HCPCS Codes - Medical Procedures, Supplies & DME Codes - a5 Codes
HCPCS Procedure, Supply & DME (Durable Medical Equipment) Codes ("a5" Codes):- A5051 ostomy pouch closed barrier attached 1 HCPCS Code Code
- A5052 ostomy pouch closed barrier attached 1 HCPCS Code Code
- A5053 ostomy pouch closed use faceplate each HCPCS Code Code
- A5054 ostomy pouch closed use barrier flange HCPCS Code Code
- A5055 stoma cap HCPCS Code Code
- A5056 Ostomy pouch, drainable, with extended wear barrier HCPCS Code Code
- A5057 Ostomy pouch, drainable, with extended wear barrier HCPCS Code Code
- A5061 ostomy pouch drainable barrier attached 1 HCPCS Code Code
- A5062 ostomy pouch drainable barrier attached 1 HCPCS Code Code
- A5063 ostomy pouch drainable use barrier flange HCPCS Code Code
- A5071 ostomy pouch urinary barrier attached 1 HCPCS Code Code
- A5072 ostomy pouch urinary barrier attached 1 HCPCS Code Code
- A5073 ostomy pouch urinary use barrier flange HCPCS Code Code
- A5081 continent device plug continent stoma HCPCS Code Code
- A5082 continent device catheter continent stoma HCPCS Code Code
- A5083 STOMA ABSORPTIVE COVER HCPCS Code Code
- A5093 ostomy accessory convex insert HCPCS Code Code
- A5102 bedside drainage bottle tubing rigid expandable HCPCS Code Code
- A5105 urinary suspensory leg bag tube each HCPCS Code Code
- A5112 urinary leg bag latex HCPCS Code Code
- A5113 leg strap latex replacement only per HCPCS Code Code
- A5114 leg strap foam fabric replacement only HCPCS Code Code
- A5119 SKIN BARRIER WIPES BOX PR 50 HCPCS Code Code
- A5120 skin barrier wipes swabs each HCPCS Code Code
- A5121 skin barrier solid 6 x 6 HCPCS Code Code
- A5122 skin barrier solid 8 x 8 HCPCS Code Code
- A5126 adhesive nonadhesive disk foam pad HCPCS Code Code
- A5131 appliance cleaner incontinence ostomy appliances per HCPCS Code Code
- A5200 percutaneous cathetertube anchoring device adhesive skin HCPCS Code Code
- A5500 diabetics only fitting including followup custom HCPCS Code Code
- A5501 diabetics only fitting including followup custom HCPCS Code Code
- A5503 diabetics only modification including fitting offtheshelf HCPCS Code Code
- A5504 diabetics only modification including fitting offtheshelf HCPCS Code Code
- A5505 diabetics only modification including fitting offtheshelf HCPCS Code Code
- A5506 diabetics only modification including fitting offtheshelf HCPCS Code Code
- A5507 diabetics only not otherwise modification including HCPCS Code Code
- A5508 diabetics only deluxe feature offtheshelf depthinlay HCPCS Code Code
- A5509 DIRECT HEAT FORM SHOE INSERT HCPCS Code Code
- A5510 diabetics only direct formed compression molded HCPCS Code Code
- A5511 CUSTOM FAB MOLDED SHOE INSER HCPCS Code Code
- A5512 diabetics only multiple density insert direct HCPCS Code Code
- A5513 diabetics only multiple density insert custom HCPCS Code Code
- A5514 For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan Code
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HCPCS Medical Codes & Code Modifiers
(HCPCS is commonly pronounced Hick-Picks.)Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Level II Code Set is one of the standard code sets used for this purpose. The HCPCS is divided into two principal subsystems, referred to as level I and level II of the HCPCS. Level I of the HCPCS is comprised of CPT (Current Procedural Terminology), a numeric coding system maintained by the American Medical Association (AMA). The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. These health care professionals use the CPT to identify services and procedures for which they bill public or private health insurance programs. Decisions regarding the addition, deletion, or revision of CPT codes are made by the AMA. The CPT codes are republished and updated annually by the AMA. Level I of the HCPCS, the CPT codes, does not include codes needed to separately report medical items or services that are regularly billed by suppliers other than physicians.
Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting claims for these items. The development and use of level II of the HCPCS began in the 1980's. Level II codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits.
In October of 2003, the Secretary of HHS delegated authority under the HIPAA legislation to CMS to maintain and distribute HCPCS Level II Codes. As stated in 42 CFR Sec. 414.40 (a) CMS establishes uniform national definitions of services, codes to represent services, and payment modifiers to the codes. Within CMS there is a CMS HCPCS Workgroup which is an internal workgroup comprised of representatives of the major components of CMS, as well as other consultants from pertinent Federal agencies. Prior to December 31, 2003, Level III HCPCS were developed and used by Medicaid State agencies, Medicare contractors, and private insurers in their specific programs or local areas of jurisdiction. For purposes of Medicare, level III codes were also referred to as local codes. Local codes were established when an insurer preferred that suppliers use a local code to identify a service, for which there is no level I or level II code, rather than use a "miscellaneous or not otherwise classified code." The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required CMS to adopt standards for coding systems that are used for reporting health care transactions. We published, in the Federal Register on August 17, 2000 (65 FR 50312), regulations to implement this part of the HIPAA legislation. These regulations provided for the elimination of level III local codes by October 2002, at which time, the level I and level II code sets could be used. The elimination of local codes was postponed, as a result of section 532(a) of BIPA, which continued the use of local codes through December 31, 2003.
(Source: http://www.cms.hhs.gov/MedHCPCSGenInfo/)
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