CORRECT CODING – DIAPERS AND UNDERPADS


Joint DME MAC Publication

Recent reports have identified that suppliers are billing Healthcare Common Procedure Coding System (HCPCS) codes A9999 (MISCELLANEOUS DME SUPPLY OR ACCESSORY, NOT OTHERWISE SPECIFIED) or E1399 (DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS) for diapers and underpads. These miscellaneous codes are not the correct codes to use for billing these items. The correct codes to bill for these items are:

  • A4520 INCONTINENCE GARMENT, ANY TYPE, (E.G., BRIEF, DIAPER), EACH
  • A4554 DISPOSABLE UNDERPADS, ALL SIZES
  • A4553 NON-DISPOSABLE UNDERPADS, ALL SIZES (effective for claims with date of service on or after January 1, 2017)
    For questions about correct coding, contact the Pricing, Data Analysis and Coding (PDAC) contractor Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form.

 

Published by Noridian as the PDAC,  December 2016.  Republished by Palmetto GBA as the PDAC, January 2019.



Last Updated: 12/20/2016