone 00-2540-951-10 00254095110 3/16 IN HYDROCOAT QUAD-LUMEN DRAIN W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT QUAD-LUMEN DRAINS Closed Silicone 00-2540-952-10 00254095210 1/4 IN HYDROCOAT QUAD-LUMEN DRAIN W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT QUAD-LUMEN DRAINS Closed Silicone 00-2540-016-10 00254001610 Y-CONNECTOR (FOR 3/32 AND 1/8 ROUND DRAINS) SILICONE CLOSED WOUND DRAINAGE ACCESSORIES Closed Silicone 00-2540-017-10 00254001710 Y-CONNECTORS (FOR 3/16 & 1/4 ROUND & FLAT DRAINS) SILICONE CLOSED WOUND DRAINAGE ACCESSORIES Closed Silicone 00-2540-018-10 00254001810 BIFURCATED DRAIN EXTENSIONS SILICONE CLOSED WOUND DRAINAGE ACCESSORIES Closed Silicone 00-2540-019-10 00254001910 SUCTION ADAPTER SILICONE CLOSED WOUND DRAINAGE ACCESSORIES Closed Silicone 00-2555-020-05 00255502005 HEMOVAC AUTOTRANSFUSION AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A SYSTEM, 1/8 PVC DRAIN (H.A.S.) on 00-2555-030-05 00255503005 HEMOVAC AUTOTRANSFUSION AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A SYSTEMS, 3/16 PVC DRAIN (H.A.S.) on 00-2555-040-05 00255504005 HEMOVAC AUTOTRANSFUSION AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A SYSTEMS, 1/4 PVC DRAIN (H.A.S.) on 00-2555-050-05 00255505005 HAS COLLECTION BOTTLE AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A REPLACEMENT (H.A.S.) on 00-2555-060-05 00255506005 HEMOVAC AUTOTRANSFUSION AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A SYSTEM, NO DRAIN (H.A.S.) on 00-2556-020-06 00255602006 ZIMMER BLOOD REINFUSION AUTOTRANSFUSION PRODUCTS ZIMMER BLOOD REINFUSION SYSTEM Autotransfusi Zimmer Blood Reinfusion N/A N/A N/A SYSTEM 1/8 (Z.B.R.S.) on System 00-2556-030-06 00255603006 ZIMMER BLOOD REINFUSION AUTOTRANSFUSION PRODUCTS ZIMMER BLOOD REINFUSION SYSTEM Autotransfusi Zimmer Blood Reinfusion N/A N/A N/A SYSTEM 3/16 (Z.B.R.S.) on System 00-2556-040-06 00255604006 ZIMMER BLOOD REINFUSION AUTOTRANSFUSION PRODUCTS ZIMMER BLOOD REINFUSION SYSTEM Autotransfusi Zimmer Blood Reinfusion N/A N/A N/A SYSTEM 1/4 (Z.B.R.S.) on System 00-2556-060-06 00255606006 ZIMMER BLOOD REINFUSION AUTOTRANSFUSION PRODUCTS ZIMMER BLOOD REINFUSION SYSTEM Autotransfusi Zimmer Blood Reinfusion N/A N/A N/A SYSTEM, NO DRAIN (Z.B.R.S.) on System 00-1044-028-00 00104402800 ADVANCE 1115 STRAIGHT TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-029-00 00104402900 ADVANCE 1115 OFFSET TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-030-00 00104403000 ADVANCE 1115 4POSTER OFFSET TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-031-00 00104403100 ADVANCE 1115 STRAIGHT STL TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-032-00 00104403200 ADVANCE 1115 OFFSET 4POSTER ST TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-033-00 00104403300 STRYKER MPS STRAIGHT ABL TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-034-00 00104403400 STRYKER MPS OFFSET ABS TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-035-00 00104403500 STRYKER MPS OFFSET ABS TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 4POSTER 00-1044-036-00 00104403600 STRYKER MPS STRAIGHT STL TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-037-00 00104403700 STRYKER MPS OFFSET STS TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-038-00 00104403800 STRYKER MPS 4POSTER STS TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-1044-039-00 00104403900 HILL-ROM 840 4POSTER TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 00-2700-020-00 00270002000 TOTALCARE FRAME-BALKAN KIT- TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A COMPLETE 00-2700-026-00 00270002600 CAREASSIST FRAME -BALKAN KIT- TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A COMPLETE 00-2700-029-00 00270002900 VERSACARE FRAME-BALKAN KIT- TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A COMPLETE 00-0619-001-00 00061900100 SWIVEL BAR W/PULLEY, 9 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0619-002-00 00061900200 DOUBLE PULLEY BAR, 18 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 21
# EDI Item # Item Header 1 Header 2 Type 00-0640-001-00 00064000100 PLAIN BAR, 96 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-002-00 00064000200 SWIVEL CLAMP BAR, 66 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-004-00 00064000400 SINGLE CLAMP BAR, 9 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-005-00 00064000500 SINGLE CLAMP BAR, 18 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-006-00 00064000600 SINGLE CLAMP BAR, 27 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-007-00 00064000700 SINGLE CLAMP BAR, 36 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-011-00 00064001100 CENTER CLAMP BAR, 36 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-019-00 00064001900 IV BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-021-00 00064002100 CURVED DOUBLE CLAMP BAR, 24 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-023-00 00064002300 PLAIN BAR, 85 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-023-01 00064002301 85 REINFORCED OVERHEAD BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-024-00 00064002400 OFFSET SWIVEL CLAMP BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-029-00 00064002900 HEAVY DUTY PLAIN BAR, 96 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-037-00 00064003700 ZIMCO TRACTION PULLEY ASSY TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-038-00 00064003800 PLASTISOL PLUG TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-042-00 00064004200 SWIVEL CLAMP ASSEMBLY W/KNOB TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-048-00 00064004800 KNOB-LOCK SCREW ASSY TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-067-00 00064006700 TRAPEZE TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-086-00 00064008600 CAP TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-092-00 00064009200 LOCKING SLEEVE TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0640-106-00 00064010600 S HOOK ONLY TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-0648-000-00 00064800000 SPREADER BAR, 22 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1038-002-00 00103800200 DOUBLE CLAMP BAR, 27 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1038-003-00 00103800300 IV POST W/CLAMP, 4 1/2 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1038-004-00 00103800400 OFFSET DOUBLE CLAMP BAR, 27 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1042-002-00 00104200200 PLAIN BAR, 36 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1042-003-00 00104200300 SWIVEL CLAMP BAR, 48 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1042-006-00 00104200600 ADJUSTABLE BAR, OVERHEAD, TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A LONG 00-1042-007-00 00104200700 SMOOTH-TRAC TRACTION BAR, TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A LONG 00-1042-015-00 00104201500 ADJUSTABLE BAR, TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A OVERHEAD,SHORT 00-1042-090-00 00104209000 SMOOTH TRAC TRACTION TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A BAR,SHORT 00-1044-005-00 00104400500 IV POST W/CLAMP, 9 3/4 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1044-006-00 00104400600 IV POST W/CLAMP, 13 3/4 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1044-007-00 00104400700 IV POST W/CLAMP, 18 3/4 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1066-003-00 00106600300 DOUBLE CLAMP BAR, 35 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1066-005-00 00106600500 OFFSET DOUBLE CLAMP BAR, 35 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1083-003-00 00108300300 SINGLE CLAMP BAR, 5 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1234-001-00 00123400100 IV POST W/CLAMP, 3 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1234-009-00 00123400900 IV POST W/CLAMP, 24 5/8 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1236-001-00 00123600100 IV POST W/CLAMP, 13 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1238-001-00 00123800100 IV POST W/CLAMP, 19 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1238-002-00 00123800200 IV POST W/CLAMP, 10 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1238-003-00 00123800300 DOUBLE CLAMP BAR, 31 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1238-004-00 00123800400 OFFSET DOUBLE CLAMP, 31 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1238-011-00 00123801100 ANGLED IV POST W/CLAMP, 19 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1238-022-00 00123802200 IV POST W/CLAMP 22 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1238-023-00 00123802300 ANGLED IV POST W/CLAMP, 23 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1241-001-00 00124100100 IV POST W/CLAMP, 16 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1241-008-00 00124100800 IV POST W/CLAMP, 24 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1241-021-00 00124102100 IV POST W/CLAMP, 28 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1241-044-00 00124104400 PLAIN BAR, 44 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1241-045-00 00124104500 ANGLED IV POST W/CLAMP, 13 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1241-048-00 00124104800 ANGLED IV POST W/CLAMP, 18 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1242-001-00 00124200100 IV POST W/CLAMP, 5 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1247-001-00 00124700100 IV POST W/CLAMP, 20 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-1247-003-00 00124700300 IV POST W/CLAMP, 12 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-021-00 00270002100 TOTALCARE-VERTICAL POST-61IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-021-01 00270002101 VERSACARE VERTICAL POST- 69IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-022-00 00270002200 TOTALCARE IV POST BRACKETHEAD TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-023-00 00270002300 TOTALCARE IV POST BRACKETFOOT TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-024-00 00270002400 CAREASSIST BRACKET HEAD TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-025-00 00270002500 CAREASSIST BRACKET FOOT TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-028-00 00270002800 VERSACARE BRACKET, FOOT TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-040-00 00270004000 TOTAL CARE 40 IN PLAIN BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 00-2700-042-00 00270004200 VERSACARE 42 IN PLAIN BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 22
# EDI Item # Item Header 1 Header 2 Type 00-0032-007-00 00003200700 VINYL PAD HALF-RING CHILD TRACTION TRACTION ACCESSORIES Traction Traction E0870 Y TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCKS) Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0032-008-00 00003200800 VINYL PAD HALF-RING YOUTH TRACTION TRACTION ACCESSORIES Traction Traction E0870 Y TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCKS) Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0032-009-00 00003200900 VINYL PAD HALF-RING ADULT TRACTION TRACTION ACCESSORIES Traction Traction E0870 Y TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCKS) Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0032-015-00 00003201500 SLING, FULL LENGTH TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0033-001-00 00003300100 PEARSON ATTACHMENT CHILD 48CM TRACTION TRACTION ACCESSORIES Traction Traction 00-0033-002-00 00003300200 PEARSON ATTACHMENT YOUTH 53CM TRACTION TRACTION ACCESSORIES Traction Traction 00-0033-003-00 00003300300 PEARSON ATTACHMENT ADULT 64CM TRACTION TRACTION ACCESSORIES Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 23
# EDI Item # Item Header 1 Header 2 Type 00-0034-001-00 00003400100 FOOT SUPPORT, 26 CM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE STRAP, EACH, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-0034-002-00 00003400200 HEEL REST, 13 CM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE STRAP, EACH, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-0056-001-00 00005600100 CANVAS KNEE SLING TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS 00-0056-002-00 00005600200 BUNKER FT PIECE W/PULLEY TRACTION TRACTION ACCESSORIES Traction Traction E0941 Y Gravity assisted traction device, any type, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-0056-008-00 00005600800 POLYESTER PILE KNEE SLING TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS 00-0056-011-00 00005601100 POLYESTER PILE KNEE SLING TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0057-001-00 00005700100 SERRATED CLIPS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0057-002-00 00005700200 ZIM CLIP TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0057-003-00 00005700300 MINI-CLIPS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0111-003-00 00011100300 FOLDING BED CRADLE TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0112-002-00 00011200200 BOHLER BRAUN LEG SPLINT TRACTION TRACTION ACCESSORIES Traction Traction A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 24
# EDI Item # Item Header 1 Header 2 Type 00-0113-002-00 00011300200 CANVAS SLINGS TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0114-004-00 00011400400 BOHLER-STEINMANN PIN HOLDER, 9 TRACTION TRACTION ACCESSORIES Traction Traction X 8CM 00-0114-005-00 00011400500 BOHLER-STEINMANN PIN HOLDER, 16 X 11CM TRACTION TRACTION ACCESSORIES Traction Traction 00-0114-006-00 00011400600 BOHLER-STEINMANN PIN HOLDER, 21 X 11CM TRACTION TRACTION ACCESSORIES Traction Traction 00-0114-054-00 00011405400 REPLACEMENT THUMB SCREW TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0121-001-00 00012100100 KIRSCHNER WIRE TRACTOR TRACTION TRACTION ACCESSORIES Traction Traction 14X10CM 00-0121-002-00 00012100200 KIRSCHNER WIRE TRACTOR 19X17CM TRACTION TRACTION ACCESSORIES Traction Traction 00-0121-003-00 00012100300 KIRSCHNER WIRE TRACTOR 24X 17CM TRACTION TRACTION ACCESSORIES Traction Traction 00-0176-002-00 00017600200 WEIGHT CARRIER, 15 CM TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0176-003-00 00017600300 WEIGHT CARRIER, 22 CM TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0176-004-00 00017600400 WEIGHT CARRIER, 30 CM TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0183-001-00 00018300100 CAST IRON TRACTION WEIGHT, 1 LB TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0183-002-00 00018300200 CAST IRON TRACTION WEIGHT, 2 LB TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0183-003-00 00018300300 CAST IRON TRACTION WEIGHT, 5 LB TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0184-001-00 00018400100 NYLON CORD, 100 FEET TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0213-000-00 00021300000 DICOSOLA ROPE HOLDER TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0286-000-00 00028600000 S-HOOK TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0311-000-00 00031100000 ST. JOSEPH BED CRADLE TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0325-000-00 00032500000 TRACTION FINGER APPARATUS, ADULT TRACTION TRACTION ACCESSORIES Traction Traction 00-0325-001-00 00032500100 FINGER GRIP, SMALL TRACTION TRACTION ACCESSORIES Traction Traction 00-0325-002-00 00032500200 FINGER GRIP, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction 00-0325-003-00 00032500300 FINGER GRIP, LARGE TRACTION TRACTION ACCESSORIES Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 25
# EDI Item # Item Header 1 Header 2 Type 00-0325-004-00 00032500400 FINGER GRIP, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction 00-0325-010-00 00032501000 TRACTION FINGER APPARATUS,PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction 00-0619-003-00 00061900300 PANEL CLAMP - BUCK'S TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0640-003-00 00064000300 TRAPEZE, HEAVY DUTY TRACTION TRACTION ACCESSORIES Traction Traction E0911 Y TRAPEZE BAR, HEAVY DUTY, FOR PATIENT WEIGHT CAPACITY GREATER THAN 250 POUNDS, ATTACHED TO BED, WITH GRAB BAR, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-0640-008-00 00064000800 PULLEY TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0640-012-00 00064001200 WALL BUMPER HORNS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0640-013-00 00064001300 PANEL CLAMP, UPPER TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0640-014-00 00064001400 PANEL CLAMP, LOWER TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0640-018-00 00064001800 WALL BUMPER ROLLER TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0849-001-00 00084900100 SPREADER BAR, 6 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0849-002-00 00084900200 SPREADER BAR, 8 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0849-003-00 00084900300 SPREADER BAR, 9 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0849-004-00 00084900400 SPREADER BAR, 12 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0905-005-00 00090500500 SPREADER BAR, STEPHAN, 8 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A MINIMUM TO 16 MAXIMUM 00-0920-000-00 00092000000 NELSON FINGER EXERCISER TRACTION TRACTION ACCESSORIES Traction Traction 00-0923-002-00 00092300200 SPREADER BLOCK, 2 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0923-003-00 00092300300 SPREADER BLOCK, 3 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0923-004-00 00092300400 SPREADER BLOCK, 4 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0967-001-00 00096700100 TRACTION CORD, 33 YDS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0967-002-00 00096700200 TRACTION CORD, 100 YDS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-0967-003-00 00096700300 TRACTION CORD, 250 YDS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1015-002-00 00101500200 TRACTION CART HOOK KIT TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1036-000-00 00103600000 MOBILE TRACTION UNIT-COMPACT TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1036-017-00 00103601700 MOBILE TRACTION UNIT, X-LONG TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1042-004-00 00104200400 CROSS CLAMP TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1231-005-00 00123100500 BRADY SPLINT ASSEMBLY TRACTION TRACTION ACCESSORIES Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 26
# EDI Item # Item Header 1 Header 2 Type 00-1231-009-00 00123100900 FOOT EXERCISER PAD TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1231-011-00 00123101100 BRADY BALANCED SUSPENSION SYSTEM TRACTION TRACTION ACCESSORIES Traction Traction 00-1231-015-00 00123101500 PEARSON ATTACHMENT, BRADY TRACTION TRACTION ACCESSORIES Traction Traction 00-1231-016-00 00123101600 FOOT EXERCISER ASSEMBLY TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1231-017-00 00123101700 BILATERAL CLAMP ASSEMBLY TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1231-028-00 00123102800 SPLINT PAD RING TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1232-000-00 00123200000 THOMAS LEG SPLINT SET, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-001-00 00123200100 THOMAS LEG SPLINT, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-002-00 00123200200 THOMAS LEG SPLINT, SMALL TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-003-00 00123200300 THOMAS LEG SPLINT, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-004-00 00123200400 THOMAS LEG SPLINT, LARGE TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-005-00 00123200500 THOMAS LEG SPLINT SET, SMALL TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-006-00 00123200600 THOMAS LEG SPLINT SET, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-007-00 00123200700 SLINGS TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 27
# EDI Item # Item Header 1 Header 2 Type 00-1232-008-00 00123200800 THOMAS LEG SPLINT SET, LARGE TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-009-00 00123200900 FOOT SUPPORT SLING TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-010-00 00123201000 STRAP CLAMPS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1232-011-00 00123201100 THOMAS LEG SPLINT SET, X-WIDE TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-012-00 00123201200 PEARSON ATTACHMENT, SMALL TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-013-00 00123201300 PEARSON ATTACHMENT, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-014-00 00123201400 PEARSON ATTACHMENT, LARGE TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-015-00 00123201500 PEARSON ATTACHMENT, X-WIDE TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-016-00 00123201600 SLINGS, EXTRA WIDE TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS 00-1232-017-00 00123201700 FOOT SUPPORT, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 28
# EDI Item # Item Header 1 Header 2 Type 00-1232-018-00 00123201800 FOOT SUPPORT, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-019-00 00123201900 FOOT SUPPORT, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-020-00 00123202000 FOOT SUPPORT, X-WIDE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-021-00 00123202100 HEEL REST, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-022-00 00123202200 HEEL REST, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-023-00 00123202300 HEEL REST, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 29
# EDI Item # Item Header 1 Header 2 Type 00-1232-024-00 00123202400 HEEL REST, X-LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-025-00 00123202500 RING PAD, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-026-00 00123202600 RING PAD, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-027-00 00123202700 RING PAD, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-028-00 00123202800 RING PAD, X-LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-030-00 00123203000 RING STRAP, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 30
# EDI Item # Item Header 1 Header 2 Type 00-1232-031-00 00123203100 RING STRAP, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-032-00 00123203200 RING STRAP, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-033-00 00123203300 RING STRAP, X-LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-034-00 00123203400 PEARSON ATTACHMENT, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction 00-1232-035-00 00123203500 FULL LENGTH SLING TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS 00-1232-038-00 00123203800 SLINGS, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS 00-1232-105-00 00123210500 RADIOLUCENT SPLINT X-WIDE TRACTION TRACTION ACCESSORIES Traction Traction Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1232-125-00 00123212500 KODEL RING PAD, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 31
# EDI Item # Item Header 1 Header 2 Type 00-1232-126-00 00123212600 KODEL RING PAD, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1232-127-00 00123212700 KODEL RING PAD, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1232-128-00 00123212800 KODEL THOMAS RING PAD TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1232-136-00 00123213600 FOOT SUPPORT TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1232-137-00 00123213700 HEEL REST TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 00-1294-001-00 00129400100 TRACTION BAR END GUARDS TRACTION TRACTION ACCESSORIES Traction Traction 00-1469-008-00 00146900800 HEAVY DUTY PULLEY TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1600-050-00 00160005000 SINGLE BAG HOOK TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 00-1600-051-00 00160005100 MULTIPLE BAG HOOK TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 32
# EDI Item # Item Header 1 Header 2 00-1601-002-00 00160100200 ZIMCODE TRACTION WEIGHT BAG, 10 LBS Type TRACTION TRACTION ACCESSORIES Traction Traction 00-1602-001-00 00160200100 SAND WEIGHT BAG, 1 LB TRACTION TRACTION ACCESSORIES Traction Traction 00-1602-002-00 00160200200 SAND WEIGHT BAG, 2 LBS TRACTION TRACTION ACCESSORIES Traction Traction 00-1602-005-00 00160200500 SAND WEIGHT BAG, 5 LBS TRACTION TRACTION ACCESSORIES Traction Traction 00-1602-010-00 00160201000 SAND WEIGHT BAG, 10 LBS TRACTION TRACTION ACCESSORIES Traction Traction 00-3860-001-00 00386000100 FLEX-FOAM TRACTION STRIPS, 2 X 42 TRACTION TRACTION ACCESSORIES Traction Traction 00-3860-002-00 00386000200 FLEX-FOAM TRACTION STRIPS 3X 42 TRACTION TRACTION ACCESSORIES Traction Traction 00-3860-003-00 00386000300 FLEX-FOAM TRACTION STRIPS 4 X 42 TRACTION TRACTION ACCESSORIES Traction Traction 00-3861-001-00 00386100100 FLEX-FOAM TRACTION STRIPS 2 IN X 25 YDS TRACTION TRACTION ACCESSORIES Traction Traction 00-3861-002-00 00386100200 FLEX-FOAM TRACTION STRIPS 3 IN X 25 YDS TRACTION TRACTION ACCESSORIES Traction Traction 00-3861-003-00 00386100300 FLEX-FOAM TRACTON STRIPS 4 IN X TRACTION TRACTION ACCESSORIES Traction Traction 25 YDS 00-3874-001-00 00387400100 SKIN-TRAC TRACTION STRIP, 2 X 24 TRACTION TRACTION ACCESSORIES Traction Traction 00-3874-002-00 00387400200 SKIN-TRAC TRACTION STRIP, 2-1/2 X 30 TRACTION TRACTION ACCESSORIES Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 33
# EDI Item # Item Header 1 Header 2 Type 00-3874-003-00 00387400300 SKIN-TRAC TRACTION STRIP, 3 X 40 TRACTION TRACTION ACCESSORIES Traction Traction 00-3874-004-00 00387400400 SKIN-TRAC TRACTION STRIP, 3 X 56 TRACTION TRACTION ACCESSORIES Traction Traction 00-3874-005-00 00387400500 SKIN-TRAC TRACTION STRIP, 4 X 60 TRACTION TRACTION ACCESSORIES Traction Traction 00-3874-011-00 00387401100 SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SMALL 00-3874-012-00 00387401200 SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A MEDIUM 00-3874-013-00 00387401300 SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A LARGE 00-3874-014-00 00387401400 SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A ADULT-LONG 00-3874-015-00 00387401500 SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A LGE, X-LONG X-WIDE 00-0551-000-00 00055100000 WILSON CONVEX FRAME TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction N/A N/A N/A 00-0561-912-00 00056191200 TRACTION SET W/912 HALTER TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0942 N/A CERVICAL HEAD HARNESS/HALTER 00-0619-000-00 00061900000 ZIMCODE BUCK'S EXTENSION SYSTEM 00-0719-010-00 00071901000 EXO-STATIC TRACTION KIT W/WATER WEIGHT TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0870 Y TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCKS) TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER 00-0965-000-00 00096500000 HILL-ROM PATIENT HELPER TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 34
# EDI Item # Item Header 1 Header 2 00-0965-001-00 00096500100 PATIENT HELPER REINFORCED OVERHEAD BAR 00-0965-002-01 00096500201 PAT HELPER ADAPTER(HEIGHT ADJ) SLEEVE Type TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar 00-2700-965-00 00270096500 PATIENT HELPER, TOTAL CARE BED TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar 00-2700-965-01 00270096501 PATIENT HELPER STAND, TOTAL CARE TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar 00-2700-965-02 00270096502 PAT HELPER VERSACARE COMP TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar 00-2700-965-03 00270096503 BED FRAME ADAPTER VERSACARE TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1164-000-00 00116400000 ANKLE DISTRACTOR HARDWARE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 35
# EDI Item # Item Header 1 Header 2 Type 00-1164-001-10 00116400110 ANKLE DISTRACTOR STRAP KIT TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1164-002-00 00116400200 ANKLE DISTRACTOR EXTENSION BAR TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1164-003-00 00116400300 ANKLE DISTRACTOR FORCE SCALE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1164-004-00 00116400400 ANKLE DISTRACTOR TENSION BAR TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-000-00 00132000000 ALVARADO KNEE SUPPORT ASSEMBLY TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-011-00 00132001100 ALVARADO KNEE SUPPORT, BASE PLATE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-012-00 00132001200 ALVARADO KNEE SUPPORT, TABLE BUTTRESS RIGHT FOOT TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-013-00 00132001300 ALVARADO KNEE SUPPORT, TABLE BUTTRESS LEFT FOOT TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-014-00 00132001400 ALVARADO SURGICAL KNEE HOLDER STABILIZING PLATE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-015-10 00132001510 ALVARADO DISPOSABLE LINER TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-200-00 00132020000 ALVARADO II KNEE SUPPORT ASSEMBLY TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-210-00 00132021000 ALVARADO II FOOT PIECE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 00-1320-211-00 00132021100 ALVARADO II BASE PLATE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 36
# EDI Item # Item Header 1 Header 2 Type 00-0912-000-00 00091200000 DELUXE DISKARD HEAD HALTERS TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER 02-0100-000-00 02010000000 MISC TRACTION REPAIR TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A 02-0112-000-00 02011200000 BOHLER BRAUN FRAME REPAIR TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A 02-0114-000-00 02011400000 STEINMANN PIN HOLDER REPAIR TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A 02-0121-000-00 02012100000 KIRSCHNER WIRE TRACTOR REPAIR TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 02-0551-000-00 02055100000 WILSON FRAME REPAIR CHG TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A 02-1042-000-00 02104200000 TRACTION KNOB REPAIR CHG TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A 02-1232-000-00 02123200000 BALANCED SUSP REPAIR CHG TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A 02-1238-000-00 02123800000 TRACTION CLAMP REPAIR CHG TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A 00-1778-001-00 00177800100 DELUXE PADDED HEAD HALTER, SMALL TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1778-002-00 00177800200 DELUXE PADDED HEAD HALTER, MEDIUM TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1778-003-00 00177800300 DELUXE PADDED HEAD HALTER, LARGE TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-2700-003-00 00270000300 ZIMMER PRO HEAD HALTER TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 37
# EDI Item # Item Header 1 Header 2 Type 00-2700-007-00 00270000700 NO.7 HEAD HALTER TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0584-021-00 00058402100 COMFORT PANEL TRACTION BELT 30-TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under 45, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0584-022-00 00058402200 COMFORT PANEL TRACTION BELT 30-TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under 52, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0584-023-00 00058402300 COMFORT PANEL TRACTION BELT SIZE 36-62 00-0738-001-00 00073800100 DELUXE FOAM PADDED PELVICBELT+C143, SMALL 26-34 TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0738-002-00 00073800200 DELUXE FOAM PADDED PELVICBELT, TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under MEDIUM 34-42, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 38
# EDI Item # Item Header 1 Header 2 Type 00-0738-003-00 00073800300 DELUXE FOAM PADDED PELVICBELT, TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under LARGE 42-50, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0738-006-00 00073800600 DELUXE FOAM PADDED PELVICBELT, TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under X-LARGE 50-58, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0743-001-00 00074300100 ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR,26-30 00-0743-002-00 00074300200 ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR,30-34 00-0743-003-00 00074300300 ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR,34-38 00-0743-004-00 00074300400 ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR,38-42 TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 39
# EDI Item # Item Header 1 Header 2 00-0743-005-00 00074300500 ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR,42-46 Type TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-0743-006-00 00074300600 ZIMCODE PELVIC BELT, -DBL STRAP,VELCRO, 46-50 TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1570-001-00 00157000100 UNIVERSAL DOUBLE-STRAP PELVIC TRACTION BELT 00-1570-002-00 00157000200 UNIVERSAL DOUBLE-STRAP PELVIC TRACTION BELT TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1570-011-00 00157001100 TRACTION STRAP KIT TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1678-001-00 00167800100 UNIVERSAL SINGLE STRAP PELVIC TRACTION BELT TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 40
# EDI Item # Item Header 1 Header 2 Type 00-1774-001-00 00177400100 UNIVERSAL TRACTION BOOT TRACTION TRACTION BOOTS Traction Traction 00-2753-008-00 00275300800 DELUXE ZIM-TRAC CONV TRACTION SPLINT, PED 00-2753-010-00 00275301000 DELUXE ZIM-TRAC CONV TRACTION SPLINT, X-SMALL 00-2753-011-00 00275301100 DELUXE ZIM-TRAC CONV TRACTION SPLINT, SMALL 00-2753-012-00 00275301200 DELUXE ZIM-TRAC CONV TRACTION SPLINT, MEDIUM 00-2753-013-00 00275301300 DELUXE ZIM-TRAC CONV TRACTION SPLINT, LARGE 00-2753-014-00 00275301400 DELUXE ZIM-TRAC CONV TRACTION SPLINT, X-LARGE 00-8712-012-00 00871201200 ECONOMY LEG TRACTION SPLINT, SMALL TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's), 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION TRACTION BOOTS Traction Traction Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 41
# EDI Item # Item Header 1 Header 2 00-8712-013-00 00871201300 ECONOMY LEG TRACTION SPLINT, MEDIUM Type TRACTION TRACTION BOOTS Traction Traction 00-8712-014-00 00871201400 ECONOMY LEG TRACTION SPLINT, LARGE TRACTION TRACTION BOOTS Traction Traction 00-8712-015-00 00871201500 ECONOMY LEG TRACTION SPLINT, X- TRACTION TRACTION BOOTS Traction Traction LARGE 00-0737-001-00 00073700100 SERPENTINE FOAM COLLAR, SM, X- WIDE, 4 X 18 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-0737-002-00 00073700200 SERPENTINE FOAM COLLAR, SMALL, ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic 3 X 16-1/2 L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-0737-003-00 00073700300 SERPENTINE FOAM COLLAR, MEDIUM, 4 X 20-1/2 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-0737-004-00 00073700400 SERPENTINE FOAM COLLAR, LARGE, 5 X 21-1/2 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-0737-005-00 00073700500 SERPENTINE FOAM COLLAR, UNIVERSAL, 3 1/2X23-1/2 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-0737-006-00 00073700600 SERPENTINE FOAM COLLAR, SM, X- LONG, 3 X 21 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-0737-007-00 00073700700 SERPENTINE FOAM COLLAR, SM, 2-1/2 X 16-1/2 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1737-001-00 00173700100 SERPENTINE FOAM COLLAR, SMALL, ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic X-WIDE L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1737-002-00 00173700200 SERPENTINE FOAM COLLAR, SMALL ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1737-003-00 00173700300 SERPENTINE FOAM COLLAR, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1737-004-00 00173700400 SERPENTINE FOAM COLLAR, LARGE ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1737-005-00 00173700500 SERPENTINE FOAM COLLAR, MEDIUM, X-LONG ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2739-001-00 00273900100 FOAM CERVICAL COLLAR, SMALL X- WIDE ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2739-002-00 00273900200 FOAM CERVICAL COLLAR, SMALL ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2739-003-00 00273900300 FOAM CERVICAL COLLAR, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 42
# EDI Item # Item Header 1 Header 2 Type 00-2739-004-00 00273900400 FOAM CERVICAL COLLAR, LARGE ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2739-005-00 00273900500 FOAM CERVICAL COLLAR, MEDIUM, X-LONG ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2740-001-00 00274000100 FOAM CERVICAL COLLAR, SMALL, X- ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic WIDE L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2740-002-00 00274000200 FOAM CERVICAL COLLAR, SMALL ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2740-003-00 00274000300 FOAM CERVICAL COLLAR, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2740-004-00 00274000400 FOAM CERVICAL COLLAR, LARGE ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-2740-005-00 00274000500 FOAM CERVICAL COLLAR, MEDIUM, X-LONG ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-8601-380-00 00860138000 PEDIATRIC CERVICAL COLLAR ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-8705-045-00 00870504500 FOAM CERVICAL COLLAR, UNIVERSAL ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1676-001-00 00167600100 EMS EXTRICATION COLLAR, PEDIATRIC ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1676-002-00 00167600200 EMS EXTRICATION COLLAR, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1676-003-00 00167600300 EMS EXTRICATION COLLAR, SHORT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1676-004-00 00167600400 EMS EXTRICATION COLLAR, REGULAR ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1676-005-00 00167600500 EMS EXTRICATION COLLAR, TALL ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1676-006-00 00167600600 EMS EXTRICATION COLLAR, PED, SHORT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 00-1741-005-00 00174100500 PHILADELPHIA CERVICAL COLLAR, SMALL, 3-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-006-00 00174100600 PHILADELPHIA CERVICAL COLLAR, MEDIUM, 3-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-007-00 00174100700 PHILADELPHIA CERVICAL COLLAR, LARGE, 3-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-010-00 00174101000 PHILADELPHIA CERVICAL COLLAR, SMALL, 4-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 43
# EDI Item # Item Header 1 Header 2 00-1741-011-00 00174101100 PHILADELPHIA CERVICAL COLLAR, MEDIUM, 4-1/4 Type ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-012-00 00174101200 PHILADELPHIA CERVICAL COLLAR, LARGE, 4-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-015-00 00174101500 PHILADELPHIA CERVICAL COLLAR, SMALL, 5-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-016-00 00174101600 PHILADELPHIA CERVICAL COLLAR, MEDIUM, 5-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-017-00 00174101700 PHILADELPHIA CERVICAL COLLAR, LARGE, 5-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-301-00 00174130100 PADDED CERVICAL COLLAR, S ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-302-00 00174130200 PADDED CERVICAL COLLAR, MED ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-303-00 00174130300 PADDED CERVICAL COLLAR, STAND ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-304-00 00174130400 PADDED CERVICAL COLLAR, T ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1741-309-00 00174130900 REPLACEMENT PAD SET ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1742-001-00 00174200100 Philly Patriot Collar, Pe ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1742-002-00 00174200200 PHILLY PATRIOT ADJUSTABLE EXTRICATION COLLAR ADULT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1750-001-00 00175000100 PHILLY ONE-PIECE EXTRICATION COLLAR, INFANT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1750-002-00 00175000200 PHILLY ONE-PIECE EXTRICATION COLLAR, PED ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1750-003-00 00175000300 PHILLY ONE-PIECE EXTRICATION COLLAR, LOW ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1750-004-00 00175000400 PHILLY ONE-PIECE EXTRICATION COLLAR, SHORT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1750-005-00 00175000500 PHILLY ONE-PIECE EXTRICATION COLLAR, REG ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1750-006-00 00175000600 PHILLY ONE-PIECE EXTRICATION COLLAR, TALL ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1751-005-00 00175100500 COOLBRACE COLLAR, SMALL ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 44
# EDI Item # Item Header 1 Header 2 Type 00-1751-006-00 00175100600 COOLBRACE COLLAR, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-1751-007-00 00175100700 COOLBRACE COLLAR, LARGE ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-8601-968-50 00860196850 PHILADELPHIA CERVICAL COLLAR, PED, 2-1/2 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 00-0764-001-10 00076400110 ZIMMER ARM SLING MULTI-PAK ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0764-002-10 00076400210 ZIMMER ARM SLING MULTI-PAK ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0764-003-10 00076400310 ZIMMER ARM SLING MULTI-PAK ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0764-004-10 00076400410 ZIMMER ARM SLING MULTI-PAK ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0764-010-00 00076401000 PEDIATRIC ARM SLING, XX-SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0764-011-00 00076401100 PEDIATRIC ARM SLING, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1796-011-00 00179601100 FASHION ARM SLING, SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1796-011-10 00179601110 FASHION ARM SLING SMALL, BOX 10 ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1796-012-00 00179601200 FASHION ARM SLING, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1796-012-10 00179601210 FASHION ARM SLING, MEDIUM, BOX 10 ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1796-013-00 00179601300 FASHION ARM SLING, LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1796-013-10 00179601310 FASHION ARM SLING, LARGE, BOX 10 ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 45
# EDI Item # Item Header 1 Header 2 Type 00-1796-014-00 00179601400 FASHION ARM SLING, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1796-014-10 00179601410 FASHION ARM SLING, X-LARGE, BOX ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic 10 A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1798-001-00 00179800100 UNIVERSAL MULTI-SLING ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1892-001-00 00189200100 PADDED STRAP ARM SLING, SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1892-002-00 00189200200 PADDED STRAP ARM SLING, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1892-003-00 00189200300 PADDED STRAP ARM SLING, LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1892-004-00 00189200400 PADDED STRAP ARM SLING, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1898-001-00 00189800100 American Way Arm Sling ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-1978-001-00 00197800100 UNIVERSAL ARM ELEVATOR/SLING ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-8600-194-00 00860019400 GARDNER ARM ELEVATOR, PEDIATRIC ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-8600-195-00 00860019500 GARDNER ARM ELEVATOR, YOUTH ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-8601-377-00 00860137700 PEDIATRIC FASHION ARM SLING, NAVY ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-8601-377-50 00860137750 PEDIATRIC FASHION ARM SLING, CHILD PRINT ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 66-0576-001-00 66057600100 STRAP ARM SLING W/PAD, SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 46
# EDI Item # Item Header 1 Header 2 Type 66-0576-002-00 66057600200 STRAP ARM SLING W/PAD, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 66-0576-003-00 66057600300 STRAP ARM SLING W/PAD, LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0763-001-00 00076300100 SHOULDER IMMOBILIZER/VELPEAU DRESSING, SMALL ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0763-002-00 00076300200 SHOULDER IMMOBILIZER/VELPEAU DRESSING, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0763-003-00 00076300300 SHOULDER IMMOBILIZER/VELPEAU DRESSING, LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0763-004-00 00076300400 SHOULDER IMMOBILIZER/VELPEAU DRESSING, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0763-011-00 00076301100 SHOULDER IMMOBILIZER/VELPEAU DRESSING, PED ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 47
# EDI Item # Item Header 1 Header 2 00-0783-001-00 00078300100 MEN ELASTIC SHOULDER IMOBILIZER, CHEST, 24-30 Type ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0783-002-00 00078300200 MEN ELASTIC SHOULDER IMOBILIZER, CHEST, 30-36 ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0783-003-00 00078300300 MEN ELASTIC SHOULDER IMOBILIZER, CHEST 36-42 ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0783-004-00 00078300400 MEN ELASTIC SHOULDER IMOBILIZER, CHEST, 42-48 ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0784-001-00 00078400100 WOMEN ELASTIC SHOULDER IMOBILIZER, CHEST 24-30 ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0784-002-00 00078400200 WOMEN ELASTIC SHOULDER IMOBILIZER, CHEST 30-36 ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 48
# EDI Item # Item Header 1 Header 2 00-0784-003-00 00078400300 WOMEN ELASTIC SHOULDER IMOBILIZER, CHEST 32-42 Type ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0784-004-00 00078400400 WOMEN ELASTIC SHOULDER IMOBILIZER, CHEST 42-48 ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0784-005-00 00078400500 ELASTIC SHOULDER IMMOBILIZER XX-LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1785-001-00 00178500100 UNIVERSAL SHOULDER IMMOBILIZER 00-1893-001-00 00189300100 PADDED ARM/SHOULDER IMMOBILIZER, SMALL ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE L3670 A SHOULDER ORTHOSIS, supplies prosthetic/orthotic devices; 0279- medical ACROMIO/CLAVICULAR (CANVAS surgical supplies other supplies/devices AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1893-002-00 00189300200 PADDED ARM/SHOULDER IMMOBILIZER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, General Medical Surgical Supplies 0270, Non- ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1893-003-00 00189300300 PADDED ARM/SHOULDER IMMOBILIZER, LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 49
# EDI Item # Item Header 1 Header 2 00-1893-004-00 00189300400 PADDED ARM/SHOULDER IMMOBILIZER, X-LARGE Type ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3898-005-00 00389800500 DELUXE SLING AND SWATHE, SMALL ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-3898-006-00 00389800600 DELUXE SLING AND SWATHE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-3898-007-00 00389800700 DELUXE SLING AND SWATHE, LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-3898-008-00 00389800800 DELUXE SLING AND SWATHE, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-3899-001-00 00389900100 UNIVERSAL SLING AND SWATHE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-8601-796-00 00860179600 DELUXE SLING AND SWATHE, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. 00-0735-001-00 00073500100 MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic X-SMALL 00-0735-002-00 00073500200 MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic SMALL L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 50
# EDI Item # Item Header 1 Header 2 Type 00-0735-003-00 00073500300 MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic MEDIUM L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0735-004-00 00073500400 MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic LARGE 00-0735-005-00 00073500500 MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic X-LARGE L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0735-011-00 00073501100 MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0735-012-00 00073501200 MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, SMALL ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0735-013-00 00073501300 MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 51
# EDI Item # Item Header 1 Header 2 00-0735-014-00 00073501400 MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, LARGE Type ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0735-015-00 00073501500 MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8600-282-00 00860028200 MCCLEOD CLAVICLE STRAP, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0799-001-00 00079900100 WRIST SPLINT, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-0799-002-00 00079900200 WRIST SPLINT, SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-0799-003-00 00079900300 WRIST SPLINT, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-0799-004-00 00079900400 WRIST SPLINT, MEDIUM, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-0799-005-00 00079900500 WRIST SPLINT, LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-0799-006-00 00079900600 WRIST SPLINT, LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-0799-007-00 00079900700 WRIST SPLINT, X-LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 52
# EDI Item # Item Header 1 Header 2 Type 00-0799-008-00 00079900800 WRIST SPLINT, X-LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1476-001-00 00147600100 ZIMMER PREMIUM WRIST BRACE, X- ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic SMALL, LEFT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1476-002-00 00147600200 ZIMMER PREMIUM WRIST BRACE, X- ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic SMALL, RIGHT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1476-003-00 00147600300 ZIMMER PREMIUM WRIST BRACE, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1476-004-00 00147600400 ZIMMER PREMIUM WRIST BRACE, SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1476-005-00 00147600500 ZIMMER PREMIUM WRIST BRACE, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 53
# EDI Item # Item Header 1 Header 2 00-1476-006-00 00147600600 ZIMMER PREMIUM WRIST BRACE, MEDIUM, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1476-007-00 00147600700 ZIMMER PREMIUM WRIST BRACE, LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1476-008-00 00147600800 ZIMMER PREMIUM WRIST BRACE, LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1476-009-00 00147600900 ZIMMER PREMIUM WRIST BRACE, X- ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic LARGE, LEFT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1476-010-00 00147601000 ZIMMER PREMIUM WRIST BRACE, X- ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic LARGE, RIGHT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1477-001-00 00147700100 ZIMMER PREMIUM THUMB SPICA, X- SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 54
# EDI Item # Item Header 1 Header 2 00-1477-002-00 00147700200 ZIMMER PREMIUM THUMB SPICA, X- SMALL, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1477-003-00 00147700300 ZIMMER PREMIUM THUMB SPICA, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1477-004-00 00147700400 ZIMMER PREMIUM THUMB SPICA, SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1477-005-00 00147700500 ZIMMER PREMIUM THUMB SPICA, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1477-006-00 00147700600 ZIMMER PREMIUM THUMB SPICA, MEDIUM, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1477-007-00 00147700700 ZIMMER PREMIUM THUMB SPICA, LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 55
# EDI Item # Item Header 1 Header 2 00-1477-008-00 00147700800 ZIMMER PREMIUM THUMB SPICA, LARGE, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1477-009-00 00147700900 ZIMMER PREMIUM THUMB SPICA, X- LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1477-010-00 00147701000 ZIMMER PREMIUM THUMB SPICA, X- LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1478-001-00 00147800100 Exo-Wrist Brace, Small, L ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1478-002-00 00147800200 Exo-Wrist Brace, Small, R ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1478-003-00 00147800300 EXO-WRIST BRACE, MEDIUM, L ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 56
# EDI Item # Item Header 1 Header 2 Type 00-1478-004-00 00147800400 EXO-WRIST BRACE, MEDIUM, R ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1478-005-00 00147800500 EXO-WRIST BRACE, LARGE, L ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1478-006-00 00147800600 EXO-WRIST BRACE, LARGE, R ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1759-001-00 00175900100 DELUXE COCKUP WRIST SPLINT, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1759-002-00 00175900200 DELUXE COCKUP WRIST SPLINT, SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1759-003-00 00175900300 DELUXE COCKUP WRIST SPLINT, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 57
# EDI Item # Item Header 1 Header 2 00-1759-004-00 00175900400 DELUXE COCKUP WRIST SPLINT, MEDIUM, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1759-005-00 00175900500 DELUXE COCKUP WRIST SPLINT, LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1759-006-00 00175900600 DELUXE COCKUP WRIST SPLINT, LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1759-007-00 00175900700 DELUXE COCKUP WRIST SPLINT, X- LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1759-008-00 00175900800 DELUXE COCKUP WRIST SPLINT, X- LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1769-002-00 00176900200 UNIVERSAL COCK-UP WRIST SPLINT, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic RIGHT L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 58
# EDI Item # Item Header 1 Header 2 00-1769-003-00 00176900300 UNIVERSAL COCK-UP WRIST, SPLINT, LEFT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-001-00 00179900100 ADJUSTABLE WRIST BRACE, X- SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-002-00 00179900200 ADJUSTABLE WRIST BRACE, X- SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-003-00 00179900300 ADJUSTABLE WRIST BRACE, SMALL, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic LEFT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-004-00 00179900400 ADJUSTABLE WRIST BRACE, SMALL, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic RIGHT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-005-00 00179900500 ADJUSTABLE WRIST BRACE, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 59
# EDI Item # Item Header 1 Header 2 00-1799-006-00 00179900600 ADJUSTABLE WRIST BRACE, MEDIUM, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-007-00 00179900700 ADJUSTABLE WRIST BRACE, LARGE, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic LEFT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-008-00 00179900800 ADJUSTABLE WRIST BRACE, LARGE, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic RIGHT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-009-00 00179900900 ADJUSTABLE WRIST BRACE, X- LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1799-010-00 00179901000 ADJUSTABLE WRIST BRACE, X- LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3447-303-00 00344730300 WRISTLET WITH STRAP, SMALL RIGHT 00-3447-304-00 00344730400 WRISTLET WITH STRAP, MEDIUM RIGHT 00-3447-305-00 00344730500 WRISTLET WITH STRAP, LARGE RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 60
# EDI Item # Item Header 1 Header 2 00-3447-306-00 00344730600 WRISTLET WITH STRAP, X-LARGE RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic 00-3447-403-00 00344740300 WRISTLET WITH STRAP, SMALL LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic 00-3447-404-00 00344740400 WRISTLET WITH STRAP, MEDIUM LEFT 00-3447-405-00 00344740500 WRISTLET WITH STRAP, LARGE LEFT 00-3447-406-00 00344740600 WRISTLET WITH STRAP, X-LARGE LEFT 00-8600-529-00 00860052900 DELUXE COCKUP WRIST SPLINT, X- SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8600-530-00 00860053000 DELUXE COCKUP WRIST SPLINT, X- SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8601-887-02 00860188702 UNIVERSAL COCK-UP WRIST SPLINT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic 6 RIGHT 00-8601-887-03 00860188703 UNIVERSAL COCK-UP WRIST SPLINT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic 6 LEFT L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 61
# EDI Item # Item Header 1 Header 2 00-1479-001-00 00147900100 ZIMMER AIRFORM BACK SUPPORT SMALL Type ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1479-002-00 00147900200 ZIMMER AIRFORM BACK SUPPORT MEDIUM ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1479-003-00 00147900300 ZIMMER AIRFORM BACK SUPPORT LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1479-004-00 00147900400 ZIMMER AIRFORM BACK SUPPORT X-ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic LARGE L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1479-005-00 00147900500 ZIMMER AIRFORM BACK SUPPORT XX-LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1730-001-00 00173000100 UNIVERSAL SACROLUMBAR SUPPORT ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0626 or L0627 A Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l- 5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 62
# EDI Item # Item Header 1 Header 2 Type 00-1735-021-00 00173502100 SPS III, LUMBAR SUPPORT, X-SMALL, ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic 28-32 00-1735-022-00 00173502200 SPS III, LUMBAR SUPPORT, SMALL, 32-36 ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic 00-1735-023-00 00173502300 SPS III, LUMBAR SUPPORT, MEDIUM, ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic 36-40 00-1735-024-00 00173502400 SPS III, LUMBAR SUPPORT, LARGE, 40-44 00-1735-025-00 00173502500 SPS III, LUMBAR SUPPORT, X- LARGE, 44-48 ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic 00-2735-022-00 00273502200 ELASTIC BACK SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 63
# EDI Item # Item Header 1 Header 2 Type 00-2735-023-00 00273502300 ELASTIC BACK SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-2735-024-00 00273502400 ELASTIC BACK SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic 00-2735-025-00 00273502500 ELASTIC BACK SUPPORT, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3449-001-00 00344900100 UNIVERSAL LUMBAR SUPPORT, SMALL/MEDIUM ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3449-002-00 00344900200 UNIVERSAL LUMBAR SUPPORT, LARGE/X-LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0584-011-00 00058401100 COMFORT PANEL RIB BELT, MALE ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic 00-0584-012-00 00058401200 COMFORT PANEL RIB BELT, FEMALE ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic 00-2721-006-00 00272100600 UNIVERSAL RIB BELT, MALE, 6 IN ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic 00-2721-008-00 00272100800 UNIVERSAL RIB BELT, MALE, 8 IN ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 64
# EDI Item # Item Header 1 Header 2 Type 00-2722-006-00 00272200600 UNIVERSAL RIB BELT, FEMALE, 6 IN ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic 00-2722-008-00 00272200800 UNIVERSAL RIB BELT, FEMALE, 8 IN ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic 00-0584-031-00 00058403100 COMFORT PANEL 9 IN ABDOMINAL BINDER ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-0584-032-00 00058403200 COMFORT PANEL 9 IN ABDOMINAL BINDER ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic 00-0584-041-00 00058404100 COMFORT PANEL 12 IN ABDOMINAL BINDER ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic 00-0584-042-00 00058404200 COMFORT PANEL 12 IN ABDOMINAL BINDER ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic 00-0584-043-00 00058404300 COMFORT PANEL ABDOMINAL S ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic 00-0584-044-00 00058404400 COMFORT PANEL ABDOMINAL S ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic 00-2732-010-00 00273201000 UNIVERSAL ABDOMINAL SUPPORT, 10 IN ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic 00-2732-012-00 00273201200 UNIVERSAL ABDOMINAL SUPPORT, 12 IN ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic 00-1876-503-12 00187650312 KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-503-16 00187650316 KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 65
# EDI Item # Item Header 1 Header 2 00-1876-503-19 00187650319 KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 19 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-503-22 00187650322 KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-503-24 00187650324 KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-504-12 00187650412 KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-504-16 00187650416 KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-504-19 00187650419 KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 66
# EDI Item # Item Header 1 Header 2 00-1876-504-22 00187650422 KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 22 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-504-24 00187650424 KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-505-12 00187650512 KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-505-16 00187650516 KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-505-19 00187650519 KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-505-22 00187650522 KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 67
# EDI Item # Item Header 1 Header 2 00-1876-505-24 00187650524 KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 24 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-506-12 00187650612 KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-506-16 00187650616 KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-506-19 00187650619 KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-506-22 00187650622 KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-506-24 00187650624 KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 68
# EDI Item # Item Header 1 Header 2 00-1876-507-19 00187650719 KNEE IMMOBILIZER FOAM CONTOURED, XX-LARGE, 19 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-507-22 00187650722 KNEE IMMOBILIZER FOAM CONTOURED, XX-LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-603-12 00187660312 KNEE IMMOBILIZER FOAM STRAIGHT, SMALL, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-603-19 00187660319 KNEE IMMOBILIZER FOAM STRAIGHT, SMALL, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-603-22 00187660322 KNEE IMMOBILIZER FOAM STRAIGHT, SMALL, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-603-24 00187660324 KNEE IMMOBILIZER FOAM STRAIGHT, SMALL, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 69
# EDI Item # Item Header 1 Header 2 00-1876-604-12 00187660412 KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 12 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-604-16 00187660416 KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-604-19 00187660419 KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-604-22 00187660422 KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-604-24 00187660424 KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-605-12 00187660512 KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 70
# EDI Item # Item Header 1 Header 2 00-1876-605-16 00187660516 KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 16 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-605-19 00187660519 KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-605-22 00187660522 KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-605-24 00187660524 KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-606-12 00187660612 KNEE IMMOBILIZER FOAM STRAIGHT, X-LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-606-19 00187660619 KNEE IMMOBILIZER FOAM STRAIGHT, X-LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 71
# EDI Item # Item Header 1 Header 2 00-1876-606-22 00187660622 KNEE IMMOBILIZER FOAM STRAIGHT, X-LARGE, 22 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-606-24 00187660624 KNEE IMMOBILIZER FOAM STRAIGHT, X-LARGE, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1876-607-19 00187660719 KNEE IMMOBILIZER FOAM STRAIGHT, XX-LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-503-12 00187750312 KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-503-16 00187750316 KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-503-19 00187750319 KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 72
# EDI Item # Item Header 1 Header 2 00-1877-503-22 00187750322 KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 22 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-503-24 00187750324 KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-504-12 00187750412 KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-504-16 00187750416 KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-504-19 00187750419 KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-504-22 00187750422 KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 73
# EDI Item # Item Header 1 Header 2 00-1877-504-24 00187750424 KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 24 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-505-12 00187750512 KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-505-16 00187750516 KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-505-19 00187750519 KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-505-22 00187750522 KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-505-24 00187750524 KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 74
# EDI Item # Item Header 1 Header 2 Type 00-1877-506-12 00187750612 KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, 12 When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-506-16 00187750616 KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, 16 00-1877-506-19 00187750619 KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, 19 00-1877-506-22 00187750622 KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, 22 00-1877-506-24 00187750624 KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, 24 When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1877-507-19 00187750719 KNEE IMMOBILIZER FOAM/TRICOT, XX-LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 75
# EDI Item # Item Header 1 Header 2 00-1877-507-22 00187750722 KNEE IMMOBILIZER FOAM/TRICOT, XX-LARGE, 22 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1880-500-12 00188050012 KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1880-500-16 00188050016 KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1880-500-19 00188050019 KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1880-500-22 00188050022 KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 22 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1880-500-24 00188050024 KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 24 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 76
# EDI Item # Item Header 1 Header 2 00-1880-500-26 00188050026 KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 26 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1880-500-28 00188050028 KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-500-12 00188250012 KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-500-16 00188250016 KNEE IMMOBILIZER TRIM FOAM,CONTOURED STAYS 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-500-19 00188250019 KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-500-22 00188250022 KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 22 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 77
# EDI Item # Item Header 1 Header 2 00-1882-500-24 00188250024 KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 24 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-500-26 00188250026 KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 26 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-500-28 00188250028 KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-600-12 00188260012 KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-600-16 00188260016 KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-600-19 00188260019 KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 78
# EDI Item # Item Header 1 Header 2 00-1882-600-22 00188260022 KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 22 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1882-600-24 00188260024 KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 24 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1883-500-12 00188350012 KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1883-500-16 00188350016 KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1883-500-19 00188350019 KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1883-500-22 00188350022 KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 22 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 79
# EDI Item # Item Header 1 Header 2 00-1883-500-24 00188350024 KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 24 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1883-500-26 00188350026 KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 26 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1883-500-28 00188350028 KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1885-500-12 00188550012 KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1885-500-16 00188550016 KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1885-500-19 00188550019 KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 80
# EDI Item # Item Header 1 Header 2 00-1885-500-22 00188550022 KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 22 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1885-500-24 00188550024 KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 24 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1885-500-26 00188550026 KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 26 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1885-500-28 00188550028 KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1888-500-12 00188850012 UNIV ELASTIC STRAP KNEE IMMOBILIZER, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1888-500-16 00188850016 UNIV ELASTIC STRAP KNEE IMMOBILIZER, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 81
# EDI Item # Item Header 1 Header 2 00-1888-500-19 00188850019 UNIV ELASTIC STRAP KNEE IMMOBILIZER, 19 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1888-500-22 00188850022 UNIV ELASTIC STRAP KNEE IMMOBILIZER, 22 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1888-500-24 00188850024 UNIV ELASTIC STRAP KNEE IMMOBILIZER, 24 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1888-500-26 00188850026 UNIV ELASTIC STRAP KNEE IMMOBILIZER, 26 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1888-500-28 00188850028 UNIV ELASTIC STRAP KNEE IMMOBILIZER, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1889-000-10 00188900010 POPLITEAL FOAM INSERT ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support 00-1444-001-00 00144400100 FORMFIT NIGHT SPLINT, SMALL ORTHOPAEDIC BRACES & SUPPORTS NIGHT SPLINTS Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 82
# EDI Item # Item Header 1 Header 2 Type 00-1444-002-00 00144400200 FORMFIT NIGHT SPLINT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS NIGHT SPLINTS Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1444-003-00 00144400300 FORMFIT NIGHT SPLINT, LARGE ORTHOPAEDIC BRACES & SUPPORTS NIGHT SPLINTS Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1716-010-00 00171601000 PAVLIK HARNESS, SMALL ORTHOPAEDIC BRACES & SUPPORTS PAVLIK HARNESSES Orthopaedic 00-1716-011-00 00171601100 PAVLIK HARNESS, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS PAVLIK HARNESSES Orthopaedic 00-1716-012-00 00171601200 PAVLIK HARNESS, LARGE ORTHOPAEDIC BRACES & SUPPORTS PAVLIK HARNESSES Orthopaedic 00-8601-416-00 00860141600 PAVLIK HARNESS, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS PAVLIK HARNESSES Orthopaedic E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 83
# EDI Item # Item Header 1 Header 2 00-0766-001-00 00076600100 ANKLE BR W/ELASTIC STRAP,X- SMALL LEFT Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0766-002-00 00076600200 ANKLE BR W/ELASTIC STRAP,X- SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0766-003-00 00076600300 ANKLE BR W/ELASTIC STRAP, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0766-004-00 00076600400 ANKLE BR W/ELASTIC STRAP,SMALL, ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic RIGHT L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0766-005-00 00076600500 ANKLE BR W/ELASTIC STRAP, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0766-006-00 00076600600 ANKLE BR W/ELASTIC STRAP, MEDIUM, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 84
# EDI Item # Item Header 1 Header 2 00-0766-007-00 00076600700 ANKLE BR W/ELASTIC STRAP, LARGE, LEFT Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0766-008-00 00076600800 ANKLE BR W/ELASTIC STRAP, LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0766-009-00 00076600900 ANKLE BR W/ELASTIC STRAP, X- LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-0766-010-00 00076601000 ANKLE BR W/ELASTIC STRAP, X- LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1421-001-00 00142100100 50/50 GEL ANKLE BRACE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1421-002-00 00142100200 50/50 GEL ANKLE BRACE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 85
# EDI Item # Item Header 1 Header 2 Type 00-1422-001-00 00142200100 80/20 GEL ANKLE BRACE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1422-002-00 00142200200 80/20 GEL ANKLE BRACE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1423-001-00 00142300100 50/50 PONY GEL ANKLE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1423-002-00 00142300200 50/50 PONY GEL ANKLE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1424-001-00 00142400100 LACE LOCK ANKLE BRACE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1424-002-00 00142400200 LACE LOCK ANKLE BRACE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 86
# EDI Item # Item Header 1 Header 2 Type 00-1425-001-00 00142500100 PONY LACE LOCK ANKLE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1425-002-00 00142500200 PONY LACE LOCK ANKLE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1435-001-00 00143500100 ZIMMER HONEYCONE ANKLE STIRRUP, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1435-002-00 00143500200 ZIMMER HONEYCOMB ANKLE STIRRUP, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1435-021-00 00143502100 ZIMMER AIR ANKLE STIRRUP, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1435-022-00 00143502200 ZIMMER AIR ANKLE STIRRUP, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 87
# EDI Item # Item Header 1 Header 2 00-1436-001-00 00143600100 ZIMMER LACE ANKLE W/O STRAPS, SMALL Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1436-002-00 00143600200 ZIMMER LACE ANKLE W/O STRAPS, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1436-003-00 00143600300 ZIMMER LACE ANKLE W/O STRAPS, LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1436-004-00 00143600400 ZIMMER LACE ANKLE W/O STRAPS, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1436-005-00 00143600500 ZIMMER LACE ANKLE W/ STRAPS, SMALL ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1436-006-00 00143600600 ZIMMER LACE ANKLE W/ STRAPS, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 88
# EDI Item # Item Header 1 Header 2 00-1436-007-00 00143600700 ZIMMER LACE ANKLE W/STRAPS, LARGE Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1436-008-00 00143600800 ZIMMER LACE ANKLE W/ STRAPS, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1767-003-00 00176700300 DELUXE ANKLE BRACE, SMALL ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1767-004-00 00176700400 DELUXE ANKLE BRACE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1767-005-00 00176700500 DELUXE ANKLE BRACE, LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic 00-1767-006-00 00176700600 DELUXE ANKLE BRACE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 89
# EDI Item # Item Header 1 Header 2 00-3453-003-00 00345300300 ANKLE SUPPORT W/CONTACT CLOSURE, SMALL Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3453-004-00 00345300400 ANKLE SUPPORT W/CONTACT CLOSURE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3453-005-00 00345300500 ANKLE SUPPORT W/CONTACT CLOSURE, LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3453-006-00 00345300600 ANKLE SUPPORT W/CONTACT CLOSURE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8916-031-00 00891603100 DH PRESSURE RELIEF WALKER, SMALL ORTHOPAEDIC BRACES & SUPPORTS PRESSURE RELIEF WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8916-032-00 00891603200 DH PRESSURE RELIEF WALKER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS PRESSURE RELIEF WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 90
# EDI Item # Item Header 1 Header 2 00-8916-033-00 00891603300 DH PRESSURE RELIEF WALKER, LARGE Type ORTHOPAEDIC BRACES & SUPPORTS PRESSURE RELIEF WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8916-004-00 00891600400 FIXED HINGE LEG WALKER, SMALL ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-004-01 00891600401 REPLACEMENT LINER FOR 8916-04 ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-005-00 00891600500 FIXED HINGE LEG WALKER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-005-01 00891600501 REPLACEMENT LINER FOR 8916-05 ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-006-00 00891600600 FIXED HINGE LEG WALKER, LARGE ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8916-006-01 00891600601 REPLACMENT LINER FOR 8916-06 ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 91
# EDI Item # Item Header 1 Header 2 Type 00-8916-011-00 00891601100 REPLACEMENT LINER FOR 8916-14 ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-012-00 00891601200 REPLACEMENT LINER FOR 8916-15 ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-013-00 00891601300 REPLACEMENT LINER FOR 8916-16 ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-014-00 00891601400 LOWER LEG ORTHOSIS II, SMALL ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-015-00 00891601500 LOWER LEG ORTHOSIS II, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-016-00 00891601600 LOWER LEG ORTHOSIS II, LARGE ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-024-00 00891602400 ZIMMER AIR WALKER, SMALL ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 00-8916-025-00 00891602500 ZIMMER AIR WALKER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 92
# EDI Item # Item Header 1 Header 2 Type 00-8916-026-00 00891602600 ZIMMER AIR WALKER, LARGE ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8916-041-00 00891604100 ZIMMER ANKLE TOP WALKER, SMALL ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8916-042-00 00891604200 ZIMMER ANKLE TOP WALKER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8916-043-00 00891604300 ZIMMER ANKLE TOP WALKER, LARGE ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1995-009-00 00199500900 CUSHION ROCKER CAST SHOE,PED ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-010-00 00199501000 CUSHION ROCKER CAST SHOE, XX- SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-011-00 00199501100 CUSHION ROCKER CAST SHOE, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-012-00 00199501200 CUSHION ROCKER CAST SHOE, SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-013-00 00199501300 CUSHION ROCKER CAST SHOE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-014-00 00199501400 CUSHION ROCKER CAST SHOE, LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-015-00 00199501500 CUSHION ROCKER CAST SHOE, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 93
# EDI Item # Item Header 1 Header 2 00-1995-021-00 00199502100 CUSHION ROCKER CAST BOOT, X- SMALL Type ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-022-00 00199502200 CUSHION ROCKER CAST BOOT, SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-023-00 00199502300 CUSHION ROCKER CAST BOOT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-024-00 00199502400 CUSHION ROCKER CAST BOOT, LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1995-025-00 00199502500 CUSHION ROCKER CAST BOOT, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1997-001-00 00199700100 DARCO CAST SHOE NAVY, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1997-002-00 00199700200 DARCO CAST SHOE NAVY, SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1997-003-00 00199700300 DARCO CAST SHOE NAVY, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1997-004-00 00199700400 DARCO CAST SHOE NAVY, LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1997-005-00 00199700500 DARCO CAST SHOE NAVY, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-8716-011-00 00871601100 ROCKER SOLE CAST SHOE, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-8716-012-00 00871601200 ROCKER SOLE CAST SHOE, SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-8716-013-00 00871601300 ROCKER SOLE CAST SHOE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-8716-014-00 00871601400 ROCKER SOLE CAST SHOE, LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-8716-015-00 00871601500 ROCKER SOLE CAST SHOE, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 00-1443-001-00 00144300100 DARCO ORTHOWEDGE HEALING SHOE, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1443-002-00 00144300200 DARCO ORTHOWEDGE HEALING SHOE, SMALL ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1443-003-00 00144300300 DARCO ORTHOWEDGE HEALING SHOE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1443-004-00 00144300400 DARCO ORTHOWEDGE HEALING SHOE, LARGE ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 94
# EDI Item # Item Header 1 Header 2 00-1443-005-00 00144300500 DARCO ORTHOWEDGE SHOE, X- LARGE Type ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1433-001-00 00143300100 DH PRESSURE RELIEF SHOE SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 00-1433-002-00 00143300200 DH PRESSURE RELIEF SHOE MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 00-1433-003-00 00143300300 DH PRESSURE RELIEF SHOE LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 00-1433-004-00 00143300400 DH PRESSURE RELIEF SHOE, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 00-1611-021-00 00161102100 PADDED POST-OP SHOE, MEN, SMALL, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1611-022-00 00161102200 PADDED POST-OP SHOE, MEN, MEDIUM, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1611-023-00 00161102300 PADDED POST-OP SHOE, MEN, LARGE, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1611-024-00 00161102400 PADDED POST-OP SHOE, WOMEN, SMALL W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1611-025-00 00161102500 PADDED POST-OP SHOE, WOMEN, MEDIUM W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1611-026-00 00161102600 PADDED POST-OP SHOE, WOMEN, LARGE, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1711-004-00 00171100400 DARCO POST-OP SHOE, WOMEN, SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1711-005-00 00171100500 DARCO POST-OP SHOE, WOMEN, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1711-006-00 00171100600 DARCO POST-OP SHOE, WOMEN, LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1711-011-00 00171101100 DARCO POST-OP SHOE, MEN, SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1711-012-00 00171101200 DARCO POST-OP SHOE, MEN, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1711-013-00 00171101300 DARCO POST-OP SHOE, MEN, LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1711-014-00 00171101400 DARCO POST-OP SHOE, MEN, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1811-001-00 00181100100 DARCO MED/SURG BLACK VELCRO, XS ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 95
# EDI Item # Item Header 1 Header 2 00-1811-002-00 00181100200 DARCO MED/SURG BLACK VELCRO, SM Type ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 00-1811-003-00 00181100300 DARCO MED/SURG BLACK VELCRO, MD ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 00-1811-004-00 00181100400 DARCO MED/SURG BLACK VELCRO, LG ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 00-1811-005-00 00181100500 DARCO MED/SURG BLACK VELCRO, XL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 00-1991-001-00 00199100100 POST-OPERATIVE SHOE, MEN'S, SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1991-002-00 00199100200 POST-OPERATIVE SHOE, MEN'S, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1991-003-00 00199100300 POST-OPERATIVE SHOE, MEN'S, LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1991-004-00 00199100400 POST-OPERATIVE SHOE, WOMEN'S, SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1991-005-00 00199100500 POST-OPERATIVE SHOE, WOMEN'S, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-1991-006-00 00199100600 POST-OPERATIVE SHOE, WOMEN'S, LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-8601-697-01 00860169701 PADDED POST-OP SHOE, PEDIATRIC, LACE-UP ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-8601-697-02 00860169702 PADDED POST-OP SHOE, YOUTH, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 00-0754-006-00 00075400600 FROIMSON TENNIS ELBOW SUPPORT, UNIVERSAL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-1295-002-00 00129500200 ZIMMER FOREARM SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-1295-003-00 00129500300 ZIMMER FOREARM SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-1295-004-00 00129500400 ZIMMER FOREARM SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-1295-005-00 00129500500 ZIMMER FOREARM SUPPORT, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-1295-008-00 00129500800 ZIMMER FOREARM SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-1295-009-00 00129500900 ZIMMER FOREARM SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 96
# EDI Item # Item Header 1 Header 2 00-1295-010-00 00129501000 ZIMMER FOREARM SUPPORT, LARGE Type ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-1295-011-00 00129501100 ZIMMER FOREARM SUPPORT, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-1445-001-00 00144500100 TENNIS ELBOW SPT W/GEL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-3448-003-00 00344800300 NEOPRENE ELBOW SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-3448-004-00 00344800400 NEOPRENE ELBOW SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-3448-005-00 00344800500 NEOPRENE ELBOW SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-3448-006-00 00344800600 NEOPRENE ELBOW SUPPORT, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 00-0774-001-00 00077400100 ELASTIC KNEE SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-0774-002-00 00077400200 ELASTIC KNEE SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-0774-003-00 00077400300 ELASTIC KNEE SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-0774-004-00 00077400400 ELASTIC KNEE SUPPORT, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-3455-003-00 00345500300 KNEE SLEEVE W/CLOSED PATELLA, BEIGE, SMALL 00-3455-004-00 00345500400 KNEE SLEEVE W/CLOSED PATELLA, BEIGE, MEDIUM 00-3455-005-00 00345500500 KNEE SLEEVE W/CLOSED PATELLA, BEIGE, LARGE 00-3455-006-00 00345500600 KNEE SLEEVE W/CLOSED PATELLA, BEIGE, X-LARGE 00-3455-007-00 00345500700 KNEE SLEEVE W/CLOSED PATELLA, BEIGE, XX-LARGE 00-3455-023-00 00345502300 KNEE SLEEVE W/CLOSED PATELLA, BLUE, SMALL ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 97
# EDI Item # Item Header 1 Header 2 00-3455-024-00 00345502400 KNEE SLEEVE W/CLOSED PATELLA, BLUE, MEDIUM 00-3455-025-00 00345502500 KNEE SLEEVE W/CLOSED PATELLA, BLUE, LARGE 00-3455-026-00 00345502600 KNEE SLEEVE W/CLOSED PATELLA, BLUE, X-LARGE 00-3455-027-00 00345502700 KNEE SLEEVE W/CLOSED PATELLA, BLUE, XX-LARGE 00-3456-003-00 00345600300 KNEE SLEEVE W/OPEN PATELLA, BEIGE, SMALL 00-3456-004-00 00345600400 KNEE SLEEVE W/OPEN PATELLA, BEIGE, MEDIUM 00-3456-005-00 00345600500 KNEE SLEEVE W/OPEN PATELLA, BEIGE, LARGE 00-3456-006-00 00345600600 KNEE SLEEVE W/OPEN PATELLA, BEIGE, X-LARGE 00-3456-007-00 00345600700 KNEE SLEEVE W/OPEN PATELLA, BEIGE, XX-LARGE 00-3456-023-00 00345602300 KNEE SLEEVE W/OPEN PATELLA, BLUE, SMALL 00-3456-024-00 00345602400 KNEE SLEEVE W/OPEN PATELLA, BLUE, MEDIUM 00-3456-025-00 00345602500 KNEE SLEEVE W/OPEN PATELLA, BLUE, LARGE 00-3456-026-00 00345602600 KNEE SLEEVE W/OPEN PATELLA, BLUE, X-LARGE 00-3456-027-00 00345602700 KNEE SLEEVE W/OPEN PATELLA, BLUE, XX-LARGE 00-3457-000-00 00345700000 NEOPRENE UNIVERSAL KNEE SUPPORT, BEIGE 00-3458-103-00 00345810300 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, SML Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 98
# EDI Item # Item Header 1 Header 2 00-3458-104-00 00345810400 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, MED 00-3458-105-00 00345810500 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, LGE 00-3458-106-00 00345810600 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, X-LGE 00-3458-107-00 00345810700 NEOPRENE KNEE SPRT INFERIOR BUTTRESS BEIGE, XX-LGE 00-3458-108-00 00345810800 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, XXXLG 00-3458-109-00 00345810900 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, XXXXL 00-3458-123-00 00345812300 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, SML 00-3458-124-00 00345812400 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, MED 00-3458-125-00 00345812500 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, LGE 00-3458-126-00 00345812600 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, X-LGE 00-3458-127-00 00345812700 NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, XX-LGE 00-3458-203-00 00345820300 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BEIGE, SML 00-3458-204-00 00345820400 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BEIGE, MED 00-3458-205-00 00345820500 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BEIGE, LGE 00-3458-206-00 00345820600 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BEIGE, X-LGE 00-3458-207-00 00345820700 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS BEIGE, XX-LGE Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 99
# EDI Item # Item Header 1 Header 2 00-3458-208-00 00345820800 NEOPRENE KNEE SPRT SUPERIOR BTRSS BGE XXX-L 00-3458-209-00 00345820900 NEOPRENE KNEE SPRT SUPERIOR BTRSS BG XXXXLGE 00-3458-223-00 00345822300 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, SML 00-3458-224-00 00345822400 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, MED 00-3458-225-00 00345822500 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, LGE 00-3458-226-00 00345822600 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, X-LGE 00-3458-227-00 00345822700 NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, XX-LGE 00-3458-303-00 00345830300 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, SML 00-3458-304-00 00345830400 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, MED 00-3458-305-00 00345830500 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, LGE 00-3458-306-00 00345830600 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, X-LGE 00-3458-307-00 00345830700 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, XX-LGE 00-3458-323-00 00345832300 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, SML 00-3458-324-00 00345832400 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, MED 00-3458-325-00 00345832500 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, LGE 00-3458-326-00 00345832600 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, X-LGE Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 100
# EDI Item # Item Header 1 Header 2 00-3458-327-00 00345832700 NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, XX-LGE 00-3458-403-00 00345840300 NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, SML 00-3458-404-00 00345840400 NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, MED 00-3458-405-00 00345840500 NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, LGE 00-3458-406-00 00345840600 NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, X-LGE 00-3458-407-00 00345840700 NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, XX-LGE 00-3458-423-00 00345842300 NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, SML 00-3458-424-00 00345842400 NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, MED 00-3458-425-00 00345842500 NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, LGE 00-3458-426-00 00345842600 NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, X-LGE 00-3458-427-00 00345842700 NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, XX-LGE 00-3459-003-00 00345900300 NEOPRENE PATELLAR STABILIZER, BEIGE, SMALL 00-3459-004-00 00345900400 NEOPRENE PATELLAR STABILIZER, BEIGE, MEDIUM 00-3459-005-00 00345900500 NEOPRENE PATELLAR STABILIZER, BEIGE, LARGE 00-3459-006-00 00345900600 NEOPRENE PATELLAR STABILIZER, BEIGE, X-LARGE 00-3459-007-00 00345900700 NEOPRENE PATELLAR STABILIZER, BEIGE, XX-LARGE Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 101
# EDI Item # Item Header 1 Header 2 00-3459-023-00 00345902300 NEOPRENE PATELLAR STABILIZER, BLUE, SMALL 00-3459-024-00 00345902400 NEOPRENE PATELLAR STABILIZER, BLUE, MEDIUM 00-3459-025-00 00345902500 NEOPRENE PATELLAR STABILIZER, BLUE, LARGE 00-3459-026-00 00345902600 NEOPRENE PATELLAR STABILIZER, BLUE, X-LARGE 00-3459-027-00 00345902700 NEOPRENE PATELLAR STABILIZER, BLUE, XX-LARGE 00-3460-003-00 00346000300 NEOPRENE HINGED KNEE SUPPORT, BEIGE, SMALL Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3460-004-00 00346000400 NEOPRENE HINGED KNEE SUPPORT, BEIGE, MEDIUM 00-3460-005-00 00346000500 NEOPRENE HINGED KNEE SUPPORT, BEIGE, LARGE 00-3460-006-00 00346000600 NEOPRENE HINGED KNEE SUPPORT, BEIGE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 102
# EDI Item # Item Header 1 Header 2 00-3460-007-00 00346000700 NEOPRENE HINGED KNEE SUPPORT, BEIGE, XX-LARGE Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3460-023-00 00346002300 NEOPRENE HINGED KNEE SUPPORT, BLUE, SMALL 00-3460-024-00 00346002400 NEOPRENE HINGED KNEE SUPPORT, BLUE, MEDIUM 00-3460-025-00 00346002500 NEOPRENE HINGED KNEE SUPPORT, BLUE, LARGE 00-3460-026-00 00346002600 NEOPRENE HINGED KNEE SUPPORT, BLUE, X-LARGE 00-3460-027-00 00346002700 NEOPRENE HINGED KNEE SUPPORT, BLUE, XX-LARGE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3461-003-00 00346100300 NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, SML 00-3461-004-00 00346100400 NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, MED ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 103
# EDI Item # Item Header 1 Header 2 00-3461-005-00 00346100500 NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, LGE 00-3461-006-00 00346100600 NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, XLG 00-3461-007-00 00346100700 NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, XXL 00-1558-001-00 00155800100 FLEXION/EXTENSION KNEE BRACE, REGULAR 00-1558-002-00 00155800200 FLEXION/EXTENSION KNEE BRACE, SHORT Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support E1812 Y DYNAMIC KNEE, EXTENSION/FLEXION DEVICE WITH ACTIVE RESISTANCE CONTROL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support E1812 Y DYNAMIC KNEE, EXTENSION/FLEXION DEVICE WITH ACTIVE RESISTANCE CONTROL 00-1746-001-00 00174600100 DROP-LOK KNEE BRACE, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1746-002-00 00174600200 DROP-LOK KNEE BRACE, SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 104
# EDI Item # Item Header 1 Header 2 Type 00-1746-003-00 00174600300 DROP-LOK KNEE BRACE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1746-004-00 00174600400 DROP-LOK KNEE BRACE, LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1746-005-00 00174600500 DROP-LOK KNEE BRACE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1747-001-00 00174700100 CARTILAGE KNEE BRACE, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-1747-002-00 00174700200 CARTILAGE KNEE BRACE, SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-1747-003-00 00174700300 CARTILAGE KNEE BRACE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-1747-004-00 00174700400 CARTILAGE KNEE BRACE, LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 00-1747-005-00 00174700500 CARTILAGE KNEE BRACE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; 0274- OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 105
# EDI Item # Item Header 1 Header 2 Type 00-1773-002-00 00177300200 HINGED KNEE SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1773-003-00 00177300300 HINGED KNEE SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1773-004-00 00177300400 HINGED KNEE SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1773-005-00 00177300500 HINGED KNEE SUPPORT, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3475-010-00 00347501000 NEOPRENE HINGED KNEE SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 106
# EDI Item # Item Header 1 Header 2 00-3475-011-00 00347501100 NEOPRENE HINGED KNEE SUPPPORT, MEDIUM Type ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3475-012-00 00347501200 NEOPRENE HINGED KNEE SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3475-013-00 00347501300 NEOPRENE HINGED KNEE SUPPORT, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-3475-014-00 00347501400 NEOPRENE HINGED KNEE SPT, XXL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-4444-002-00 00444400200 STANDARD ORTHOPAEDIC WRAP, 2IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-003-00 00444400300 STANDARD ORTHOPAEDIC WRAP, 3IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-004-00 00444400400 STANDARD ORTHOPAEDIC WRAP, 4IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 107
# EDI Item # Item Header 1 Header 2 00-4444-006-00 00444400600 STANDARD ORTHOPAEDIC WRAP, 6IN X 5YD Type ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-012-00 00444401200 STANDARD ORTHOPAEDIC WRAP, 2IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-013-00 00444401300 STANDARD ORTHOPAEDIC WRAP, 3IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-014-00 00444401400 STANDARD ORTHOPAEDIC WRAP, 4IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-016-00 00444401600 STANDARD ORTHOPAEDIC WRAP, 6IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-024-00 00444402400 STANDARD ORTHOPAEDIC WRAP, 4IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-026-00 00444402600 STANDARD ORTHOPAEDIC WRAP, 6IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-002-00 00555500200 PREMIUM ORTHOPAEDIC WRAP, 2IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-003-00 00555500300 PREMIUM ORTHOPAEDIC WRAP, 3IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-004-00 00555500400 PREMIUM ORTHOPAEDIC WRAP, 4IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-006-00 00555500600 PREMIUM ORTHOPAEDIC WRAP, 6IN X 5.5 YDS ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-024-00 00555502400 PREMIUM ORTHOPAEDIC WRAP, 4IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-026-00 00555502600 PREMIUM ORTHOPAEDIC WRAP, 6IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 108
# EDI Item # Item Header 1 Header 2 00-5555-032-00 00555503200 STERILE PREMIUM ORTHOPAEDIC WRAP, 2IN X 5.5YD Type ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-033-00 00555503300 STERILE PREMIUM ORTHOPAEDIC WRAP, 3IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-034-00 00555503400 STERILE PREMIUM ORTHOPAEDIC WRAP, 4IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-036-00 00555503600 STERILE PREMIUM ORTHOPAEDIC WRAP, 6IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-044-00 00555504400 STERILE PREMIUM ORTHOPAEDIC WRAP, 4IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-046-00 00555504600 STERILE PREMIUM ORTHOPAEDIC WRAP, 6IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-102-00 00444410200 STANDARD ORTHOPAEDIC WRAP NON-LATEK 2IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-103-00 00444410300 STANDARD ORTHOPAEDIC WRAP NON-LATEKX 3IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-104-00 00444410400 STANDARD ORTHOPAEDIC WRAP NON-LATEX 4IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-106-00 00444410600 STANDARD ORTHOPAEDIC WRAP NON-LATEX 6IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-112-00 00444411200 STANDARD ORTHOPAEDIC WRAP NON-LATEX 2IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-113-00 00444411300 STANDARD ORTHOPAEDIC WRAP NON-LATEX 3IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-114-00 00444411400 STANDARD ORTHOPAEDIC WRAP NON-LATEX 4IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 109
# EDI Item # Item Header 1 Header 2 00-4444-116-00 00444411600 STANDARD ORTHOPAEDIC WRAP NON-LATEX 6IN X 5YD Type ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-124-00 00444412400 STANDARD ORTHOPAEDIC WRAP NON-LATEX 4IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-4444-126-00 00444412600 STANDARD ORTHOPAEDIC WRAP NON-LATEX 6IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-102-00 00555510200 PREMIUM ORTHOPAEDIC WRAP NON-LATEX 2IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-103-00 00555510300 PREMIUM ORTHOPAEDIC WRAP NON-LATEX 3IN X 5.5 YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-104-00 00555510400 PREMIUM ORTHOPAEDIC WRAP NON-LATEX 4IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-106-00 00555510600 PREMIUM ORTHOPAEDIC WRAP NON-LATEX 6IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-124-00 00555512400 PREMIUM ORTHOPAEDIC WRAP NON-LATEX 4IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-126-00 00555512600 PREMIUM ORTHOPAEDIC WRAP NON-LATEX 6IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-232-00 00555523200 STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-233-00 00555523300 STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-234-00 00555523400 STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-236-00 00555523600 STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 110
# EDI Item # Item Header 1 Header 2 Type 00-5555-244-00 00555524400 STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-5555-246-00 00555524600 STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non- 00-1610-014-00 00161001400 INSTANT COLD PACK, SMALL ORTHOPAEDIC BRACES & SUPPORTS COLD PACKS Orthopaedic 00-1610-015-00 00161001500 INSTANT COLD PACK, LARGE ORTHOPAEDIC BRACES & SUPPORTS COLD PACKS Orthopaedic 00-2761-022-12 00276102212 COLD THERAPY WRAP, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic 00-2761-023-12 00276102312 COLD THERAPY WRAP, SMALL ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic 00-2761-024-12 00276102412 COLD THERAPY WRAP, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic 00-2761-025-12 00276102512 COLD THERAPY WRAP, LARGE ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic 00-2761-026-12 00276102612 COLD THERAPY WRAP, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic 00-2761-027-12 00276102712 COLD THERAPY WRAP, SHOULDER ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic 00-2763-025-12 00276302512 COLD THERAPY WRAP, X-LONG ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic 00-1702-005-00 00170200500 PLASTIC FOREARM SPLINT, CHILD, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1702-006-00 00170200600 PLASTIC FOREARM SPLINT, CHILD, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 111
# EDI Item # Item Header 1 Header 2 00-1702-007-00 00170200700 PLASTIC FOREARM SPLINT, YOUTH, LEFT Type SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1702-008-00 00170200800 PLASTIC FOREARM SPLINT, YOUTH, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1702-009-00 00170200900 PLASTIC FOREARM SPLINT, ADULT, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1702-010-00 00170201000 PLASTIC FOREARM SPLINT, ADULT, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1704-005-00 00170400500 PLASTIC COLLES SPLINT, SMALL CHILD, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1704-006-00 00170400600 PLASTIC COLLES SPLINT, SMALL CHILD, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1704-007-00 00170400700 PLASTIC COLLES SPLINT, CHILD, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1704-008-00 00170400800 PLASTIC COLLES SPLINT, CHILD, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1704-009-00 00170400900 PLASTIC COLLES SPLINT, YOUTH/SMALL ADULT, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- Service not separately priced by part B 00-1704-010-00 00170401000 PLASTIC COLLES SPLINT, YOUTH/SMALL ADULT, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1704-011-00 00170401100 PLASTIC COLLES SPLINT, ADULT, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 00-1704-012-00 00170401200 PLASTIC COLLES SPLINT, ADULT, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0012-001-00 66001200100 FOREARM SPLINT, LEFT, CHILD, PADDED, 7-1/2 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 112
# EDI Item # Item Header 1 Header 2 66-0012-002-00 66001200200 FOREARM SPLINT, RIGHT, CHILD, PADDED, 7-1/2 Type SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0012-003-00 66001200300 FOREARM SPLINT, LEFT, YOUTH, PADDED, 10 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0012-004-00 66001200400 FOREARM SPLINT, RIGHT, YOUTH, PADDED, 10 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0012-005-00 66001200500 FOREARM SPLINT, LEFT, ADULT, PADDED, 11-1/2 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0012-006-00 66001200600 FOREARM SPLINT, RIGHT, ADULT, PADDED, 11-1/2 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0020-001-00 66002000100 COLLES SPLINT PADDED LEFTSMALL CHILD SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0020-002-00 66002000200 COLLES SPLINT, PADDED, RIGHT, SMALL CHILD SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0020-003-00 66002000300 COLLES SPLINT, PADDED, LEFT, CHILD, 8 1/4 X 2 3/4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0020-004-00 66002000400 COLLES SPLINT, PADDED, RIGHT, CHILD, 8 1/4 X 2 3/4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0020-005-00 66002000500 COLLES SPLINT, PADDED, LEFT, YOUTH, 10 X 3 1/4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0020-006-00 66002000600 COLLES SPLINT, PADDED, RIGHT, YOUTH, 10 X 3 1/4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0020-007-00 66002000700 COLLES SPLINT, PADDED, LEFT, ADULT, 11 X 4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 66-0020-008-00 66002000800 COLLES SPLINT, PADDED, RIGHT, ADULT, 11 X 4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 113
# EDI Item # Item Header 1 Header 2 00-0016-001-00 00001600100 METACARPAL SPLINT, LEFT, YOUTH, ANTERIOR 9 X 8CM 00-0016-002-00 00001600200 METACARPAL SPLINT, RIGHT, YOUTH, ANTERIOR 9 X 8CM 00-0016-003-00 00001600300 METACARPAL SPLINT, LEFT, ADULT, ANTERIOR 10 X 9CM 00-0016-004-00 00001600400 METACARPAL SPLINT, RIGHT,ADULT, ANTERIOR 10 X 9CM 00-0025-001-00 00002500100 FINGER PROTECTORS NONPADDED 4 CM Type SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc 00-0025-002-00 00002500200 FINGER PROTECTORS NONPADDED 8 CM SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-0025-003-00 00002500300 FINGER PROTECTORS NONPADDED 9 CM SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-0376-001-00 00037600100 MASON-ALLEN SPLINT SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274-00-0376-002-00 00037600200 MASON-ALLEN SPLINT SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274-00-0548-001-00 00054800100 ZIMFOAM FINGER SPLINTS, 46 X 2 CM 00-0548-002-00 00054800200 ZIMFOAM FINGER SPLINTS, 46 X 3 CM 00-0548-005-00 00054800500 ZIMFOAM FINGER SPLINTS, 23 X 1 CM SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274-00-0756-001-00 00075600100 ZIMFOAM BASEBALL SPLINTS, 2-3/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274-00-0756-002-00 00075600200 ZIMFOAM BASEBALL SPLINTS, 2-13/16 SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274-00-0756-011-00 00075601100 ZIMFOAM BASEBALL SPLINTS, 2-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274-00-1756-001-00 00175600100 ZIMFOAM FINGER SPLINT KIT SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274-00-2548-001-00 00254800100 FINGER SPLINT KITS, ASSORTED SIZES SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2548-011-00 00254801100 FINGER SPLINT KITS, 1-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2548-012-00 00254801200 FINGER SPLINT KITS, 2-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2548-013-00 00254801300 FINGER SPLINT KITS, 3-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2548-014-00 00254801400 FINGER SPLINT KITS, 4-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 114
# EDI Item # Item Header 1 Header 2 Type 00-2548-015-00 00254801500 FINGER SPLINT KIT, W/BULB, 3-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2548-016-00 00254801600 FINGER SPLINT KIT, W/BULB, 4-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2548-017-00 00254801700 FINGER SPLINT KIT, W/BULB, 5-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2548-018-00 00254801800 FINGER SPLINT KIT, W/BULB, 6-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2548-019-00 00254801900 FINGER SPLINT KIT, W/BULB, 7-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2549-001-00 00254900100 STAX FINGER SPLINT KIT SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-2549-011-00 00254901100 REPLACEMENT SPLINTS, 1 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 00-2549-012-00 00254901200 REPLACEMENT SPLINTS, 2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 00-2549-013-00 00254901300 REPLACEMENT SPLINTS, 3 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 00-2549-014-00 00254901400 REPLACEMENT SPLINTS, 4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 00-2549-015-00 00254901500 REPLACEMENT SPLINTS, 5 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 00-2549-016-00 00254901600 REPLACEMENT SPLINTS, 5-1/2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 00-2549-017-00 00254901700 REPLACEMENT SPLINTS, 6 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 00-2549-018-00 00254901800 REPLACEMENT SPLINTS, 7 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 66-0017-001-00 66001700100 PADDED FINGER SPLINTS, 1-5/8 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0017-002-00 66001700200 PADDED FINGER SPLINTS, 2-5/8 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0017-003-00 66001700300 PADDED FINGER SPLINTS, 6 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 115
# EDI Item # Item Header 1 Header 2 Type 66-0017-004-00 66001700400 FINGER COTS, PADDED, 1-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0017-005-00 66001700500 FINGER COTS, PADDED, 2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0017-006-00 66001700600 FINGER COTS, PADDED, 3 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0017-007-00 66001700700 FINGER COTS, PADDED, 3-1/2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0017-008-00 66001700800 ZIMFOAM FINGER SPLINTS, PADDED, 3-5/8 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0017-009-00 66001700900 ZIMFOAM FINGER SPLINTS, PADDED, 4-5/8 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0017-013-00 66001701300 NARROW FINGER SPLINTS, PADDED, 6 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0025-001-00 66002500100 FINGER PROTECTORS, PADDED, 1-1/2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0025-002-00 66002500200 FINGER PROTECTORS, PADDED, 3 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0025-003-00 66002500300 FINGER PROTECTORS, PADDED, 3-1/2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 66-0080-001-00 66008000100 LEWIN STERN THUMB SPLINT,6 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 66-0080-002-00 66008000200 LEWIN STERN FINGER SPLINT8-7/16 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 66-0081-000-00 66008100000 LEWIN BASEBALL SPLINTS, 3 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 66-0081-002-00 66008100200 LEWIN BASEBALL SPLINTS, 4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) 66-0081-003-00 66008100300 LEWIN BASEBALL SPLINTS, 5 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 00-8905-002-00 00890500200 UNIVERSAL PLASTER SPLINTING, 7.2 YD SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-00-8905-003-00 00890500300 UNIVERSAL PLASTER SPLINTING, 7.2 YD SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-00-8905-004-00 00890500400 UNIVERSAL PLASTER SPLINTING, 7.2 YD SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 116
# EDI Item # Item Header 1 Header 2 00-8905-005-00 00890500500 UNIVERSAL PLASTER SPLINTING, 7.2 YD Type SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-00-8905-006-00 00890500600 UNIVERSAL PLASTER SPLINTING, 7.2 YD SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-00-8906-013-00 00890601300 FIBERGLASS SPLINTING, 3 X 12 SPLINTS UNIVERSAL SPLINTS Splints Splint A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8906-014-00 00890601400 FIBERGLASS SPLINTING, 4 X 15 SPLINTS UNIVERSAL SPLINTS Splints Splint A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8906-024-00 00890602400 FIBERGLASS SPLINTING, 4 X 30 SPLINTS UNIVERSAL SPLINTS Splints Splint A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-1706-005-00 00170600500 PLASTIC TIBIA/FIBULA SPLINT SML CHILD, KNEE LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 00-1706-006-00 00170600600 PLASTIC TIBIA/FIBULA SPLINT, CHILD, KNEE LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 00-1706-007-00 00170600700 PLASTIC TIBIA/FIBULA SPLINT, YOUTH, KNEE LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 00-1706-008-00 00170600800 PLASTIC TIBIA/FIBULA SPLINT, ADULT, KNEE LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 00-1706-009-00 00170600900 PLASTIC TIBIA/FIBULA SPLINT SML CHILD, HIP LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 00-1706-010-00 00170601000 PLASTIC TIBIA/FIBULA SPLINT, CHILD, HIP LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 00-1706-011-00 00170601100 PLASTIC TIBIA/FIBULA SPLINT, YOUTH, HIP LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 00-1706-012-00 00170601200 PLASTIC TIBIA/FIBULA SPLINT, ADULT, HIP LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 66-0040-001-00 66004000100 TIBIA/FIBULA SPLINT, PAD,SMALL CHILD, 8-3/4 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 66-0040-002-00 66004000200 TIBIA/FIBULA SPLINT, PAD,CHILD, 11-3/4 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 66-0040-003-00 66004000300 TIBIA/FIBULA SPLINT, PAD,YOUTH/SMALL ADULT, 14 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 117
# EDI Item # Item Header 1 Header 2 Type 66-0040-004-00 66004000400 TIBIA/FIBULA SPLINT, PAD,ADULT, 15- SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274-3/4 See Also Q4051 Splint supplies misc 66-0040-005-00 66004000500 TIBIA/FIBULA SPLINT, PAD,HIP, SMALL CHILD, 14 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 66-0040-006-00 66004000600 TIBIA/FIBULA SPLINT, PAD,HIP, CHILD, 19-1/2 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 66-0040-007-00 66004000700 TIBIA/FIBULA SPLINT, PAD, HIP, Y/SML ADULT SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 66-0040-008-00 66004000800 TIBIA/FIBULA SPLINT, PAD,HIP, ADULT, 31 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; 0274- See Also Q4051 Splint supplies misc 00-1632-010-00 00163201000 HUMERAL FRACTURE BRACE, SMALL SPLINTS FRACTURE BRACES Cast Cast L3980 A Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1632-011-00 00163201100 HUMERAL FRACTURE BRACE, LARGE SPLINTS FRACTURE BRACES Cast Cast L3980 A Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8915-043-00 00891504300 THUMB/WRIST IMMOBILIZER, SMALL, SPLINTS FRACTURE BRACES Cast LEFT 00-8915-044-00 00891504400 THUMB/WRIST IMMOBILIZER, SMALL, SPLINTS FRACTURE BRACES Cast RIGHT Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 118
# EDI Item # Item Header 1 Header 2 00-8915-045-00 00891504500 THUMB/WRIST IMMOBILIZER, MEDIUM, LEFT Type SPLINTS FRACTURE BRACES Cast Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8915-046-00 00891504600 THUMB/WRIST IMMOBILIZER, MEDIUM, RIGHT SPLINTS FRACTURE BRACES Cast Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8915-047-00 00891504700 THUMB/WRIST IMMOBILIZER, LARGE, LEFT SPLINTS FRACTURE BRACES Cast Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-8915-048-00 00891504800 THUMB/WRIST IMMOBILIZER, LARGE, RIGHT SPLINTS FRACTURE BRACES Cast Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 00-1086-002-00 00108600200 ABDUCTION PILLOW SET, SMALL FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-1086-003-00 00108600300 ABDUCTION PILLOW SET, MEDIUM FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-1086-004-00 00108600400 ABDUCTION PILLOW SET, LARGE FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-1086-012-00 00108601200 ABDUCTION PILLOW BAND, SMALL FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-1086-013-00 00108601300 ABDUCTION PILLOW BAND, MEDIUM FOAM PRODUCTS ABDUCTION PILLOWS Foam Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES 0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 119
# EDI Item # Item Header 1 Header 2 00-1086-014-00 00108601400 ABDUCTION PILLOW BAND, LARGE FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-1086-022-00 00108602200 TUBULAR ZIMFOAM PADS, SMALL FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-1086-023-00 00108602300 TUBULAR ZIMFOAM PADS, MEDIUM FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-1086-024-00 00108602400 TUBULAR ZIMFOAM PADS, LARGE FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-1086-032-00 00108603200 ABDUCTION PILLOW STRAPS, SMALL 00-1086-033-00 00108603300 ABDUCTION PILLOW STRAPS, MEDIUM 00-1086-034-00 00108603400 ABDUCTION PILLOW STRAPS, LARGE Type FOAM PRODUCTS ABDUCTION PILLOWS Foam FOAM PRODUCTS ABDUCTION PILLOWS Foam FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-2671-001-00 00267100100 ABDUCTION PILLOWS FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-2671-002-00 00267100200 ABDUCTION PILLOWS FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-2671-003-00 00267100300 ABDUCTION PILLOWS FOAM PRODUCTS ABDUCTION PILLOWS Foam 00-0658-001-00 00065800100 HEEL PROTECTORS, ZIMMER FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH 0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274- Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 120
# EDI Item # Item Header 1 Header 2 00-1761-001-00 00176100100 HEEL PROTECTOR, ECONOMY FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam Type Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-1782-001-00 00178200100 HEEL/ELBOW PROTECTORS, ULTRA- FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam CARE Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-2790-010-00 00279001000 HEEL/ELBOW PROTECTORS, SLEEVE KNIT FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 00-8713-001-00 00871300100 HEEL/ELBOW PROTECTORS FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam 00-2656-000-00 00265600000 OR DONUTS FOAM PRODUCTS POSITIONERS Foam 00-2658-000-00 00265800000 MULTI-CRADLE POSITIONER FOAM PRODUCTS POSITIONERS Foam 00-2663-000-00 00266300000 LAMINECTOMY ARM CRADLES FOAM PRODUCTS POSITIONERS Foam 00-2664-000-00 00266400000 ULNAR NERVE PROTECTORS FOAM PRODUCTS POSITIONERS Foam Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 121
# EDI Item # Item Header 1 Header 2 00-2665-000-00 00266500000 BODY ALIGNERS FOAM PRODUCTS POSITIONERS Foam 00-2666-000-00 00266600000 CAST ELEVATORS FOAM PRODUCTS POSITIONERS Foam 00-2669-000-00 00266900000 FOOT DROP STOPS FOAM PRODUCTS POSITIONERS Foam 00-2670-000-00 00267000000 CRADLE BOOTS FOAM PRODUCTS POSITIONERS Foam 00-2675-000-00 00267500000 SHOULDER ABDUCTION POSITIONER Type FOAM PRODUCTS POSITIONERS Foam 00-2678-000-00 00267800000 L-P ULNAR NERVE PROTECTORS FOAM PRODUCTS POSITIONERS Foam 00-2679-000-00 00267900000 OR HEAD POSITIONER FOAM PRODUCTS POSITIONERS Foam 00-2680-000-00 00268000000 DEROTATION BOOT, COMPLETE FOAM PRODUCTS POSITIONERS Foam 00-2680-001-00 00268000100 DEROTATION BOOT LINER FOAM PRODUCTS POSITIONERS Foam 00-2040-003-00 00204000300 PCS KNEE ANTI-EMBOLISM STOCKINGS, SMALL, SHORT ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-0270 Medical surgical supplies general; 0274-00-2040-004-00 00204000400 PCS KNEE ANTI-EMBOLISM STOCKINGS, MEDIUM, SHORT ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-005-00 00204000500 PCS KNEE ANTI-EMBOLISM STOCKINGS, LARGE, SHORT ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-007-00 00204000700 PCS KNEE ANTI-EMBOLISM STOCKINGS, SMALL, REGULAR ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-008-00 00204000800 PCS KNEE ANTI-EMBOLISM STOCKINGS, MEDIUM, REGULAR ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-009-00 00204000900 PCS KNEE ANTI-EMBOLISM STOCKINGS, LARGE, REGULAR ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 122
# EDI Item # Item Header 1 Header 2 00-2040-010-00 00204001000 PCS KNEE ANTI-EMBOLISM STOCKINGS, X-LARGE, REGULAR Type ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-011-00 00204001100 PCS KNEE ANTI-EMBOLISM STOCKINGS, SMALL, LONG ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-012-00 00204001200 PCS KNEE ANTI-EMBOLISM STOCKINGS, MEDIUM, LONG ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-013-00 00204001300 PCS KNEE ANTI-EMBOLISM STOCKINGS, LARGE, LONG ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-014-00 00204001400 PCS KNEE ANTI-EMBOLISM STOCKINGS, X-LARGE, LONG ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; 0274-00-2040-023-00 00204002300 PCS THIGH ANTI-EMBOLISM STOCKINGS, SMALL, SHORT ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-024-00 00204002400 PCS THIGH ANTI-EMBOLISM STOCKINGS, MEDIUM, SHORT ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-025-00 00204002500 PCS THIGH ANTI-EMBOLISM STOCKINGS, LARGE, SHORT ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-027-00 00204002700 PCS THIGH ANTI-EMBOLISM STOCKINGS, SMALL, REGULAR ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-028-00 00204002800 PCS THIGH ANTI-EMBOLISM STOCKINGS, MEDIUM, REGULAR ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-029-00 00204002900 PCS THIGH ANTI-EMBOLISM STOCKINGS, LARGE, REGULAR ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-030-00 00204003000 PCS THIGH ANTI-EMBOLISM STOCKINGS, X-LGE, REGULAR ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-031-00 00204003100 PCS THIGH ANTI-EMBOLISM STOCKINGS, SMALL, LONG ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-032-00 00204003200 PCS THIGH ANTI-EMBOLISM STOCKINGS, MEDIUM, LONG ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-033-00 00204003300 PCS THIGH ANTI-EMBOLISM STOCKINGS, LARGE, LONG ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-2040-034-00 00204003400 PCS THIGH ANTI-EMBOLISM STOCKINGS, X-LARGE, LONG ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; 0274-00-0211-001-00 00021100100 WHITE FELT PADDING, 3/8 X 36 X 21 CASTING PRODUCTS CAST PADDING Cast Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 123
# EDI Item # Item Header 1 Header 2 00-0217-005-00 00021700500 WHITE FELT PADDING, 1/8 X 36 X 21 CASTING PRODUCTS CAST PADDING Cast Type Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-00-0775-001-00 00077500100 WHITE FELT PADDING, 1/4 X 36 X 21 CASTING PRODUCTS CAST PADDING Cast 00-0775-002-00 00077500200 WHITE FELT PADDING, 1/2 X 36 X 21 CASTING PRODUCTS CAST PADDING Cast 00-8890-002-00 00889000200 ORTHO CAST PADDING, 2 CASTING PRODUCTS CAST PADDING Cast 00-8890-003-00 00889000300 ORTHO CAST PADDING, 3 CASTING PRODUCTS CAST PADDING Cast 00-8890-004-00 00889000400 ORTHO CAST PADDING, 4 CASTING PRODUCTS CAST PADDING Cast 00-8890-005-00 00889000500 ORTHO CAST PADDING, 5 CASTING PRODUCTS CAST PADDING Cast Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274- Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274- Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274- Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274- Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274- Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-00-8899-002-00 00889900200 CAST VACUUM CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast 00-8899-019-00 00889901900 BAGS FILTER REPLACEMENT CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast Cast N/A N/A N/A Cast 00-8899-026-00 00889902600 CAST VAC WIREFORM CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast 00-8909-001-00 00890900100 ZIMMER CAST SAW CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast 00-8909-007-00 00890900700 ZIMMER CAST REMOVAL SYSTEM CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast 00-8909-011-00 00890901100 SUPER UNIVERSAL SAW BLADE CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast 00-8909-012-00 00890901200 UNIVERSAL CAST SAW BLADE,2-1/2 CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast Cast 00-8909-015-00 00890901500 CUTTER II SHROUD ASSEMBLY, 90 DEG CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast 00-8909-016-00 00890901600 CUTTER II SHROUD ASSEMBLY, CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast STRAIGHT 00-8909-065-00 00890906500 VACUUM CONNECTOR KIT, 90 DEG CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast 00-8909-066-00 00890906600 VACUUM CONNECTOR KIT, CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast STRAIGHT 02-8909-000-00 02890900000 CAST CUTTER REPAIR CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast 00-8896-013-00 00889601300 CASTING SPLINTS, 3 X 15 CASTING PRODUCTS CAST TAPE Cast Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8896-014-00 00889601400 CASTING SPLINTS, 4 X 15 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 124
# EDI Item # Item Header 1 Header 2 00-8896-023-00 00889602300 CASTING SPLINTS, 3 X 24 CASTING PRODUCTS CAST TAPE Cast Type Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8896-024-00 00889602400 CASTING SPLINTS, 4 X 24 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8896-030-00 00889603000 CASTING SPLINTS, 4 X 30 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-002-00 00889700200 ZIM-FLEX CAST TAPE 2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-002-01 00889700201 ZIM-FLEX CAST TAPE, RED 2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-002-02 00889700202 ZIM-FLEX CAST TAPE, PINK,2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-002-03 00889700203 ZIM-FLEX CAST TAPE, LIGHTBLUE, 2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-002-04 00889700204 ZIM-FLEX CAST TAPE, BLUE,2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-002-06 00889700206 ZIM-FLEX CAST TAPE, GREEN, 2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-003-00 00889700300 ZIM-FLEX CAST TAPE, 3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-003-01 00889700301 ZIM-FLEX CAST TAPE, RED, 3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-003-02 00889700302 ZIM-FLEX CAST TAPE, PINK,3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-003-03 00889700303 ZIM-FLEX CAST TAPE, LIGHTBLUE, 3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-003-04 00889700304 ZIM-FLEX CAST TAPE, BLUE,3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-003-06 00889700306 ZIM-FLEX CAST TAPE, GREEN, 3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-004-00 00889700400 ZIM-FLEX CAST TAPE, 4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-004-01 00889700401 ZIM-FLEX CAST TAPE, RED, 4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 125
# EDI Item # Item Header 1 Header 2 00-8897-004-02 00889700402 ZIM-FLEX CAST TAPE, PINK,4 CASTING PRODUCTS CAST TAPE Cast Type Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-004-03 00889700403 ZIM-FLEX CAST TAPE, LT BLU, 4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-004-04 00889700404 ZIM-FLEX CAST TAPE, BLUE,4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-004-06 00889700406 ZIM-FLEX CAST TAPE, GREEN, 4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-8897-005-00 00889700500 ZIM-FLEX CAST TAPE, 5 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; 0274-00-1720-000-00 00172000000 ESMARCH PLASTER SHEARS CASTING PRODUCTS CAST INSTRUMENTS Cast 00-3807-002-00 00380700200 UNIVERSAL SCISSORS, 18CM CASTING PRODUCTS CAST INSTRUMENTS Cast 00-3809-000-00 00380900000 UTILITY FELT SHEARS CASTING PRODUCTS CAST INSTRUMENTS Cast 00-3812-000-00 00381200000 BRUN PLASTER SHEARS CASTING PRODUCTS CAST INSTRUMENTS Cast 00-3820-000-00 00382000000 CAST CART CASTING PRODUCTS CAST INSTRUMENTS Cast 00-3820-054-00 00382005400 DISPOSABLE BUCKETS CASTING PRODUCTS CAST INSTRUMENTS Cast Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast 00-3826-000-00 00382600000 CAST SPREADER CASTING PRODUCTS CAST INSTRUMENTS Cast 00-3835-000-00 00383500000 BOEHLER CAST BREAKER CASTING PRODUCTS CAST INSTRUMENTS Cast 00-8889-002-00 00888900200 STOCKINETTE, 2 CASTING PRODUCTS STOCKINETTE Cast 00-8889-003-00 00888900300 STOCKINETTE, 3 CASTING PRODUCTS STOCKINETTE Cast 00-8889-004-00 00888900400 STOCKINETTE, 4 CASTING PRODUCTS STOCKINETTE Cast 00-8889-005-00 00888900500 STOCKINETTE, 5 CASTING PRODUCTS STOCKINETTE Cast Cast N/A N/A N/A Cast N/A N/A N/A Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274- Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274- Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274- Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; 0274-00-8801-000-00 00880100000 ZIMMER AIR DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A COMPLETE KIT 00-8801-001-00 00880100100 ZIMMER AIR DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A HANDPIECE 00-8821-000-00 00882100000 ZIMMER ELECTRIC DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A COMPLETE KIT 00-8821-001-00 00882100100 ZIMMER ELECTRIC DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A HANDPIECE 00-8831-001-00 00883100100 ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A 00-2195-000-00 00219500000 MESHGRAFT II TISSUE EXPANSION SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting N/A N/A N/A SYSTEM 00-2195-001-00 00219500100 MESHGRAFT II TISSUE EXPANSION UNIT SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting 00-7701-000-00 00770100000 ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 126
# EDI Item # Item Header 1 Header 2 Type 00-7701-001-00 00770100100 ZIMMER SKIN GRAFT MESHER COMPLETE 00-7701-002-00 00770100200 ZIMMER SKIN GRAFT MESHER W/ CUTTERS 00-8800-000-10 00880000010 ZIMMER DERMATOME BLADES STERILE SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting N/A N/A N/A SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting N/A N/A N/A SKIN GRAFT PRODUCTS DISPOSABLE DERMATOME BLADES Skin Grafting Skin Grafting 00-8831-000-10 00883100010 ZIMMER TISSUE BANK DERMATOME BLADES STERILE SKIN GRAFT PRODUCTS DISPOSABLE DERMATOME BLADES Skin Grafting Skin Grafting 00-8801-002-00 00880100200 AIR DERMATOME HOSE SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 00-8801-003-00 00880100300 DERMATOME AUTOCLAVE CASE SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 00-8802-001-00 00880200100 WIDTH PLATE, 1 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 00-8802-002-00 00880200200 WIDTH PLATE, 2 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting 00-8802-003-00 00880200300 WIDTH PLATE, 3 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting 00-8802-004-00 00880200400 WIDTH PLATE, 4 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting 00-8802-015-00 00880201500 WIDTH PLATE, 1.5 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting 00-8803-000-00 00880300000 DERMATOME SCREWDRIVER SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 00-8803-001-10 00880300110 WIDTH PLATE SCREWS SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting 00-8821-006-00 00882100600 ZIMMER ELECTRIC DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A POWER SUPPLY 00-8831-003-00 00883100300 ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A AUTOCLAVE CASE 00-8831-004-00 00883100400 ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 3 IN WIDTH PLATE 00-8831-005-00 00883100500 ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 4 IN WIDTH PLATE 00-8831-006-00 00883100600 ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A POWER SUPPLY 06-0018-104-06 06001810406 AIR DERMATOME MANUAL SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 06-0018-105-79 06001810579 ELECTRIC DERMATOME MANUAL SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 00-2195-012-00 00219501200 DERMACARRIER II, 1.5:1, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting 00-2195-013-00 00219501300 DERMACARRIER II, 3:1, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 127
# EDI Item # Item Header 1 Header 2 Type 00-2195-014-00 00219501400 DERMACARRIER II, 6:1, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting 00-2195-015-00 00219501500 DERMACARRIER II, 9:1, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting 00-7708-000-10 00770800010 ZIMMER SKIN GRAFT CARRIER, 8 IN, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting 00-7716-000-10 00771600010 ZIMMER SKIN GRAFT CARRIER, 16 IN, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting 00-2195-006-00 00219500600 MESHGRAFT II AUTOCLAVE CASE SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting 00-2195-022-00 00219502200 MESHGRAFT II RATCHET HANDLE SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting 00-7701-003-00 00770100300 ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A AUTOCLAVE CASE 00-7701-022-00 00770102200 ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A RATCHET HANDLE 00-7701-026-00 00770102600 ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A COMB 00-7703-015-00 00770301500 CUTTER 1.5:1 EXPANSION RATIO SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 00-7703-020-00 00770302000 CUTTER 2:1 EXPANSION RATIO SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 00-7703-030-00 00770303000 CUTTER 3:1 EXPANSION RATIO SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 00-7703-040-00 00770304000 CUTTER 4:1 EXPANSION RATIO SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 06-0018-105-92 06001810592 ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A MANUAL 06-0018-105-93 06001810593 MESHGRAFT II MANUAL SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 02-8801-000-00 02880100000 ZIMMER AIR DERMATOME REPAIR SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A CHARGE 02-8801-002-00 02880100200 AIR DERMATOME HOSE (8801-02) SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A REPAIR CHARGE 02-8821-000-00 02882100000 ZIMMER ELECTRIC DERMATOME SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A REPAIR CHARGE 02-8821-006-00 02882100600 ELECTRIC DERMATOME POWER SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A SUPPLY REPAIR CHARGE 02-8831-000-00 02883100000 TISSUE BANK DERMATOME REPAIR SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A CHARGE 02-2195-000-00 02219500000 MESHGRAFT II REPAIR CHARGE SKIN GRAFT PRODUCTS MESHER REPAIRS Skin Grafting Skin Grafting N/A N/A N/A 02-2195-022-00 02219502200 MESHGRAFT II RATCHET HANDLE SKIN GRAFT PRODUCTS MESHER REPAIRS Skin Grafting Skin Grafting N/A N/A N/A REPAIR CHARGE 02-7701-000-00 02770100000 ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER REPAIRS Skin Grafting Skin Grafting N/A N/A N/A REPAIR CHARGE 02-7701-022-00 02770102200 MESHER RATCHET HANDLE REPAIR SKIN GRAFT PRODUCTS MESHER REPAIRS Skin Grafting Skin Grafting N/A N/A N/A 00-8600-056-00 00860005600 TUCK SHEET, 58 IN X 108 IN, STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 128
# EDI Item # Item Header 1 Header 2 Type 00-8600-057-00 00860005700 FLAT SHEET, 40 IN X 72 IN, STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting 00-8600-058-00 00860005800 HALF SHEET, 58 IN X 54 IN, STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting 00-8600-059-00 00860005900 MINI-SHEET, 20 IN X 30 IN, STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting 00-8600-070-00 00860007000 DISPENSER ROLL, 40 IN X 25 YD, NON-STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting 00-1112-140-01 00111214001 PALACOS R 1X40 SINGLE BONE CEMENT& ACCESSORIES PALACOS BONE CEMENT Bone Palacos Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories 00-1113-140-01 00111314001 PALACOS R+G 1X40 SINGLE (WITH GENTAMICIN) BONE CEMENT& ACCESSORIES PALACOS BONE CEMENT Bone Palacos Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories 00-1118-140-01 00111814001 PALACOS LV 1X40 SINGLE BONE CEMENT& ACCESSORIES PALACOS BONE CEMENT Bone Palacos Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories 00-1119-140-01 00111914001 PALACOS LVG 1X40 SINGLE BONE CEMENT& ACCESSORIES PALACOS BONE CEMENT Bone Palacos Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories 00-1101-002-00 00110100200 OSTEOBOND COPOLYMER BONE CEMENT SINGLE KIT 40GM 00-1101-012-00 00110101200 OSTEOBOND COPOLYMER BONE CEMENT TEN PK 40GM BONE CEMENT& ACCESSORIES OSTEOBOND COPOLYMER BONE CEMENT Bone Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories BONE CEMENT& ACCESSORIES OSTEOBOND COPOLYMER BONE CEMENT Bone Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories 00-5049-053-00 00504905300 QUIK-USE CURETTE 10 PACK BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories 00-5049-055-00 00504905500 FEMORAL BONE CEMENT PREP KIT BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories 00-5049-055-10 00504905510 FEMORAL BONE CEMENT PREP KIT 10 PACK BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories 00-5059-013-00 00505901300 FEMORAL BONE BRUSHES BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories 00-5059-080-00 00505908000 ORTHO DRI FEMORAL CANAL SPONGE BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 129
# EDI Item # Item Header 1 Header 2 00-5069-012-00 00506901200 HARRIS FEMORAL PRESSURIZER INTACT GREATER TROC Type BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories 00-5069-019-00 00506901900 FEMORAL NOZZLE SEAL INTACT GREATER TROCHANTER BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories 00-5069-020-00 00506902000 FEMORAL NOZZLE SEAL TROCHANTER OFF BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories 00-5069-051-00 00506905100 MILLER FEMORAL CANAL PRESSURIZERS MEDIUM BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories 00-5069-059-00 00506905900 MILLER BONE CEMENT INJECTOR CANCELLOUS PRESS SMALL BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories 00-5069-060-00 00506906000 MILLER BONE CEMENT INJECTOR CANCELLOUS PRESS LARGE BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories 00-5069-071-00 00506907100 MILLER FEMORAL CANAL PRESURIZERS SMALL BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories 00-5069-081-00 00506908100 MILLER FEMORAL CANAL PRESSURIZERS LARGE BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories 00-4032-050-00 00403205000 CHARNLEY TYPE ACETABULAR CUP CEMENT RESTRICTORS BONE CEMENT& ACCESSORIES RESTRICTORS Bone Bone Cement Cement & Accessories Accessories 00-4043-020-00 00404302000 CEMENT RESTRICTORS BONE CEMENT& ACCESSORIES RESTRICTORS Bone Bone Cement Cement & Accessories Accessories 00-4045-009-00 00404500900 CEMENT RESTRICTORS FLAT DISK BONE CEMENT& ACCESSORIES RESTRICTORS Bone Bone Cement Cement & Accessories Accessories 00-1102-012-00 00110201200 ZIMMER DOUGH-TYPE BONE CEMENT 40GM/20ML SINGLE 00-1102-022-00 00110202200 ZIMMER DOUGH-TYPE BONE CEMENT 40GM/20ML 10 PACK BONE CEMENT& ACCESSORIES ZIMMER BONE CEMENT Bone Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories BONE CEMENT& ACCESSORIES ZIMMER BONE CEMENT Bone Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories 00-1109-001-00 00110900100 ZIMMER POLY-PLUG INSERTER BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 130
# EDI Item # Item Header 1 Header 2 00-1109-009-00 00110900900 ZIMMER POLY-PLUG MEDULLARY PLUG, 9MM Type BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-1109-011-00 00110901100 ZIMMER POLY-PLUG MEDULLARY PLUG, 11MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-1109-013-00 00110901300 ZIMMER POLY-PLUG MEDULLARY PLUG, 13MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-1109-015-00 00110901500 ZIMMER POLY-PLUG MEDULLARY PLUG, 15MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-1109-017-00 00110901700 ZIMMER POLY-PLUG MEDULLARY PLUG, 17MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-1109-019-00 00110901900 ZIMMER POLY-PLUG MEDULLARY PLUG, 19MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-010-01 00801101001 12MM/16MM PLUGS WITH INSERTER BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-020-01 00801102001 20MM/24MM PLUGS WITH INSERTER BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-020-12 00801102012 ALLEN PLUG HDPE/BAS04 7C/12FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-020-16 00801102016 ALLEN PLUG HDPE/BASO4 8C/16FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-020-20 00801102020 ALLEN PLUG HDPE/BASO4 10C/20FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-020-24 00801102024 ALLEN PLUG HDPE/BASO4 12C/24FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-020-28 00801102028 ALLEN PLUG HDPE/BASO4 14C/28FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 131
# EDI Item # Item Header 1 Header 2 Type 00-8011-020-32 00801102032 ALLEN PLUG HDPE/BASO4,16C/32FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-030-01 00801103001 28MM/32MM PLUGS WITH INSERTER BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 00-8011-210-00 00801121000 ALLEN PLUG INSERTER METAL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 0961 0961 STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 1 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 3202 3202 STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 2 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 3208 3208 STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 2.5 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 3203 3203 STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 3 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 3209 3209 STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 3.5 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 3204 3204 STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 4 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 3205 3205 STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 5 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 3206 3206 STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 6 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 3207 3207 STUHMER/WEBER INTRAMED PLUG, SIZE 7 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 0981 0981 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 1, 8.1MM DIAMETER Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 132
# EDI Item # Item Header 1 Header 2 Type 3222 3222 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 2, 10.6MM DIAMETER Cement & Accessories Accessories 3228 3228 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 2.5,11.8MM DIAMETE Cement & Accessories Accessories 3223 3223 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 3, 13.5MM DIAMETER Cement & Accessories Accessories 3229 3229 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 3.5, 14.7MM DIAMET Cement & Accessories Accessories 3224 3224 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 4, 16.0MM DIAMETER Cement & Accessories Accessories 3225 3225 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 5, 18.5MM DIAMETER Cement & Accessories Accessories 3226 3226 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 6, 21.0MM DIAMETER Cement & Accessories Accessories 3227 3227 S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 7, 24.0MM DIAMETER Cement & Accessories Accessories 00-5069-006-00 00506900600 MILLER RATCHET INJECTOR BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 00-5069-008-00 00506900800 POWER-FLO CEMENT INJECTOR (CGUN) BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 00-5069-041-00 00506904100 MILLER 90-DEGREE INJECTOR NOZZLE BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 00-5069-045-00 00506904500 90 DEGREE BREAKAWAY NOZZLE BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 00-5069-054-00 00506905400 MILLER BONE CEMENT INJECTOR FLEX NOZZLE 12X0.25IN BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 133
# EDI Item # Item Header 1 Header 2 00-5069-056-00 00506905600 MILLER BONE CEMENT INJECTOR FLEX NOZZLE 16X0.38IN Type BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 00-5069-061-00 00506906100 MILLER BONE CEMENT INJECTOR BEZEL BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 00-5069-070-00 00506907000 MILLER TAPERED CEMENT NOZZLE BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 00-5069-091-00 00506909100 MILLER 90-DEGREE SHORT TIP INJECTOR NOZZLE BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 00-5049-001-00 00504900100 QUICK-VAC MIXING BOWL SINGLE BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories 00-5049-001-10 00504900110 QUICK-VAC MIXING BOWL 10 PACK BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories 00-5049-021-01 00504902101 QUICK-VAC MIXING SYSTEM SINGLE BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A N/A N/A N/A N/A N/A N/A 00-5049-025-01 00504902501 ZIMMER POWER-MIX VACUUM CEMENT MIXING SYSTEM BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A 00-5049-035-01 00504903501 ZIMMER COMPACT MIXING SYS BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A 00-5049-045-01 00504904501 3 DOSE COMPACT VACUUM MIXING SYSTEM BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A 00-5049-009-00 00504900900 MONOMER BOWL DEFLECTOR RING BONE CEMENT& ACCESSORIES MONOMER FUME EVACUATION BOWLS Bone Bone Cement Cement & Accessories Accessories 00-5049-010-00 00504901000 MONOMER BOWL WITH DEFLECTOR RING BONE CEMENT& ACCESSORIES MONOMER FUME EVACUATION BOWLS Bone Bone Cement Cement & Accessories Accessories 00-5049-030-00 00504903000 SUPER BOWL MIXING/EVACUATING SYSTEM BONE CEMENT& ACCESSORIES MONOMER FUME EVACUATION BOWLS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A 00-5049-040-00 00504904000 SUPER BOWL SECOND USE KIT BONE CEMENT& ACCESSORIES MONOMER FUME EVACUATION BOWLS Bone Bone Cement Cement & Accessories Accessories 00-5049-011-00 00504901100 DISPOSABLE MIXING BOWLS WITH SPATULA BONE CEMENT& ACCESSORIES DISPOSABLE MIXING BOWLS Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 134
# EDI Item # Item Header 1 Header 2 Type 00-5049-013-00 00504901300 BONE CEMENT MIXING SPATULAS BONE CEMENT& ACCESSORIES DISPOSABLE MIXING BOWLS Bone Bone Cement Cement & Accessories Accessories 93.00.56 930056 DISPOSABLE MIXING BOWL W/SPATULA (12 PK, NON-STER) BONE CEMENT& ACCESSORIES DISPOSABLE MIXING BOWLS Bone Bone Cement Cement & Accessories Accessories 00-4044-019-00 00404401900 MEDULLARY VENT TUBING* BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories 00-5049-038-00 00504903800 STRYKER/QUICK-VAC ADAPTER BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A N/A N/A N/A 00-5049-085-00 00504908500 ZIMMER VACUUM FOOT PUMP II NITROGEN BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A 00-5049-086-00 00504908600 ZIMMER VACUUM FOOT PUMP II AIR BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A 00-5051-005-00 00505100500 MONOMER FUME FILTER WITH 3/8 ADAPTORS BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A 00-5069-052-00 00506905200 MILLER CARTRIDGE KITS BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories 70-2000-070-00 70200007000 GLOVE LINER, SMALL BONE CEMENT& ACCESSORIES SURGICAL GLOVE LINERS Bone Bone Cement Cement & Accessories Accessories 70-2000-075-00 70200007500 GLOVE LINER, MEDIUM BONE CEMENT& ACCESSORIES SURGICAL GLOVE LINERS Bone Bone Cement Cement & Accessories Accessories 70-2000-080-00 70200008000 GLOVE LINER, LARGE BONE CEMENT& ACCESSORIES SURGICAL GLOVE LINERS Bone Bone Cement Cement & Accessories Accessories 70-2000-085-00 70200008500 GLOVE LINER, X-LARGE BONE CEMENT& ACCESSORIES SURGICAL GLOVE LINERS Bone Bone Cement Cement & Accessories Accessories 01040158 01040158 BOPS CHARGER CORD BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00505 PMX00505 BOPS POWER MODULE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00520 PMX00520 BOPS 4-BAY CHARGER BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00521 PMX00521 BOPS CHARGER BAY COVER BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00530 PMX00530 BOPS CHARGER MODULE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 135
# EDI Item # Item Header 1 Header 2 PMX00550 PMX00550 BOPS STERILE TRANS SLEEVE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00570 PMX00570 BOPS AUTOCLAVE CASE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00580 PMX00580 BOPS CANISTER LID BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) Type Brasseler BS Large Bone Common Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08500 PMX08500 BOPS MODULAR HANDPIECE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX12500 PMX12500 BOPS SAGITTAL/OSCIL SAW BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX14500 PMX14500 BOPS RECIPROCATOR SAW BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) Brasseler BS Large Bone Handpieces Brasseler BS Large Bone Handpieces Brasseler BS Large Bone Handpieces N/A N/A N/A N/A N/A N/A N/A N/A N/A PMX14901 PMX14901 STERNUM SAW GUARD BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08901 PMX08901 BOPS PIN DRIVER BOPS PIN/WIRE DRIVERS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08902 PMX08902 BOPS WIRE DRIVER BOPS PIN/WIRE DRIVERS Brasseler BS Large Bone Common N/A N/A N/A Accessrs 0103103 0103103 BOPS 5/32 CHUCK KEY LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs 0103104 0103104 BOPS 1/4 CHUCK KEY LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08905 PMX08905 TRINKLE/AO DRILL LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08910 PMX08910 1/4 JACOBS DRILL LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08915 PMX08915 5/32 JACOBS CHUCK LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08920 PMX08920 HUDSON DRILL LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08925 PMX08925 ZIMMER DRILL LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08930 PMX08930 1/4 KEYLESS CHUCK LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08935 PMX08935 3MM KEYLESS CHUCK LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08911 PMX08911 HI TORQUE 1/4 CHUCK LARGE BONE REAMER ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08950 PMX08950 HUDSON REAMER LARGE BONE REAMER ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08955 PMX08955 ZIMMER REAMER LARGE BONE REAMER ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08960 PMX08960 AO REAMER LARGE BONE REAMER ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs B60119035 B60119035 ST 90.0 X 11.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 136
# EDI Item # Item Header 1 Header 2 Type B60119050 B60119050 ST 90.0 X 11.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B60189035 B60189035 ST 90.0 X 18.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B60189050 B60189050 ST 90.0 X 18.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B602510050 B602510050 ST 100.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B60257535 B60257535 ST 75.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B60259050 B60259050 ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B60259053 B60259053 ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200001 K200001 LI 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200001T K200001T LI 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200002 K200002 LI 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200003 K200003 LI 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200004 K200004 LI 90.0 X 31.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200005 K200005 LI 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 137
# EDI Item # Item Header 1 Header 2 Type K200005I K200005I LI 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200005J K200005J LI 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200006 K200006 LI 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200006I K200006I LI 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200007 K200007 LI 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200008 K200008 LI 90.0 X 12.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200021 K200021 MD 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200021T K200021T MD 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200022 K200022 MD 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200023 K200023 MD 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200024 K200024 MD 90.0 X 31.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200025 K200025 MD 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200025I K200025I MD 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 138
# EDI Item # Item Header 1 Header 2 Type K200025J K200025J MD 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200026 K200026 MD 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200026F K200026F MD 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200026I K200026I MD 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200027 K200027 MD 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000302 K2000302 ST 85.0 X 25.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000305 K2000305 ST 70.0 X 25.0MM.015 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000328 K2000328 ST 95.0 X 25.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200041 K200041 ST 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200042 K200042 ST 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200043 K200043 ST 90.0 X 31.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200045 K200045 ST 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200045I K200045I ST 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 139
# EDI Item # Item Header 1 Header 2 Type K200045J K200045J ST 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200046 K200046 ST 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200047 K200047 ST 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000501 K2000501 SY 70.0 X 19.0MMM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000503 K2000503 SY 70.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000504 K2000504 SY 70.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000505 K2000505 SY 70.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000507 K2000507 SY 50.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K2000508 K2000508 SY 50.0 X 12.5MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200051 K200051 SY 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200051T K200051T SY 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200052 K200052 SY 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200053 K200053 SY 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 140
# EDI Item # Item Header 1 Header 2 Type K200055 K200055 SY 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200055I K200055I SY 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200055J K200055J SY 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200056 K200056 SY 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200056I K200056I SY 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200057 K200057 SY 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200058 K200058 SY 90.0 X 12.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200061 K200061 ST 90.0 X 19.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200062 K200062 ST 90.0 X 19.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200063 K200063 ST 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200064 K200064 ST 90.0 X 31.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200065 K200065 ST 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200065I K200065I ST 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 141
# EDI Item # Item Header 1 Header 2 Type K200065J K200065J ST 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200065T K200065T ST 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200066 K200066 ST 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200066I K200066I ST 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200066IS K200066IS LI 25.0 X 90.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200067 K200067 ST 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200067J K200067J ST 90.0 X 12.5MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200068 K200068 ST 90.0 X 12.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200069 K200069 ST 100.0 X 19.0MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200071 K200071 ST 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200072 K200072 LI 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200073 K200073 LI 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200074 K200074 LI 90.0 X 31.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 142
# EDI Item # Item Header 1 Header 2 Type K200075 K200075 LI 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200075I K200075I LI 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200075J K200075J LI 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200076 K200076 LI 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200076I K200076I LI 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200077 K200077 LI 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200078 K200078 LI 90.0 X 12.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6129035 K6129035 ST 90.0 X 12.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6129039 K6129039 ST 90.0 X 12.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6129050 K6129050 ST 90.0 X 12.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K61910050 K61910050 ST 100.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6197535 K6197535 ST 75.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6199035 K6199035 ST 90.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 143
# EDI Item # Item Header 1 Header 2 Type K6199050 K6199050 ST 90.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6199054 K6199054 ST 90.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K62510050 K62510050 ST 100.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6257535 K6257535 ST 75.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6259035 K6259035 ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6259039 K6259039 ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6259047 K6259047 ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6259050 K6259050 ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6259054 K6259054 ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K6259058 K6259058 ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7129035 K7129035 LI 90.0 X 12.5MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7129050 K7129050 LI 90.0 X 12.5MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7199035 K7199035 LI 90.0 X 19.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 144
# EDI Item # Item Header 1 Header 2 Type K7199050 K7199050 LI 90.0 X 19.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7199054 K7199054 LI 90.0 X 19.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K72510050 K72510050 LI 100.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7259035 K7259035 LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7259039 K7259039 LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7259047 K7259047 LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7259050 K7259050 LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7259054 K7259054 LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K7259058 K7259058 LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM101L KM101L MD 90.0 X 19.0MM.062 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM102L KM102L MD 90.0 X 29.0MM.066 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM10P KM10P MD 53.6 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM1100 KM1100 ST 62.5/11.5MM CUT EDGE LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 145
# EDI Item # Item Header 1 Header 2 Type KM110010 KM110010 MD 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM110020 KM110020 ST 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM110030 KM110030 LI 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM110210 KM110210 ST 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM110220 KM110220 ST 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM110230 KM110230 MD 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM11065 KM11065 ST 13.0MM CUT EDGE LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM111070 KM111070 ST 60.0 X 12.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM111810 KM111810 MD 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112010 KM112010 ST 90.0 X 25.4MM.056 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112030 KM112030 MD 90.0 X 25.4MM.056 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112040 KM112040 LI 90.0 X 25.4MM.056 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112184 KM112184 ST 60.0 X 12.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 146
# EDI Item # Item Header 1 Header 2 Type KM112212 KM112212 ST 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112213 KM112213 ST 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112214 KM112214 60.0 X 12.7MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112215 KM112215 ST 60.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112217 KM112217 ST 84.5 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112220 KM112220 ST 90.0 X 25.0MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112222 KM112222 ST 90.0 X 25.5MM.049 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112235 KM112235 MD 90.0 X 12.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112236 KM112236 LI 90.0 X 12.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112261 KM112261 LI 90.0 X 12.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112269 KM112269 LI 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112270 KM112270 LI 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM112324 KM112324 ST 85.0 X 12.7MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 147
# EDI Item # Item Header 1 Header 2 Type KM112325 KM112325 ST 90.0 X 12.7MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM11P KM11P MD 54.4 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM120136 KM120136 MD 19.5 X 86MM 1.27MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM120144 KM120144 LI 86.0 X 19.5MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM120176 KM120176 ST 19.5 X 86MM 1.27MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM120184 KM120184 SY 19.5 X 86MM 1.27MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM12P KM12P MD 78.0 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM13P KM13P MD 78.0 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM155236 KM155236 MD 13.5 X 64MM 0.9MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM155272 KM155272 ST 60.0 X 13.5.09MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM155284 KM155284 SY 64.0 X 13.5MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM193L KM193L MD 90.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM195L KM195L MD 25.0 X 9.5MM.025 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 148
# EDI Item # Item Header 1 Header 2 Type KM196L KM196L MD 85.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM197L KM197L MD 90.0 X 19.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM198L KM198L MD 90.0 X 30.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM205L KM205L MD 85.0 X 31.0MM.039 OS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM21L KM21L MD 60.0 X 15.5MM.062 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM227937 KM227937 MD 12.5 X 76MM 0.9MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM227973 KM227973 ST 71.6 X 12.7MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM22L KM22L MD 61.5 X 31.5MM.062 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM23L KM23L MD 60.0 X 15.5MM.043 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM24L KM24L MD 61.5 X 31.5MM.044 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM250R KM250R ST 60.0 X 6.35MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM251 KM251 LI 60.0X32.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM256 KM256 LI 60.0X33.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 149
# EDI Item # Item Header 1 Header 2 Type KM25L KM25L MD 30.0 X 7.0MM.040 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM26L KM26L MD 60.0 X 15.2MM.062 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM272 KM272 LI 70.0X19.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM274 KM274 LI 80.0X19.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM275R KM275R ST 70.0MM RECIPROCATING LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM27L KM27L MD 61.5 X 31.5MM.058 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM28L KM28L MD 61.5 X 31.5MM.036 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM29L KM29L MD 60.0 X 15.5MM.038 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM305 KM305 ST 70.0X25.4MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM307 KM307 ST 75.0X28.5MM.038 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM309 KM309 ST 85.0X25.4MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM30L KM30L MD 70.0 X 28.5MM.043 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM310 KM310 ST 70.0X25.4MM.060 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 150
# EDI Item # Item Header 1 Header 2 Type KM311 KM311 ST 85.0X25.4MM.066 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM315 KM315 ST 75.0X19.1MM.037 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM325R KM325R ST 77.5 X 11.2MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM330 KM330 ST 50.0X25.4MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM337Z KM337Z 30.0 X 82.0MM.040 STERN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM340 KM340 ST 60.0X32.0MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM350 KM350 ST 70.0X12.5MM.035 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM360 KM360 ST 70.0X25.4MM.046 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM375 KM375 ST 60.0X9.6MM.037 IN SAG LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM385 KM385 ST 110X19.0MM.058 IN SAG LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM393 KM393 ST 90.0X25.0MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM405 KM405 LI 90.0X25.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM407 KM407 LI 100.0 X 19.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 151
# EDI Item # Item Header 1 Header 2 Type KM408 KM408 LI 90.0 X 30.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM450 KM450 LI 60.0 X 49.0MM.040 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM451 KM451 LI 60.0 X 32.0MM.039 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM452 KM452 LI 60.0 X 12.5MM.039 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM453 KM453 LI 60.0 X 19.0MM.039 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM454 KM454 LI 70.0 X 19.0MM.067 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM455 KM455 LI 70.0 X 33.0MM.068 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM456 KM456 LI 60.0 X 33.0MM.049 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM458 KM458 LI 89.0 X 12.5MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM459 KM459 LI 52.6 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM460 KM460 LI 38.0 X 9.6MM.024 REC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM461 KM461 LI 89.0 X 12.2MM.068 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM472 KM472 LI 70.0 X 19.0MM.037 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 152
# EDI Item # Item Header 1 Header 2 Type KM473 KM473 LI 73.5 X 12.7MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM479 KM479 LI 76.0 X 12.7MM.038 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM493 KM493 LI 90.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM5071553V KM5071553V LI 60.0 X 19.0MM.036 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM5071581V KM5071581V LI 90.0 X 19.8MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM5072101 KM5072101 ST 86.0 X 19.5MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM5072181 KM5072181 ST 86.0 X 19.5MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51910 KM51910 SY 50.0 X 27.0MM.026 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM519119 KM519119 SY 90.0 X 27.0MM.042 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51915 KM51915 SY 45.0 X 14.0MM.026 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51917 KM51917 SY 70.0 X 27.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM519177 KM519177 SY 70.0 X 14.0MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51919 KM51919 SY 70.0 X 50.0MM.030 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 153
# EDI Item # Item Header 1 Header 2 Type KM51921 KM51921 SY 70.0 X 27.0MM.046 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51925 KM51925 SY 25.0 X 14.0MM.023 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM600 KM600 ST 70.0 X 25.0MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM602 KM602 ST 90.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM605 KM605 ST 70.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM609 KM609 ST 85.0 X 20.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM610 KM610 ST 73.0 X 25.0MM.059 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM611 KM611 ST 78.7 X 25.0MM.057 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM613 KM613 ST 34.0 X 16.5MM.068 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM615 KM615 ST 73.2 X 19.0MM.037 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM618 KM618 ST 78.7 X 25.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM619 KM619 ST 98.3 X 25.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM620 KM620 ST 60.5 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 154
# EDI Item # Item Header 1 Header 2 Type KM622 KM622 ST 95.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM625 KM625 30.0 X 42.0MM.040 STERN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM626 KM626 ST 90.0 X 25.0MM.053 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM627 KM627 ST 97.8 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM628 KM628 ST 90.0 X 30.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM631 KM631 ST 47.5 X 17.1MM.042 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM637 KM637 25.0 X 80.5MM.040 STERN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM640 KM640 ST 58.0 X 29.0MM.041 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM644 KM644 ST 24.0 X 6.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM645 KM645 ST 24.0 X 9.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM648 KM648 ST 34.5 X 9.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM650 KM650 ST 70.0 X 12.5MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM651 KM651 ST 85.0 X 25.0MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 155
# EDI Item # Item Header 1 Header 2 Type KM652 KM652 ST 81.5 X 12.5MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM655 KM655 ST 73.0 X 12.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM656 KM656 ST 80.0 X 12.5MM.057 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM658 KM658 ST 81.5 X 12.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM660 KM660 ST 73.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM675 KM675 ST 60.0 X 9.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM676 KM676 ST 80.0 X 25.0MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM677 KM677 ST 85.0 X 25.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM682 KM682 ST 83.0 X 18.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM683 KM683 ST 83.5 X 29.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM685 KM685 ST 104.0 X 18.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM689 KM689 ST 81.5 X 25.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM692 KM692 ST 40.0 X 20.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 156
# EDI Item # Item Header 1 Header 2 Type KM693 KM693 ST 81.5 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM695 KM695 ST 90.0 X 48.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM697 KM697 ST 60.0 X 48.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7010 KM7010 34.0 X 9.5MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71201 KM71201 LI 86.0 X 19.5MM HARDENED LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71232 KM71232 LI 41.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71233 KM71233 LI 25.0 X 9.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71234 KM71234 LI 41.0 X 9.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7126 KM7126 LI 15.0 X 63.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7127 KM7127 LI 35.0 X 8.5MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71520 KM71520 LI 95.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71523 KM71523 LI 95.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71524 KM71524 LI 95.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 157
# EDI Item # Item Header 1 Header 2 Type KM71540 KM71540 LI 80.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71542 KM71542 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71543 KM71543 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71545 KM71545 LI 72.0 X 13.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71550 KM71550 LI 63.0 X 49.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71551 KM71551 LI 63.0 X 32.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71552 KM71552 LI 64.0 X 13.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71553 KM71553 LI 63.0 X 19.5MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71554 KM71554 LI 71.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71555 KM71555 LI 71.0 X 33.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71556 KM71556 LI 64.0 X 35.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71561 KM71561 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71563 KM71563 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 158
# EDI Item # Item Header 1 Header 2 Type KM71567 KM71567 LI 90.0 X 19.5MM HARDENED LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71572 KM71572 LI 71.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71574 KM71574 LI 86.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71577 KM71577 LI 71.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71578 KM71578 LI 80.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71580 KM71580 LI 85.0 X 10.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71581 KM71581 LI 86.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71585 KM71585 LI 80.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71586 KM71586 LI 64.0 X 32.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71595 KM71595 LI 80.0 X 19.5MM HARDENED LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71596 KM71596 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7201 KM7201 LI 85.0 X 20.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7228 KM7228 LI 40.0 X 45.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 159
# EDI Item # Item Header 1 Header 2 Type KM7229 KM7229 LI 40.0 X 55.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7230 KM7230 LI 40.0 X 66.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7232 KM7232 LI 40.0 X 19.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7233 KM7233 LI 25.0 X 9.5MM.024 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7234 KM7234 LI 40.0 X 9.0MM.024 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7235 KM7235 LI 30.0 X 5.0MM.043 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7325 KM7325 LI 45.0 X 41.0MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7540 KM7540 LI 80.0 X 25.4MM.055 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7541 KM7541 LI 80.0 X 19.5MM.055 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7542 KM7542 LI 90.0 X 25.4MM.055 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7543 KM7543 LI 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7544 KM7544 LI 85.0 X 25.4MM.059 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7545 KM7545 LI 70.0 X 13.0MM.059 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 160
# EDI Item # Item Header 1 Header 2 Type KM7550 KM7550 LI 65.0 X 49.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7551 KM7551 LI 60.0 X 33.0MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7552 KM7552 LI 65.0 X 13.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7553 KM7553 LI 60.0 X 19.0MM.036 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7554 KM7554 LI 70.0 X 19.0MM.059 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7555 KM7555 LI 70.0 X 33.0MM.063 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7556 KM7556 LI 60.0 X 33.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7561 KM7561 LI 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7566 KM7566 LI 60.0 X 32.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7572 KM7572 LI 70.0 X 19.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7574 KM7574 LI 85.0 X 19.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7577 KM7577 LI 70.0 X 19.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7578 KM7578 LI 80.0 X 19.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 161
# EDI Item # Item Header 1 Header 2 Type KM7579 KM7579 LI 90.0 X 25.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7580 KM7580 LI 90.0 X 19.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7581 KM7581 LI 90.0 X 30.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM758140 KM758140 LI 85.0 X 19.8MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7593 KM7593 LI 90.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7595 KM7595 LI 80.0 X 19.5MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM97 KM97 32.0 X 6.35MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM97N KM97N 32.0 X 6.0MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM98 KM98 32.0 X 6.35MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM98N KM98N 32.0 X 6.35MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012100 PMX012100 S/O 25X73X0.99MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012101 PMX012101 S/O 25X90X0.99MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012102 PMX012102 S/O 25X73X0.99MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 162
# EDI Item # Item Header 1 Header 2 PMX012103 PMX012103 S/O 20.5X85X0.99MM (0.89)BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012104 PMX012104 S/O 25X73X1.50MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012105 PMX012105 S/O 25X78X1.45MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012106 PMX012106 S/O 16.5X34X1.73MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012107 PMX012107 S/O 19X73X0.94MM (0.79) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012108 PMX012108 S/O 25X78X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012109 PMX012109 S/O 25X98X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012110 PMX012110 S/O 17.5X47.5X1.07MM(.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012111 PMX012111 S/O 29X58X1.04MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012112 PMX012112 S/O 12.5X73X0.99MM (0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012113 PMX012113 S/O 25X85X1.19MM (1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012114 PMX012114 S/O 12.5X81.5X1.19MM(1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012115 PMX012115 S/O 25X80X1.47MM (1.47) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 163
# EDI Item # Item Header 1 Header 2 PMX012116 PMX012116 S/O 19X83.5X1.27MM (1.27)BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012117 PMX012117 S/O 19X86X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012118 PMX012118 S/O 19X60.5X0.97MM (0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012120 PMX012120 S/O 40.5X47.5X1.02MM(.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012121 PMX012121 S/O 25X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012122 PMX012122 S/O 19X97X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012123 PMX012123 S/O 6.0X24X0.84MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012124 PMX012124 S/O 9.5X24X0.84MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012125 PMX012125 S/O 9.5X34.5X0.84MM(0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012126 PMX012126 S/O 12.5X73X1.45MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012127 PMX012127 S/O 12.5X80X1.45MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012128 PMX012128 S/O 12.5X81.5X1.27MM(1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012129 PMX012129 S/O 25X73X1.40MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 164
# EDI Item # Item Header 1 Header 2 PMX012130 PMX012130 S/O 9.5X60.5X1.02MM(0.64)BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012131 PMX012131 S/O 25X86.5X1.35MM (1.35)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012132 PMX012132 S/O 29X83.5X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012133 PMX012133 S/O 19X104X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012134 PMX012134 S/O 25X LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 81.5X1.27MM(1.27)BRASSELER BOPS PMX012135 PMX012135 S/O 25X81.5X 0.99MM(0.99)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012136 PMX012136 S/O 48.5X90X0.99MM (0.99)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012137 PMX012137 S/O 19.5X86X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012140 PMX012140 S/O 25X90X1.25MM (0.99) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012141 PMX012141 S/O 25X90X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012142 PMX012142 S/O 12.5X60X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012143 PMX012143 S/O 12.5X90X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012144 PMX012144 S/O 25X86X1.47MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 165
# EDI Item # Item Header 1 Header 2 PMX012601 PMX012601 S/O 12.5X90X0.89MM (0.89)BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012604 PMX012604 S/O 12.5X90X1.37MM (1.37)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012610 PMX012610 S/O 19X100X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012611 PMX012611 S/O 19X75X0.89MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012612 PMX012612 S/O 19X90X0.89MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012614 PMX012614 S/O 19X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012615 PMX012615 S/O 19X100X1.19MM (1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012616 PMX012616 S/O 19X90X0.99MM (.099) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012620 PMX012620 S/O 25X100X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012621 PMX012621 S/O 25X75X0.89MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012622 PMX012622 S/O 25X90X0.89MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012623 PMX012623 S/O 25X90X0.99MM (0.99) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012624 PMX012624 S/O 25X90X1.19MM (1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 166
# EDI Item # Item Header 1 Header 2 PMX012625 PMX012625 S/O 25X90X1.27MM (1.27) BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012626 PMX012626 S/O 25X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012627 PMX012627 S/O 25X90X1.47MM (1.47) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012628 PMX012628 S/O 19X95X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012631 PMX012631 S/O 25X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012633 PMX012633 S/O 31X90X0.99MM (0.99) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012634 PMX012634 S/O 31X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012701 PMX012701 S/O 12.5X70X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012801 PMX012801 S/O 11X90X0.89MM (0.79) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012802 PMX012802 S/O 11X90X1.27MM (1.12) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012810 PMX012810 S/O 18X90X0.89MM (0.79) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012811 PMX012811 S/O 18X90X1.27MM (1.12) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012821 PMX012821 S/O 25X100X1.27MM (1.12) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 167
# EDI Item # Item Header 1 Header 2 PMX012822 PMX012822 S/O 25X75X0.89MM (0.79) BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012823 PMX012823 S/O 25X90X1.27MM (1.12) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX012824 PMX012824 S/O 25X90X1.35MM (1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX014301 PMX014301 RCP 6.3X60X1.04MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX014302 PMX014302 RCP 12.5X70X1.00 MM(0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX014303 PMX014303 RCP 6.3X77.5X1.04MM(0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX014901 PMX014901 STERNM 6.3X32X1.04MM(.80)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX014902 PMX014902 STERNM 6.3X32X1.02MM(.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large ST-2108-100 ST2108100 73.0X25.0X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-102 ST2108102 89.5X25.0X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-103 ST2108103 89.5X12.5X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-105 ST2108105 73.0X25.0X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-109 ST2108109 84.5X21.0X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 168
# EDI Item # Item Header 1 Header 2 ST-2108-110 ST2108110 73.0X25.0X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone ST-2108-111 ST2108111 79.5X25.0X1.25MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-115 ST2108115 73.0X18.5X0.76MM (.031IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-118 ST2108118 79.5X25.0X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-120 ST2108120 60.5X18.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-125 ST2108125 47.5X40.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-131 ST2108131 47.5X17.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-140 ST2108140 58.0X29.0X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-145 ST2108145 24.0X9.0X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-148 ST2108148 34.5X9.0X0.64MM ).025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-150 ST2108150 73.0X12.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-151 ST2108151 85.0X25.0X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-152 ST2108152 81.5X12.5X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 169
# EDI Item # Item Header 1 Header 2 ST-2108-155 ST2108155 73.0X12.5X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone ST-2108-156 ST2108156 79.5X12.5X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-158 ST2108158 81.5X12.5X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-160 ST2108160 73.0X25.0X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-175 ST2108175 60.5X9.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-176 ST2108176 79.5X25.0X1.50MM (.058IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-177 ST2108177 86.5X25.0X1.32MM (.052IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-182 ST2108182 83.5X18.5X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-183 ST2108183 83.5X29.0X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-185 ST2108185 104.0X18.5X1.24MM (.049IN LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-189 ST2108189 81.5X25.0X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-193 ST2108193 81.5X25.0X1.04MM (.041IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-2108-195 ST2108195 90.0X48.5X0.96MM (.038IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 170
# EDI Item # Item Header 1 Header 2 ST-2108-197 ST2108197 61.0X48.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone ST-2108-218 ST2108218 98.5X25.0X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4111-127-09 ST411112709 90X11X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4118-089-07 ST411808907 75X18X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4118-089-09 ST411808909 90X18X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4118-119-09 ST411811909 90X18X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4118-127-09 ST411812709 90X18X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4118-127-10 ST411812710 100X18X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4118-135-09 ST411813509 90X18X1.35MM (.053IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4118-137-09 ST411813709 90X18X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4125-064-07 ST412506407 75X25X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4125-089-07 ST412508907 75X25X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4125-127-09 ST412512709 90X25X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 171
# EDI Item # Item Header 1 Header 2 ST-4125-127-10 ST412512710 100X25X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone ST-4125-135-09 ST412513509 90X25X1.35MM (.053IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST-4125-147-09 ST412514709 90X25X1.47MM (.058IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1290-39 K9129039 90.0X12.5X0.99MM (.039IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1290-47 K9129047 90.0X12.5X01.19MM (.047IN LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1290-50 K9129050 90.0X12.5X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1290-54 K9129054 90.0X12.5X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1910-047 K91910047 100X19.0X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1910-050 K91910050 100X19.0X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1911-050 K91911050 110X19.0X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1990-39 K9199039 90.0X19.0X0.99MM (.039IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1990-50 K9199050 90.0X19.0X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-1990-54 K9199054 90.0X19.0X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 172
# EDI Item # Item Header 1 Header 2 K9-2510-050 K92510050 100X25.4X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone K9-2590-35 K9259035 90.0X25.4X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-39 K9259039 90.0X25.4X0.99MM(.039IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-39F K9259039F 90.0X25.4X0.99MM (.039IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-47 K9259047 90.0X25.4X1.19MM(.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-47F K9259047F 90.0X25.4X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-50 K9259050 90.0X25.4X1.27MM(.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-50F K9259050F 90.0X25.4X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-54 K9259054 90.0X25.4X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-54F K9259054F 90.0X25.4X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-58 K9259058 90.0X25.4X1.47MM (.058) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K9-2590-58F K9259058F 90.0X25.4X1.47MM (.058IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 11-2078-119-BO 112078119BO RCP 11.2X78X1.19MM BLADE SNGL BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 173
# EDI Item # Item Header 1 Header 2 12-5090-099-BO 125090099BO S/O 12.5X90X0.99MM BLADE BRASSELER BOPS Type ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 12-5090-119-BO 125090119BO S/O 12.5X90X1.19MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 12-5090-127-BO 125090127BO S/O 12.5X90X1.27MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 12-7076-097-BO 127076097BO RCP 12.7X76X0.97MM BLADE DBL BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 12-7076-127-BO 127076127BO RCP 12.7X76X1.27MM BLADE DBL BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 19-0090-127-BO 190090127BO S/O 19.0X90X1.27MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 19-0110-127-BO 190110127BO S/O 19.0X110X1.27MM BLADEBRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 25-4090-099-BO 254090099BO S/O 25.4X90X0.99MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 25-4090-119-BO 254090119BO S/O 25.4X90X1.19MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 25-4090-127-BO 254090127BO S/O 25.4X90X1.27MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 25-4090-147-BO 254090147BO S/O 25.4X90X1.47MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 31-0065-099-BO 310065099BO S/O 31.0X65X0.99MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 11-2078-119-LP 112078119LP RCP 11.2X78X1.19MM BLADE SNGL LINVATEC ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 174
# EDI Item # Item Header 1 Header 2 12-5090-099-LP 125090099LP S/O 12.5X90X0.99MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Type Brasseler BS Blades - Large Bone 12-5090-099-LV 125090099LV S/O 12.5X90X0.99MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 12-5090-119-LP 125090119LP S/O 12.5X90X1.19MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 12-5090-119-LV 125090119LV S/O 12.5X90X1.19MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 12-5090-127-LP 125090127LP S/O 12.5X90X1.27MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 12-5090-127-LV 125090127LV S/O 12.5X90X1.27MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 12-7076-097-LP 127076097LP RCP 12.7X76X0.97MM BLADE DBL LINVATEC ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 12-7076-127-LP 127076127LP RCP 12.7X76X1.27MM BLADE DBL LINVATEC ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 19-0090-127-LP 190090127LP S/O 19.0X90X1.27MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 19-0090-127-LV 190090127LV S/O 19.0X90X1.27MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 19-0110-127-LP 190110127LP S/O 19.0X110X1.27MM BLADELINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 19-0110-127-LV 190110127LV S/O 19.0X110X1.27MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 25-4090-099-LP 254090099LP S/O 25.4X90X0.99MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 175
# EDI Item # Item Header 1 Header 2 25-4090-099-LV 254090099LV S/O 25.4X90X0.99MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Type Brasseler BS Blades - Large Bone 25-4090-119-LP 254090119LP S/O 25.4X90X1.19MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 25-4090-119-LV 254090119LV S/O 25.4X90X1.19MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 25-4090-127-LP 254090127LP S/O 25.4X90X1.27MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 25-4090-127-LV 254090127LV S/O 25.4X90X1.27MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 25-4090-147-LP 254090147LP S/O 25.4X90X1.47MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 25-4090-147-LV 254090147LV S/O 25.4X90X1.47MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 31-0065-099-LP 310065099LP S/O 31.0X65X0.99MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 31-0065-099-LV 310065099LV S/O 31.0X65X0.99MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 11-2078-119-MD 112078119MD RCP 11.2X78X1.19MM BLADE SNGL 3M MAXI-DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 12-5090-099-MD 125090099MD S/O 12.5X90X0.99MM BLADE 3M MAXI- DRIVER 12-5090-119-MD 125090119MD S/O 12.5X90X1.19MM BLADE 3M MAXI- DRIVER 12-5090-127-MD 125090127MD S/O 12.5X90X1.27MM BLADE 3M MAXI- DRIVER 12-7076-097-MD 127076097MD RCP 12.7X76X0.97MM BLADE DBL 3M MAXI-DRIVER 12-7076-127-MD 127076127MD RCP 12.7X76X1.27MM BLADE DBL 3M MAXI-DRIVER 19-0090-127-MD 190090127MD S/O 19.0X90X1.27MM BLADE 3M MAX- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A 19-0110-127-MD 190110127MD S/O 19.0X110X1.27MM BLADE3M MAXI-DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 25-4090-099-MD 254090099MD S/O 25.4X90X0.99MM BLADE 3M MAXI- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 176
# EDI Item # Item Header 1 Header 2 25-4090-119-MD 254090119MD S/O 25.4X90X1.19MM BLADE 3M MAXI- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Type Brasseler BS Blades - Large Bone N/A N/A N/A 25-4090-127-MD 254090127MD S/O 25.4X90X1.27MM BLADE 3M MAXI- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 25-4090-147-MD 254090147MD S/O 25.4X90X1.47MM BLADE 3M- MAXI-DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 31-0065-099-MD 310065099MD S/O 31.0X65X0.99MM BLADE 3M MAXI- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 11-2078-119-SS 112078119SS RCP 11.2X78X1.19MM BLADE SNGL STRYKER SYS 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone 12-5090-099-SS 125090099SS S/O 12.5X90X0.99MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 12-5090-119-SS 125090119SS S/O 12.5X90X1.19MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 12-5090-127-SS 125090127SS S/O 12.5X90X1.27MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 12-7076-097-SS 127076097SS RCP 12.7X76X0.97MM BLADE DBL STRYKER SYS 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone 12-7076-127-SS 127076127SS RCP 12.7X76X1.27MM BLADE DBL STRYKER SYS 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone 19-0090-127-SS 190090127SS S/O 19.0X90X1.27MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 19-0110-127-SS 190110127SS S/O 19.0X110X1.27MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 25-4090-099-SS 254090099SS S/O 25.4X90X0.99MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 25-4090-119-SS 254090119SS S/O 25.4X90X1.19MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 25-4090-127-SS 254090127SS S/O 25.4X90X1.27MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 25-4090-147-SS 254090147SS S/O 25.4X90X1.47MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 31-0065-099-SS 310065099SS S/O 31.0X65X0.99MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A PMM09200 PMM09200 HI SPEED DRILL SMALL BONE SMALL BONE POWER SYSTEM DRILLS Brasseler BS Small Bone Handpieces N/A N/A N/A PMM10200 PMM10200 MEDIUM SPEED DRILL SMALL BONE SMALL BONE POWER SYSTEM DRILLS Brasseler BS Small Bone Handpieces N/A N/A N/A PMM12200 PMM12200 SAGITTAL SAW W/WRENCH SMALL BONE SMALL BONE POWER SYSTEM SAWS Brasseler BS Small Bone Handpieces N/A N/A N/A PMM13200 PMM13200 OSCILLATING SAW W/WRENCH SMALL BONE SMALL BONE POWER SYSTEM SAWS Brasseler BS Small Bone Handpieces N/A N/A N/A PMM14200 PMM14200 RECIPROCATING SAW SMALL BONE SMALL BONE POWER SYSTEM SAWS Brasseler BS Small Bone Handpieces N/A N/A N/A PM-M11-200 PMM11200 WIREDRIVER SMALL BONE POWER SYSTEM WIREDRIVER Brasseler BS Small Bone Handpieces N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 177
# EDI Item # Item Header 1 Header 2 KMA90200 KMA90200 PNUEMICRO HOSE 10 FT SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES KM-A90-200-15 KMA9020015 HOSE 15 FT SMALL BONE POWER SYSTEM ACCESSORIES Type Brasseler BS Other Small Bone N/A N/A N/A Brasseler BS Other Small Bone N/A N/A N/A KMA90201 KMA90201 CLEANING CAP SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A KMA9020115 KMA9020115 PNUEMICRO HOSE 15 FT SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A KMA91000 KMA91000 FOOT CONTROL SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A KMA95000 KMA95000 STERIL'N CASE 11 X7 X1 SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A PMA95000 PMA95000 STERIL'N CASE 12 X7 X4 SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A PMM10901 PMM10901 MEDIUM BUR GUARD SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A PMM10902 PMM10902 LONG BUR GUARD SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A PM-M11-201 PMM11201 WIRE GUARD SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Small Bone Handpieces N/A N/A N/A PMM12001 PMM12001 WRENCH SYSTEM SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A KMB46111 KMB46111 1.1X63.5MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46113 KMB46113 1.3X63.5MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46115 KMB46115 1.5X63.5MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46120 KMB46120 2.0X63.5MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46125 KMB46125 2.5X76.0MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46127 KMB46127 2.7X76.0MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46132 KMB46132 3.2X76.0MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 178
# EDI Item # Item Header 1 Header 2 Type KMB46135 KMB46135 3.5X76.0MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KM060 KM060 RCP 8X25.4X0.63MM (0.4) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM070 KM070 RCP 7.6X38X0.63MM (0.4) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM071 KM071 RCP 9.5X39X0.58MM (0.4) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM50 KM50 RCP 5.0X7X0.84MM (0.50) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM51 KM51 RCP 4X17.5X0.76MM (0.50) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM53 KM53 RCP 7.0X25X0.89MM (0.50) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM54 KM54 RCP 8.0X25X0.66MM (0.4) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM80 KM80 RCP 11X5.5MM TEAR RASP SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM81 KM81 RCP 12.5X7.0MM TEAR RASP SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM82 KM82 RCP 11X5.5MM TEAR RASP SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM83 KM83 RCP 12.5X7.0MM TEAR RASP SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM300 KM300 ST 70.0X25.4MM.039 IN SA SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 179
# EDI Item # Item Header 1 Header 2 KM3000 KM3000 OSC 5.5X19X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Type Brasseler BS Blades - Small Bone KM3001 KM3001 OSC 5.5X26.5X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3002 KM3002 OSC 9.5X29.6X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3003 KM3003 OSC 5.5X22.2X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3004 KM3004 OSC 9.5X27.8X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3004C KM3004C OSC 9.5X27.8X0.76MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3005 KM3005 OSC 9.5X19X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3006 KM3006 OSC 5.5X14.5X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3008 KM3008 OSC 18.5X29.6X0.63MM(0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM300R KM300R ST 77.5MM X 6.35MM SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3258 KM3258 OSC 9.5x11.7X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3259 KM3259 OSC 9.5X13.7X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3261 KM3261 OSC 9.5X13.2X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 180
# EDI Item # Item Header 1 Header 2 KM3265 KM3265 OSC 9.5X29.0X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Type Brasseler BS Blades - Small Bone KM3267 KM3267 OSC 5.5X13.7X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3268 KM3268 OSC 9.5x13.7X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM70 KM70 OSC 9X12X0.6MM (0.4) CRESCENTIC SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM71 KM71 OSC 13.5X25.5X0.6MM (0.4)CRESCENTIC SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM72 KM72 OSC 18X30X0.6MM (0.4) CRESCENTIC SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM76 KM76 OSC 13.5X32X0.6MM (0.4) CRESCENTIC SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3055 KM3055 SAG 3.8X25X6.3MM (0.4) DIAM ABRADER SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3056 KM3056 SAG 3.8X25X6.3MM (0.4) DIAM ABRADER SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3057 KM3057 SAG 3.8X25X6.3MM (0.4) DIAM ABRADER SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3100C KM3100C SAG 14X41X0.70MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3101 KM3101 SAG 9.5X25.5X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3101C KM3101C SAG 9.5X25.5X0.70MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 181
# EDI Item # Item Header 1 Header 2 KM3102 KM3102 SAG 4.5X25.5X0.56MM (0.4) Type SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3104 KM3104 SAG 9.5X15X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3105 KM3105 SAG 4.5X15X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3106 KM3106 SAG 5.5X25.5X0.70MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3107 KM3107 SAG 6X34X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3108 KM3108 SAG 4X34X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3109C KM3109C SAG 19.5X25.5X0.70MM(0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3228 KM3228 SAG 9.5X7.5X0.63MM (0.63) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3229 KM3229 SAG 9.5X13.5X0.63MM(0.63) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3231 KM3231 SAG 19.5X41X0.70MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3234 KM3234 SAG 5.5X9X0.97MM (0.6) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3235 KM3235 SAG 5.5X18X0.97MM (0.6) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3236 KM3236 SAG 14X15.5X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 182
# EDI Item # Item Header 1 Header 2 KM3237 KM3237 SAG 14X25.5X0.71MM (0.4) Type SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3240 KM3240 SAG 9.5X41X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3406 KM3406 SAG 20X6MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3408 KM3408 SAG 20X8MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3409 KM3409 SAG 20X9MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3410 KM3410 SAG 20X10MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3411 KM3411 SAG 20X11MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3412 KM3412 SAG 20X12MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone 01S1701 01S1701 1.0X19X37MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 01S1703 01S1703 1.5X19X37MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 01S1704 01S1704 2.0X19X37MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03C0312 03C0312 4.0X10X48MM BARREL BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03C0901 03C0901 4.0X48MM OVAL BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 183
# EDI Item # Item Header 1 Header 2 03C0905 03C0905 5.5X48MM OVAL BUR CARB Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D0135 03D0135 4.0X48MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D0138 03D0138 6.0X48MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D0911 03D0911 4.0X8X48MM OVAL BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D1901 03D1901 4.0X15X48MM STRT BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D1902 03D1902 7.0X15X48MM STRT BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03S1101 03S1101 6.0X48MM FLAME BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0101 04C0101 1.0X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0103 04C0103 1.5X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0104 04C0104 1.8X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0105 04C0105 2.0X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0106 04C0106 2.3X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0107 04C0107 3.01X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 184
# EDI Item # Item Header 1 Header 2 04C0108 04C0108 4.0X51MM RND BUR CARB Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0109 04C0109 5.0X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0110 04C0110 6.0X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0170 04C0170 6.5X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0302 04C0302 1.0X6X51MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0303 04C0303 1.2X6X51MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0306 04C0306 1.5X7.5X51MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0307 04C0307 1.6X4.3X51MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0310 04C0310 2.0X10X51MM BARREL BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0404 04C0404 1.2X4.2X51MM STRT-RND-ENDBUR CARB SIDCUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0601 04C0601 0.9X5.2X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0602 04C0602 0.9X5.2X51MM TAPRD-FISSURBUR CARB SIDCUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0604 04C0604 1.0X6X51MM TAPRD BUR CARBSIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 185
# EDI Item # Item Header 1 Header 2 04C0606 04C0606 1.2X4.2X51MM TAPRD-FISSURBUR CARB SIDCUT Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0607 04C0607 1.6X4.3X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0609 04C0609 1.5X10X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0612 04C0612 1.8X4.6X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0615 04C0615 2.1X4.9X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0617 04C0617 2.0X7.5X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C0623 04C0623 1.2X6X51MM TAPRD BUR CARBSIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C1803 04C1803 1.9X13X51MM LINDEMN BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04D0133 04D0133 3.0X51MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04D0139 04D0139 2.0X51MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04D1903 04D1903 12X15X51MM DERMABRADE BURDIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04D2001 04D2001 10X15X51MM TAPRD BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04S0402 04S0402 6.0X51MM CYL RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 186
# EDI Item # Item Header 1 Header 2 04S1501 04S1501 2.3X12X51MM SHANNON BUR SS Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04S1701 04S1701 1.0X19X51MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04S1703 04S1703 1.5X19X51MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04S1704 04S1704 2.0X19X51MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 06C0619 06C0619 2.0X19X57MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 06S1601 06S1601 2.0X57MM SWANSON REAMR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 07S1602 07S1602 3.0X62MM SWANSON REAMR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 07S1604 07S1604 5.0X62MM SWANSON REAMR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 07S1605 07S1605 4.0X62MM SWANSON REAMR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 08S1802 08S1802 1.5X25X67MM LINDEMAN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09C0170 09C0170 6.5X70MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09C0613 09C0613 1.7X12X70MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09C0901 09C0901 4.0X70MM OVAL BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 187
# EDI Item # Item Header 1 Header 2 09C0905 09C0905 5.5X70MM OVAL BUR CARB Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0128 09D0128 1.0X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0129 09D0129 1.6X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0132 09D0132 2.9X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0133 09D0133 3.0X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0134 09D0134 3.5X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0135 09D0135 4.0X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0138 09D0138 6.0X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0139 09D0139 2.0X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0140 09D0140 2.3X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0141 09D0141 5.0X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0142 09D0142 0.6X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0143 09D0143 0.8X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 188
# EDI Item # Item Header 1 Header 2 09D0144 09D0144 1.2X70MM RND BUR DIAM Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0145 09D0145 1.4X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0146 09D0146 1.8X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0147 09D0147 7.0X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0148 09D0148 6.5X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0171 09D0171 0.6X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0173 09D0173 1.0X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0179 09D0179 2.3X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0180 09D0180 3.0X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0183 09D0183 4.0X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0184 09D0184 5.0X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0185 09D0185 6.0X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0187 09D0187 7.0X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 189
# EDI Item # Item Header 1 Header 2 09D0403 09D0403 2X15X70MM RHINOPLASTY BURDIAM Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0911 09D0911 4X8X70MM OVAL BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D0920 09D0920 4.2X70MM OVL BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0101 09S0101 1.0X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0111 09S0111 1.0X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0114 09S0114 2.3X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0115 09S0115 2.3X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0120 09S0120 4.0X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0123 09S0123 4.5X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0125 09S0125 7.0X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0148 09S0148 0.6X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0149 09S0149 0.8X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0150 09S0150 1.4X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 190
# EDI Item # Item Header 1 Header 2 Type 09S0151 09S0151 1.8X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0152 09S0152 2.7X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0153 09S0153 3.1X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0154 09S0154 3.5X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0155 09S0155 5.0X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0156 09S0156 6.0X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0159 09S0159 1.8X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0161 09S0161 3.1X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0162 09S0162 3.5X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0163 09S0163 4.0X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S0167 09S0167 7.0X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C0101 10C0101 1.0X73MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C0103 10C0103 1.6X73MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 191
# EDI Item # Item Header 1 Header 2 10C0105 10C0105 2.0X73MM RND BUR CARB Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C0107 10C0107 3.0X73MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C0108 10C0108 4.0X73MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C0306 10C0306 1.5X7.5X73MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C0310 10C0310 2.0X10X73MM BARREL BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C0617 10C0617 2.0X7.5X73MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10D0133 10D0133 3.0X73MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10D0139 10D0139 2.0X73MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 11C0619 11C0619 2.0X19X80MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC0101 24NC0101 1.0X26.5MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC0103 24NC0103 1.5X26.5MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC0105 24NC0105 2.0X26.5MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC0305 24NC0305 1.5X7.5X25.5MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 192
# EDI Item # Item Header 1 Header 2 24NC0609 24NC0609 1.5X10X25.5MM TAPRD BUR CARB SIDECUT Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC0613 24NC0613 1.7X12X34.5MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC0617 24NC0617 2.0X7.5X25.0MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C0105 65C0105 2.0X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C0108 65C0108 4.0X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C0109 65C0109 5.0X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C0153 65C0153 3.0X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C0170 65C0170 6.5X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C0901 65C0901 4.0X95MM OVAL BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C0905 65C0905 5.5X95MM OVAL BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65D0133 65D0133 3.0X95MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65D0135 65D0135 4.0X95MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65D0139 65D0139 2.0X95MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65D0141 65D0141 5.0X95MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 193
Part A OPPS Status Indicators Status indicators are assigned to HCPCS/CPT codes to indicate how the service is processed and/or paid under the (OPPS). Providers may reference Addendum B to determine the status indicator assigned to a particular code. Addendum B is published quarterly in January, April, July and October and posted on the CMS Web site at http://www.cms.gov/hospitaloutpatientpps/au/list.asp. ADDENDUM D1. FINAL OPPS PAYMENT STATUS INDICATORS FOR CY 2011 Indicator Item/Code/Service OPPS Payment Status A Services furnished to a hospital outpatient that are paid under a fee schedule or payment system other than OPPS, for example: Ambulance Services Clinical Diagnostic Laboratory Services Non-Implantable Prosthetic and Orthotic Devices EPO for ESRD Patients Physical, Occupational, and Speech Therapy Routine Dialysis Services for ESRD Patients Provided in a Certified Dialysis Unit of a Hospital Diagnostic Mammography Screening Mammography Not subject to deductible or coinsurance. Not subject to deductible. B Codes that are not recognized by OPPS when submitted on an outpatient hospital Part B bill type (12x and 13x). Not paid under OPPS. C Inpatient Procedures Not paid under OPPS. Admit patient. Bill as inpatient. D Discontinued Codes Not paid under OPPS or any other Medicare payment system. E Items, Codes, and Services: That are not covered by any Medicare outpatient benefit based on statutory exclusion. That are not covered by any Medicare outpatient benefit for reasons other than statutory exclusion. That are not recognized by Medicare for outpatient claims but for which an alternate code for the same item or service may be available. For which separate payment is not provided on outpatient claims. May be paid by fiscal intermediaries/macs when submitted on a different bill type, for example, 75x (CORF), but not paid under OPPS. An alternate code that is recognized by OPPS when submitted on an outpatient hospital Part B bill type (12x and 13x) may be available. Not paid by Medicare when submitted on outpatient claims (any outpatient bill type). F Corneal Tissue Acquisition; Certain CRNA Services and Hepatitis B Vaccines Not paid under OPPS. Paid at reasonable cost. G Pass-Through Drugs and Biologicals Paid under OPPS; separate APC payment. H Pass-Through Device Categories Separate cost-based pass-through payment; not subject to copayment. K Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals Paid under OPPS; separate APC payment. L Influenza Vaccine; Pneumococcal Pneumonia Vaccine Not paid under OPPS. Paid at reasonable cost; not subject to deductible or coinsurance. M Items and Services Not Billable to the Fiscal Intermediary/MAC Not paid under OPPS. N Items and Services Packaged into APC Rates Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. P Partial Hospitalization Paid under OPPS; per diem APC payment. Q1 STVX-Packaged Codes Paid under OPPS; Addendum B displays APC assignments when services are (1) Packaged APC payment if billed on the same date of service as a HCPCS code assigned status indicator S, T, V, or X. (2) In all other circumstances, payment is made through a separate APC payment. Q2 T-Packaged Codes Paid under OPPS; Addendum B displays APC assignments when services are (1) Packaged APC payment if billed on the same date of service as a HCPCS code assigned status indicator T. (2) In all other circumstances, payment is made through a separate APC payment. Q3 Codes That May Be Paid Through a Composite APC Paid under OPPS; Addendum B displays APC assignments when services are R Blood and Blood Paid under OPPS; separate APC payment. S Significant Procedure, Not Discounted When Multiple Paid under OPPS; separate APC payment. T Significant Procedure, Multiple Reduction Applies Paid under OPPS; separate APC payment. U Brachytherapy Sources Paid under OPPS; separate APC payment. V Clinic or Emergency Department Visit Paid under OPPS; separate APC payment. X Ancillary Services Paid under OPPS; separate APC payment. Addendum M displays composite APC assignments when codes are paid through a composite APC. (1) Composite APC payment based on OPPS composite-specific payment criteria. Payment is packaged into a single payment for specific combinations of service. (2) In all other circumstances, payment is made through a separate APC payment or packaged into payment for other services. Y Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. 2011 Medical Learning, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 194
Zimmer Surgical Trademarks August 11, 2011 A.T.S. 750, 1200, 2000, 3000 and 4000 Automatic Tourniquet Systems A.T.S. Cuffs A.T.S. Dual Bladder Control Valve Brown Air Dermatome Powered Skin Grafting Instrument Brown Dermatome Blades Brown Electro-Dermatome Powered Skin Grafting Instr. CDIS Controlled Distention Irrigation System Cemlock Medullary Plug Cemplug Medullary Plug Cushion Rocker Cast Shoe Dermacarriers Skin Graft Carriers Dermacarriers II Skin Graft Carriers Drop-Lok Cartilage Knee Brace H.A.S. Autotransfusion System Hemovac Autotransfusion System Hemovac Closed Autotransfusion System Hemovac Compact Evacuator Hemovac Hydrocoat Drains Hemovac Device Hys-T-Tube Hysterectomy Tube McLeod Padded Clavicle Splint Meshgraft Manual Dermatome Meshgraft II Manual Dermatome Meshgraft Tissue Expansion System Miller Bone Cement Injector Miller Cement Delivery System Mini-Snyder Hemovac Device Orthoblend Powered Bone Mill Ortho-Dri Absorbent Packing Ortho-Dri Copolymer Bone Cement Ortho-Dri Vacuum Mixing System Power-Flo Bone Cement Injector Pulsavac Debridement System Pulsavac Plus Debridement System Pulsavac Plus AC Debridement System Pulsavac III Debridement System Quad-Lumen Drain Quick-Vac Vacuum Mixing System Quik-Use Curette Quik-Use Femoral Bone Cement Preparation Kit Skin-Trac Skin Traction Strips Smooth-Trac Traction Bar Snyder Hemovac Device Sports-Caster ACL Brace Sports-Caster Derotational Super Bowl Mixing/Evacuating System Sure-Closure Skin Stretching System Surgivac Device TempSeal Resorbable Medullary Plug Ultra-Care Heel and Elbow Protector Ultra-Care Sheeting Ultra-Care Slippers Urevac Urinary Kit Var-A-Pulse Debridement System Y-Tube Tube Z-Drape X-Ray Cassette Bag Zimcode Traction Components & Cord Zimcode Traction Weight Bags Zim-Flex Synthetic Cast Tape and Elastic Bandages Zim-Flex II Knit Elastic Bandages Zimfoam Head Halter Zimfoam Patient Pad and Positioners Zimfoam Splint Padding Zim-Plicity Arm Sling Zim-Trac Perforated Traction Splint Zimmer Air Dermatome Zimmer Ambulatory Pump Zimmer Blood Reinfusion System Zimmer Cold Therapy System Zimmer Contour Thigh Cuff Zimmer Disposable Cuffs Zimmer Electric Dermatome Zimmer L.V.C. Low Viscosity Bone Cement Zimmer Patient Helper HD Zimmer PCS Anti-Embolism Stockings Zimmer Poly-Plug Intramedullary System Zimmer Portable Cold Therapy System Zimmer Skin Graft Mesher Zimmer Sterile Disposable Tourniquet Cuff Zimmer Surgical Power System 700 Zimmer Ultra Power System Zimmer Universal Power System The listed trademarks of the following companies require marking and attribution: Alvarado Surgical Knee Holder is a trademark of Thomas D. Peterson A.O.R. Instrumentation is a trademark of Alvarado Orthopedic Research Coolbrace Cervical Orthosis is a trademark of Leonard G. Davis and Dr. Lytton Williams EASYMIX Vacuum Cartridge Cement Mixing EASYMIX Pro Vacuum Cartridge Cement Mixing System Hi-Fatigue Bone Cement are trademarks of aap Biomaterials GmbH EZblade is a trademark of Gebr. Brasseler GmbH & Co.KG Hug-U-Vac Surgical Positioning Device is a trademark of Sports-Doc, Inc. Corporation Jacob Chuck is a trademark of Jacob Chuck Manufacturing MIXIGUN Bone Cement Mixing and Dispensing System is a trademark of Asept Medical AB, Sweden MultiDrive and TraumaDrive Powered Medical Instruments are trademarks of desoutter Medical Limited Orth-O Rad Radiation Resistant Surgical Gloves is a trademark of The Branford Companies, Inc Palm Pump Pain Management System is a trademark of Sorenson Medical, Inc PALACOS Bone Cement is a trademark of Heraeus Kulzer GmbH Philadelphia Cervical Collar is a trademark of Philadelphia Cervical Collar Company REX Cement Stop Bone Plug is a trademark of Spierings Orthopedics B.V. SynPlug Intramedullary Plug is a trademark of Integra Life Sciences Corporation 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 195
Regulatory References used in this document: Medicare Claims Processing (PUB. 100-04) Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS) CMS-1504-FC Final Changes to the Hospital and CY 2011 Payment Rates https://www.dmepdac.com/ Administered by Noridian Administrative Services, LLC (NAS) provides HCPCS coding assistance and national pricing information via searches for HCPCS Level II codes and modifiers, DMEPOS (durable medical equipment, and prosthetics. 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 196