complete, accurate, or applicable to any particular ...

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

Kendall Simplicity™ Garment Liner Moderate Abosorbency 7" x 17" (17.8cm x

635 43.2cm) 25 Bag, 8 Bags/Case, 200 Eaches/Case T4535 08080-6350-00

Kendall Simplicity™ Flat Fold Adult Briefs Large 31"-52" (78.7cm - 132.1cm)

640 10/Clear Bag Of 10 Packaging, 100 Eaches/Case T4535 08080-6400-00

Kendall Simplicity™ Flat Fold Adult Briefs X-Large 31"-56" (78.7cm - 142.2cm)

685 6/Clear Bag Of 10 Packaging, 60 Eaches/Case T4535 08080-6850-01

Kendall Simplicity™ Cotton Snap Pant Small 22"-28" (55.9cm - 71.1cm) 12

689 Eaches/Case T4536 08080-6890-01

Kendall Simplicity™ Cotton Snap Pant Medium 30"-36" (76.2cm - 91.4cm) 12

691 Eaches/Case T4536 08080-6910-01

Kendall Simplicity™ Cotton Snap Pant Large 38"-44" (96.5cm - 111.8cm) 12

694 Eaches/Case T4536 08080-6940-01

Kendall Simplicity™ Cotton Snap Pant X-Large 46"-52" (116.8cm - 132.1cm)

698 12 Eaches/Case T4536 08080-6980-01

Kendall Simplicity™ Cotton Snap Pant XX-Large 52"-58" (132.1cm - 147.3cm)

699 12 Eaches/Case T4536 08080-6990-01

Kendall Wings™ Fluff and Polymer Underpads Super Absorbancy 30" x 30"

948 (76.2cm x 76.2cm) 10/Bag, 10 Bags/Case, 100 Eaches/Case T4541 08080-9480-00

Kendall Wings™ Fluff Underpads 17" x 24" (43.2cm x 61cm) Bulk 300

949 Eaches/Case T4542 08080-9490-00

Kendall Wings™ Fluff and Polymer Underpads with Adhesive Strip 30" x 36"

959 (76.2cm x 91.4cm) 6/Bag, 12 Bags/Case Packaging, 72 Eaches/Case T4541 08080-9590-00
968 08080-0968-00
984 Kendall Wings™ Fluff and Polymer Underpads Super Absorbancy 36" x 36" 08080-0984-00
988 08080-0988-00
995 (91.4cm x 91.4cm) 12/Bag, 4 Bags/Case, 48 Eaches/Case T4541 08080-0995-00
1038 08080-1038-00
1040 Kendall Wings™ Breathable Underpads 30" x 36" (76.2cm x 91.4cm) 10 Bag, 6 08080-1040-00

Bags/Case, 60 Eaches/Case T4541

Kendall Wings™ Breathable Underpads 23" x 36" (58.4cm x 91.4cm) 12/Bag,

6 Bags/Case, 72 Eaches/Case T4541

Kendall Wings™ Tuckable Fluff and Polymer Underpads 36" x 70" (91.4cm x

177.8cm) 6/Bag, 8 Bags/Case Packaging, 48 Eaches/Case T4541

Kendall Wings™ Fluff Underpads23" x 24" (58.4cm x 61cm) Bulk 200

Eaches/Case T4541

Kendall Simplicity™ Insert Pad 12" x 21" (30.5cm x 53.3cm) 12/Bag, 12 Clear

Bags/Case, 144 Eaches/Case T4535

Page 1

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

Kendall Simplicity™ Insert Pad12" x 24" (30.5cm x 61cm) Heavy 12/Bag, 8

1042 Clear Bags/Case, 96 Eaches/Case T4535 08080-1042-00
1044 08080-1044-00
1046 Kendall Simplicity™ Insert Pad12" x 28" (30.5cm x 71.1cm) Overnite, 12/Bag, 08080-1046-00
1058 08080-1058-00
1093 6 Clear Bags/Case, 72 Eaches/Case T4535 08080-1093-00

1205 Kendall Simplicity™ Insert Pad14" x 30" (35.6cm x 76.2cm) Overnite Plus, 08080-1205-00

1215 12/Bag, 4 Clear Bags/Case, 48 Eaches/Case T4535 08080-1215-00

1225 Kendall Simplicity™ Belted Undergarment Super Absorbency One Fits All 08080-1225-01
1429 08080-1429-00
1530 30/Bag, 4 Printed Bags/Case, 120 Eaches/Case T4535 08080-1530-00
1532 08080-1532-01
1533 Kendall Wings™ Fluff Underpads Heavy Absorbency 23" x 36" (58.4cm x 08080-1533-01
1534 08080-1534-01
1535 91.4cm) 10's T4541 08080-1535-01
1545 08080-1545-00
1547 Kendall SureCare™ Protective Underwear Super Absorbancy Medium 34"-46" 08080-1547-00
1550 08080-1550-00
(86.4cm - 116.8cm) 4 Green Strands Band Color, 18/Bag, 4 Bags/Case
1602 08080-1602-01
Packaging, 73 Eaches/Case T4526

Kendall SureCare™ Protective Underwear Super Absorbancy Large 44"-54"

(111.8cm - 137.2cm) 4 Blue Strands Band Color, 16/Bag, 4 Bags/Case

Packaging, 64 Eaches/Case T4527

Kendall SureCare™ Protective Underwear Super Absorbancy X-Large 48"-66"

(121.9cm - 167.6cm) 7 Blue Strands Band Color, 12/Bag, 4 Bags/Case

Packaging, 48 Eaches/Case T4528

Kendall SureCare™ Cleaners Medium 250/Bag, 12 Bags/Case Packaging, 3,000

Eaches/Case T5999

Kendall Simplicity™ Garment Liner Small, 4.5" x 14" (11.4cm x 35.6cm) Light

Absorbency, 25 Bag, 5 Bags/Case, 125 Eaches/Case T4535

Kendall SureCare™ Adult Briefs Small 20"-31" (50.8cm - 78.7cm) 26.5"

(67.3cm)L T4521

Kendall SureCare™ Adult Briefs Medium 32"-44" (81.3cm - 111.8cm) T4522

Kendall SureCare™ Adult Briefs Large 45"-58" (114.3cm - 147.3cm) T4523

Kendall SureCare™ Adult Briefs X-Large 59"-64" (149.9cm - 162.6cm) T4524

Kendall SureCare™ Fluff Underpads 17" x 24" (43.2cm x 61cm) T4542

Kendall SureCare™ Fluff Underpads 23" x 24" (58.4cm x 61cm) T4541

Kendall SureCare™ Fluff Underpads 23" x 36" (58.4cm x 91.4cm) T4541

Kendall SureCare™ Protective Underwear Extra Absorbancy Small/Medium

34"-46" (86.4cm - 116.8cm) 4 Green Strands Band Color, 20/Bag, 2 Bags/Case

Packaging, 40 Eaches/Case T4526

Page 2

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

Kendall SureCare™ Protective Underwear Extra Absorbancy Large 44"-54"

(111.8cm - 137.2cm) 4 Blue Strands Band Color, 18/Bag, 2 Bags/Case

1603 Packaging, 36 Eaches/Case T4527 08080-1603-01

1605 Kendall SureCare™ Protective Underwear Extra Absorbancy Medium 34"-46" 08080-1605-00

1615 (86.4cm - 116.8cm) 4 Green Strands Band Color, 20/ Bag, 4 Bags/Case 08080-1615-00

1625 Packaging, 80 Eaches/Case T4526 08080-1625-00
1630 08080-1630-00
1665 Kendall SureCare™ Protective Underwear Extra Absorbancy Large 44"-54" 08080-1665-00

1645 (111.8cm - 137.2cm) 4 Blue Strands Band Color, 18/Bag, 4 Bags/ Case 08080-1645-01
1913 08080-1913-00
2630 Packaging, 72 Eaches/Case T4527 08080-2630-00
2818 08080-2818-00
5874 Kendall SureCare™ Protective Underwear Extra Absorbancy X-Large 48"-66" 08080-5874-00
6229 08080-6229-01
6349 (121.9cm - 167.6cm) 7 Blue Strands Band Color, 14/Bag, 4 Bags/Case 08080-6349-01
6360 08080-6360-00
6361 Packaging, 56 Eaches/Case T4528 08080-6361-00

Kendall SureCare™ Protective Underwear Extra Absorbancy XX-Large 12/Bag,

4 Bags/Case Packaging, 48 Eaches/Case T5999

Kendall SureCare™ Protective Underwear Extra Absorbancy XX-Large 12/Bag,

3 Bags/Case Packaging T5999

Kendall SureCare™ Protective Underwear Extra Absorbancy X-Large 48"-66"

(121.9cm - 167.6cm) 7 Blue Strands Band Color, 14/Bag, 3 Bags/Case

Packaging, 42 Eaches/Case T4528

Kendall SureCare™ Cleaners Large 250/Bag, 8 Bags/Case Packaging, 2,000

Eaches/Case T5999

Kendall SureCare™ Nursing Pad 5" (12.7cm) Round 12/Box, 24 Boxes/Case

Packaging, 288 Eaches/Case T5999

Kendall SureCare™ 100% Cotton OB Sponge 4" x 4" (10.2cm x 10.2cm)

40/Bag, 50 Bags/Case Packaging, 2,000 Eaches/Case T5999

Kendall Simplicity™ Pant Liners with Adhesive Strip 8" x 24" (20.3cm x 61cm)

White Color Code, Bulk Packaging, 100 Eaches/Case T4535

Kendall Simplicity™ Flat Fold Adult Briefs Medium 31"-48" (78.7cm -

121.9cm) Bulk, 100/Case Packaging T4535

Kendall Wings™ Fluff Underpads 23" x 24" (58.4cm x 61cm) Lt. Blue

Backsheet, 10/Bag, 20 Bags/Case, 200 Eaches/Case T4541

Kendall SureCare™ Washcloths Blue 9.5" x 13.25" (24.1cm x 33.7cm) 9 3/8" X

13 1/2", 125/Bag, 4 Bags/Case Packaging, 500 Eaches/Case T5999

Kendall Surecare™ Washcloths Pink 11.5" x 13.5" (29.2cm x 33.7cm) 50/Bag,

10 Bags/Case Packaging, 500 Eaches/Case T5999

Page 3

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

6363 Kendall SureCare™ Washcloths White 10" x 13" (25.4cm x 33cm) 50/Bag, 15 T5999 08080-6363-00
6426 Bags/Case Packaging, 750 Eaches/Case T4541 08080-6426-01
7053 Kendall Simplicity™ Insert Pad 6.5" x 17" (16.5cm x 43.2cm) White Color T5999 08080-7053-00
Code, Bulk Packaging, 100 Eaches/Case
7058 Kendall SureCare™ 100% Cotton OB Sponge 4" x 4" (10.2cm x 10.2cm) T4541 08080-7058-01
100/Bag, 20 Bags/Case Packaging, 2,000 Eaches/Case
Kendall Simplicity™ Plus Layered Tissue with Polymer Underpads Super
Absorbancy 30" x 30" (76.2cm x 76.2cm) Teal Backsheet, 5/Bag, 15
Bags/Case, 75 Eaches/Case

7059 Kendall Simplicity™ Layered Tissue with Polymer Underpads 30" x 36" T4541 08080-7059-01
7105 (76.2cm x 91.4cm) Teal Backsheet, 5/Bag, 12 Bags/Case, 60 Eaches/Case T4542 08080-7105-00
7107 Kendall Simplicity™ Fluff Underpads 17" x 24" (43.2cm x 61cm) Lt. Blue T4542 08080-7107-01
Backsheet, Bulk 300 Eaches/Case
Kendall Simplicity™ Fluff Underpads 17" x 24" (43.2cm x 61cm) Lt. Blue
Backsheet, 10/Bag, 30 Bags/Case, 300 Eaches/Case

7134 Kendall Simplicity™ Fluff Underpads 23" x 24" (58.4cm x 61cm) Lt. Blue 50'S T4541 08080-7134-00
7136 Kendall Simplicity™ Fluff Underpads 23" x 24" (58.4cm x 61cm) Lt. Blue T4541 08080-7136-00
7158 Backsheet, 10/Bag, 20 Bags/Case, 200 Eaches/Case T4541 08080-7158-01
7159 Kendall Simplicity™ Layered Tissue with Polymer Underpads 30" x 30" T4541 08080-7159-01
(76.2cm x 76.2cm) Teal Backsheet, Bulk 75 Eaches/Case
Kendall Simplicity™ Layered Tissue with Polymer Underpads 30" x 36"
(76.2cm x 91.4cm) Teal Backsheet, Bulk 60 Eaches/Case

7174 Kendall Simplicity™ Fluff Underpads 23" x 36" (58.4cm x 91.4cm) Lt. Blue 50'S T4541 08080-7174-00
7176 08080-7176-00
Kendall Simplicity™ Fluff Underpads 23" x 36" (58.4cm x 91.4cm) Lt. Blue

Backsheet, 10/Bag, 15 Bags/Case, 150 Eaches/Case T4541

7193 Kendall Wings™ Fluff Underpads 23" x 36" (58.4cm x 91.4cm) Lt. Blue, 15'S T4541 08080-7193-00
7194 Kendall Wings™ Fluff Underpads 23" x 36" (58.4cm x 91.4cm) Lt. Blue T4541 08080-7194-01
7209 Backsheet, 5/Bag, 15 Bags/Case, 75 Eaches/Case T4535 08080-7209-00
Kendall SureCare™ Infant Crib Liner 10" x 14" (25.4cm x 35.6cm) Bulk
Packaging, 600 Eaches/Case

Page 4

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

7420 Kendall SureCare™ 100% Cotton OB Sponge 4" x 4" (10.2cm x 10.2cm) T5999 08080-7420-00
20/Bag, 100 Bags/Case Packaging, 2,000 Eaches/Case

9173 Kendall Wings™ Fluff and Polymer Underpads Super Absorbancy 30" x 30" T4541 08080-9173-00
21267 (76.2cm x 76.2cm) Beige Backsheet, 10/Bag, 8Bags/Case, 80 Eaches/Case T4535 08080-2126-70
Kendall Simplicity™ Belted Undergarment One Fits All 30/Bag, 4 Printed
Bags/Case, 120 Eaches/Case

60003 Kendall Wings™ Classic Adult Briefs Medium 32"-44" (81.3cm - 111.8cm) T4522 08080-6000-30
60004 White Color Code, 12/Clear Bag, 8 Bags/Case Packaging, 96 Eaches/Case 08080-6000-40

Kendall Wings™ Classic Adult Briefs Large 45"-58" (114.3cm - 147.3cm) Blue

Color Code, 12/Clear Bag, 6 Bags/Case Packaging, 72 Eaches/Case T4523

Kendall Wings™ Classic Adult Briefs X-Large 59"-64" (149.9cm - 162.6cm)

60010 Beige Color Code, 12/Clear Bag, 6 Bags/Case Packaging, 72 Eaches/Case T4524 08080-6001-00
60031 08080-6003-10
Kendall Wings™ Choice Plus Adult Briefs Youth 20"-31" (50.8cm - 78.7cm) 23"

(58.4cm) L Green Color Code, 12/Bag, 8 Clear Bags/Case Packaging, 96

Eaches/Case T4521

60032 Kendall Wings™ Choice Plus Adult Briefs Small 20"-31" (50.8cm - 78.7cm) T4521 08080-6003-20
26.5" (67.3cm)L Peach Color Code, 12/Bag, 8 Clear Bags/Case Packaging

Kendall Wings™ Choice Plus Adult Briefs Medium 32"-44" (81.3cm - 111.8cm)

60033 White Color Code, 12/Bag, 8 Clear Bags/Case Packaging, 96 Eaches/Case T4522 08080-6003-30

Kendall Wings™ Choice Plus Adult Briefs Large 45"-58" (114.3cm - 147.3cm)

60034 Blue Color Code, 12/Bag, 6 Clear Bags/Case Packaging, 72 Eaches/Case T4523 08080-6003-40

Kendall Wings™ Choice Plus Adult Briefs X-Large 59"-64" (149.9cm - 162.6cm)

60035 Beige Color Code, 12/Bag, 5 Clear Bags/Case Packaging, 60 Eaches/Case T4524 08080-6003-50

60043 Kendall Wings™ Choice Adult Briefs Medium 32"-44" (81.3cm - 111.8cm) T4522 08080-6004-30
White Color Code, 12/Bag, 8 Clear Bags/Case Packaging, 96 Eaches/Case

Page 5

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

Kendall Wings™ Choice Adult Briefs Large 45"-58" (114.3cm - 147.3cm) Blue

60044 Color Code, 12/Bag, 6 Clear Bags/Case Packaging, 72 Eaches/Case T4523 08080-6004-40

Kendall Wings™ Choice Adult Briefs Large 45"-58" (114.3cm - 147.3cm) Beige

60045 Color Code, 10/Bag, 6 Clear Bags/Case Packaging, 60 Eaches/Case T4524 08080-6004-05

Kendall Wings™ 3D Adult Briefs Medium 32"-44" (81.3cm - 111.8cm) White

63013 Color Code, 12/Bag, 8 Clear Bags/Case Packaging, 96 Eaches/Cas T4522 08080-6301-03

63014 Kendall Wings™ 3D Adult Briefs Large 45"-58" (114.3cm - 147.3cm) Blue T4523 08080-6301-04
Color Code, 12/Bag, 6 Clear Bags/Case Packaging, 72 Eaches/Case

Kendall Wings™ 3D Adult Briefs X-Large 59"-64" (149.9cm - 162.6cm) Beige

63015 Color Code, 12/Bag, 5 Clear Bags/Case Packaging, 60 Eaches/Case T4524 08080-6301-05
63023 08080-6302-30
63024 Kendall Wings™ 3D Adult Briefs Moderate Abosorbency Medium 32"-44" 08080-6302-40
63025 08080-6302-50
63062 (81.3cm - 111.8cm) White Color Code, 12/Bag, 8 Clear Bags/Case Packaging, 08080-6306-02
63063 08080-6306-03
63064 96 Eaches/Case T4522 08080-6306-40
63065 08080-6306-50
Kendall Wings™ 3D Adult Briefs Moderate Abosorbency Large 45"-58"

(114.3cm - 147.3cm) Blue Color Code, 12/Bag, 6 Clear Bags/Case Packaging,

72 Eaches/Case T4523

Kendall Wings™ 3D Adult Briefs Moderate Abosorbency X-Large 59"-64"

(149.9cm - 162.6cm) Beige Color Code, 12/Bag, 5 Clear Bags/Case Packaging,

60 Eaches/Case T4524

Kendall Wings™ Hook & Loop 3D Adult Briefs Small 20"-31" (50.8cm -

78.7cm) 26.5" (67.3cm) Peach Color Code, 12/Clear Bag, 8 Bags/Case

Packaging, 96 Eaches/Case T4521

Kendall Wings™ Hook & Loop 3D Adult Briefs Medium 32"-44" (81.3cm -

111.8cm) White Color Code, 12/Bag, 8 Clear Bags/Case Packaging, 96

Eaches/Case T4522

Kendall Wings™ Hook & Loop 3D Adult Briefs Large 45"-58" (114.3cm -

147.3cm) Blue T4523

Kendall Wings™ Hook & Loop 3D Adult Briefs X-Large 59"-64" (149.9cm -

162.6cm) Beige T4524

Page 6

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

Kendall Wings™ Hook and Loop Ultra 3D Adult Briefs Maximum Absorbancy

Small 20"-31" (50.8cm - 78.7cm), 26.5" (67.3cm)L Peach Color Code, 12/Clear

63072 Bag, 8 Bags/Case Packaging, 96 Eaches/Case T4521 08080-6307-02
63073 08080-6307-30
63074 Kendall Wings™ Hook & Loop Ultra 3D Adult Briefs Maximum Absorbancy 08080-6307-40
63075 08080-6307-05
66032 Medium 32"-44" (81.3cm - 111.8cm) White T4522 08080-6603-20
66033 08080-6603-30
66034 Kendall Wings™ Hook & Loop Ultra 3D Adult Briefs Maximum Absorbancy 08080-6603-40
66035 08080-6603-50
Large 45"-58" (114.3cm - 147.3cm) Blue T4523

Kendall Wings™ Hook & Loop Ultra 3D Adult Briefs Maximum Absorbancy X-

Large 59"-64" (149.9cm - 162.6cm) Beige T4524

Kendall Wings™ Choice Plus Quilted Adult Briefs Small 20"-31" (50.8cm -

78.7cm) 26.5" (67.3cm)L Peach T4521

Kendall Wings™ Choice Plus Quilted Adult Briefs Medium 32"-44" (81.3cm -

111.8cm) White T4522

Kendall Wings™ Choice Plus Quilted Adult Briefs Large 45"-58" (114.3cm -

147.3cm) Blue T4523

Kendall Wings™ Choice Plus Quilted Adult Briefs X-Large 59"-64" (149.9cm -

162.6cm) Beige T4524

67033 Kendall Wings™ Quilted Overnight Adult Brief, Medium 32" To 44", White T4522 08080-6703-30
67034 08080-6703-40
Kendall Wings™ Quilted Overnight Adult Brief, Large 45" To 58", Blue T4523

67035 Kendall Wings™ Quilted Overnight Adult Brief, Xlarge 59" To 64", Beige T4524 08080-6703-50
67093 Kendall Wings™ Adult Brief, Xxlarge Up To 69", Green T4524 08080-6709-30
67095 Kendall Wings™ Barriatric Adult Briefs T4543 08080-6709-50
Kendall SureCare™ Perineal Cold Pad, Cool Comfort Basic 5.75" X 13"
52000024 Individually Wrapped T5999 08080-5200-24

1100B Kendall SureCare™ Bladder Control Pads Regular Absorbancy 4" x 9.75" 08080-1100-01
(10.2cm x 24.8cm) 22/Bag, 6 Printed Bags/Case Packaging, 132 Eaches/Case T4535

1110B Kendall SureCare™ Bladder Control Pads Extra Absorbancy4" x 10.75" T4535 08080-1110-01
1130A (10.2cm x 27.3cm) 20/Bag, 6 Printed Bags/Case Packaging, 120 Eaches/Case T4535 08080-1130-01
1140A Kendall SureCare™ Bladder Control Pads Ultra Plus 4" x 14½" White T4535 08080-1140-01
1380A Kendall SureCare™ Bladder Control Pads Extra Plus 4" x 12½" White T4535 08080-1380-01
Covidien™ Curity™ Peri-Pad Regular 3.75" x 10" (9.6 cm x 25.2 cm)

Page 7

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

1552MD Kendall SureCare™ Fluff Underpads 30" x 36" (76.2cm x 91.4cm) Lt Blue T4541 08080-1552-01
1580A Covidien™ Curity™ Peri-Pad Winged 4" x 11" (10 cm x 28 cm) T4535 08080-1580-01
Kendall Simplicity™ Belted Undergarment One Fits All 10/Bag, 12 Clear
171B10 Sleeves/Case Packaging, 120 Eaches/Case T4535 08080-1710-10
Kendall Simplicity™ Beltless Undergarment One Fits All 30/Clear Bag, 4 Clear
181B30 Bags/Case, 120 Eaches/Case T4535 08080-1810-30
2022A Covidien™ Curity™ Maternity Pad 4.3" x 12.25" (11 cm x 31 cm) T4535 08080-2022-01
23246A Kendall SureCare™ Guards for Men 6.5" x 13" (16.5cm x 33cm) T4535 08080-2324-61
6040N Kendall Wings™ ExcilonTM Washclothes, White 10" X 13" T5999 08080-6040-01
6399SP Kendall WingsTM Adult Wet Wipes 48 Ct Sp T5999 08080-6399-10
Kendall Wings™ Fluff and Polymer Underpads Super Absorbancy 23" x 36"
6418N (58.4cm x 91.4cm) Beige 24's T4541 08080-6418-00

6422P Kendall Wings™ Fluff and Polymer Underpads Super Absorbancy 23" x 36" T4541 08080-6422-00
(58.4cm x 91.4cm) Beige Backsheet, 5/Bag, 15 Bags/Case, 75 Eaches/Case T4541
6569N Kendall Wings™ Fluff and Polymer Underpads Super Absorbancy 30" x 30" 08080-6569-01
(76.2cm x 76.2cm) Beige, 24's
6596B22 08080-6596-22
Kendall Wings™ Day Regular Contoured Insert Pad 13.4" x 24" (34cm x 61cm)
6597B20 08080-6597-01
Blue Color Code, 22/Clear Bag, 4 Bags/Case Packaging, 88 Eaches/Case T4535
6598B24 08080-6598-01
6599N Kendall Wings™ Day Plus Contoured Insert Pad 14.1" x 26.4" (35.8cm x 08080-6599-10
6699N 08080-6699-01
6899N 67.1cm) Yellow Color Code, 20/Clear Bag, 4 Bags/Case Packaging, 80 08080-6899-00
70063BA 08080-7063-10
70063GA Eaches/Case T4535 08080-7063-00
70064BA 08080-7064-10
70064GA Kendall Wings™ Night Super Contoured Insert Pad Super Green Color Code, 08080-7064-00
70065BA 08080-7065-10
70065GA 24/Clear Bag, 2 Bags/Case Packaging, 48 Eaches/Case T4535 08080-7065-00

Kendall Wings™ Premoistened Washcloths 64 Count Tub T5999

Kendall Wings™ Premoistened Washcloths 64 Count Refill T5999

Kendall Wings™ Adult Wet Wipes 8 Count T5999

Curity™ Training Pant Boys Medium 2T-3T up to 34 lbs T4529

Curity™ Training Pant Girls Medium 2T-3T up to 34 lbs T4529

Curity™ Training Pant Boys Large 3T-4T up to 32-40 lbs T4530

Curity™ Training Pant Girls Large 3T-4T up to 32-40 lbs T4530

Curity™ Training Pant Boys X-Large 4T-5T 38 lbs & over T4530

Curity™ Training Pant Girls X-Large 4T-5T 38 lbs & over T4530

Page 8

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

70073A Youth Pants Unisex Medium 45-65 lbs/20-29 kg T4534 08080-7073-00
70074A Youth Pants Unisex Large 65-85 lbs/29-39 kg T4534 08080-7074-00
70075A Youth Pants Unisex X-Large 85-125 lbs/39-57 kg T4534 08080-7075-00

705A Kendall Wings™ Incontinence Care Seamless Knit Pants S/M Yellow/Blue 5's T4536 08080-7050-00

706A Kendall Wings™ Incontinence Care Seamless Knit Pants L/XL Brown/Green 5's T4536 08080-7060-00
706M 08080-7060-01
Kendall Wings™ Maternity Care Seamless Knit Pants L/XL Brown/Green Bulk

100's T4536

706M2 Kendall Wings™ Maternity Care Seamless Knit Pants L/XL Brown/Green 2's T4536 08080-7060-11
707A 08080-7070-00
707M Kendall Wings™ Incontinence Care Seamless Knit Pants XXL/XXXL Purple/Grey 08080-7070-01
707M2 08080-7070-11
708A 5's T4536 08080-7080-00

Kendall Wings™ Maternity Care Seamless Knit Pants XXL/XXXL Purple/Gray

Bulk 100's T4536

Kendall Wings™ Maternity Care Seamless Knit Pants XXL/XXXL Purple/Gray

2's T4536

Kendall Wings™ Incontinence Care Seamless Knit Pants XXXXL White 5's T4536

708M Kendall Wings™ Maternity Care Seamless Knit Pants XXXXL White Bulk 50's T4536 08080-7080-01
80008A Curity™ Baby Diapers Boys & Girls Small 8-14 lbs (4-6 kg) Size1 T4529 08080-8080-00
80008ANB Curity™ Baby Diapers Boys & Girls Up to 10 lbs T4529 08080-8081-00
80018A Curity™ Baby Diapers Boys & Girls Sm/Med12-18 lbs (5-8 kg) Size 2 T4529 08080-8018-00
80028A Curity™ Baby Diapers Boys & Girls Med 16-28 lbs (7-13 kg) Size 3 T4529 08080-8028-00
80038A Curity™ Baby Diapers Boys & Girls Large 22-37 lbs (10-17 kg) Size 4 T4530 08080-8038-00
80048A Curity™ Baby Diapers Boys & Girls X-Lg Over 27 lbs (over 12kg) Size5 T4530 08080-8048-00
80058A Curity™ Baby Diapers Boys & Girls XX-Large Over 35 lbs Size 6 T4530 08080-8058-00
Kendall Simplicity™ Garment Liner Large 10" x 24" (25.4cm x 61cm) Heavy
931B24 Absorbency, 24/Bag, 6 Bags/Case, 144 Eaches/Case T4535 08080-9310-24
Kendall Wings™ Fluff Underpads 30" x 30" (76.2cm x 76.2cm) Lt. Blue
949B10 Backsheet, 10/Bag,10 Bags/Case, 100 Eaches/Case T4541 08080-9490-10

958B10 Kendall Wings™ Fluff and Polymer Underpads Super Absorbancy 30" x 36" 08080-9580-10
(76.2cm x 91.4cm) Green Backsheet, 10/Bag, 5 Bags/Case, 50 Eaches/Case T4541

Page 9

Incontinence Products

DISCLAIMER: The Centers for Medicare and Medicaid Services was the primary source of any HCPCS information contained
in this document. Covidien does not represent or guarantee that any HCPCS information contained in this document is
complete, accurate, or applicable to any particular patient or third-party payer and disclaims all liability for any
consequence resulting from any reliance on such information. The final billing-related decisions for any product must be
made by the health care provider considering the medical necessity of the product furnished as well as the requirements of
third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is
providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering
legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own
advisors regarding coding and payment.

REIMBURSEMENT HOT LINE 800-346-7197 X6076

Covidien Product Description HCPCS Code HRI's
Reorder
Number

965B20 Kendall Simplicity™ Garment Liner 6.5" x 17" (16.5cm x 43.2cm) Light T4535 08080-9652-00
Absorbency, 20/Bags, 10 Bags/Case, 200 Eaches/Case

982B10 Kendall Wings™ Fluff and Polymer Underpads Super Absorbancy 23" x 36" T4541 08080-9820-10
988B6 (58.4cm x 91.4cm) Beige Backsheet, 10/Bag, 10 Bags/Case, 100 Eaches/Case T4541 08080-9886-00
988HD Kendall Wings™ Breathable Underpads 23" x 36" (58.4cm x 91.4cm) Lt. Blue T4541 08080-9880-00
Backsheet, 6/Bag, 12 Bags/Case, 72 Eaches/Case
Kendall Wings™ Breathable Underpads 23" x 36" (58.4cm x 91.4cm) Lt. Blue
Backsheet, 12/Bag, 6 Bags/Case, 72 Eaches/Case

MH20002 Perineal Cold Pad, Cool Comfort Enhanced 5.75" X 13" Individually Wrapped T5999 08080-2000-20
P2336B Kendall Wings™ Quilted Breathable Underpads 23"x36" Beige 12's T4541 08080-2336-01
P2336C Kendall Wings™ Quilted Cloth-like 23X36 T4541 08080-2336-10
P3030B Kendall Wings™ Quilted Breathable Underpads 30"x30" Beige 10's T4541 08080-3030-01
P3030C Kendall Wings™ Quilted Cloth-like 30X30 T4541 08080-3030-10
P3036B Kendall Wings™ Quilted Breathable Underpads 30"x36" Beige 10's T4541 08080-3036-01
P3036C Kendall Wings™ Quilted Cloth-like 30X36 T4541 08080-3036-10
65033 Simplicity™ Quilted Brief Medium T4522 08080-6503-31
65034 Simplicity™ Quilted Brief Large T4523 08080-6503-41
65034R Simplicity™ Quilted Brief Large Retail T4523 08080-6503-42
65035 Simplicity™ Quilted Brief XLarge T4524 08080-6503-51
65035R Simplicity™ Quilted Brief XLarge Retail T4524 08080-6503-52

Page 10