Q1004 HCPCS code: New technology intraocular lens category 4 as defined in federal register notice
Q1004 is the HCPCS Level II code for new technology intraocular lens category 4 as defined in federal register notice. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 2 per day on practitioner claims.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 57 |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1999-07-01 |
| Last action effective | 2003-10-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| practitioner claims | 2 | Anatomic Consideration |
What changed for Q1004
- 1999-07-01: Q1004 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code Q1004?
Q1004 is the HCPCS Level II code for new technology intraocular lens category 4 as defined in federal register notice. Short descriptor: "Ntiol category 4".
Does Medicare cover Q1004?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of Q1004 can be billed per day?
2 on practitioner claims (NCCI medically unlikely edits).
Related Q10 codes
- Q1005 — New technology intraocular lens category 5 as defined in federal register notice
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Next steps
- Run a reimbursement report for a device billed under Q1004
- Watch Q1004 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q1004
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.