CORRECT CODING – HYGIENIC ITEMS, WASH CLOTHS, AND CLEANSING WIPES


DME MAC Joint Publication

A recent analysis of HCPCS code A4649 (SURGICAL SUPPLY; MISCELLANEOUS) revealed that 19% of the claim lines submitted were incorrectly coded. Correct coding requires the use of a specific HCPCS code for Medicare billing when a specific code exists that appropriately describes the item provided. Use of a miscellaneous or NOC (not otherwise classified) code for billing when a specific code exists is incorrect coding. The most common incorrectly coded items in this report are for hygienic items such as wash cloths and cleaning wipes.

Hygienic items such as wash cloths and cleaning wipes are correctly billed with HCPCS code

A9286 - HYGIENIC ITEM OR DEVICE, DISPOSABLE OR NON-DISPOSABLE, ANY TYPE, EACH

Correct coding is an essential element for correct claim payment. The Pricing, Data Analysis, and Coding (PDAC) contractor maintains a variety of resources to assist suppliers in determining the appropriate code for Medicare billing. For questions about correct coding, contact the PDAC 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 questions to the PDAC by completing the DME PDAC Contact Form.

Published by Noridian as the PDAC, November 2017.  Republished by Palmetto GBA as the PDAC, January 2019.



Last Updated: 11/29/2017