Correct Coding - A9286 - Hygienic Item or Device, Disposable or Non-disposable, Any Type, Each
In November 2017 the DME MACs published an article, Correct Coding - Hygienic Items Wash Cloths and Cleansing Wipes, explaining the correct coding for hygienic items. Examples of incorrect miscellaneous or not otherwise classified (NOC) codes billed for these items are:
- A4649 (SURGICAL SUPPLY; MISCELLANEOUS)
- A9999 (MISCELLANEOUS DME SUPPLY OR ACCESSORY, NOT OTHERWISE SPECIFIED)
- E1399 (DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS)
Correct coding requires the use of specific HCPCS codes for Medicare billing when a specific code exists that appropriately describes the item provided. Use of a miscellaneous or NOC code for billing when a specific code exists is incorrect coding. Hygienic items are correctly billed with HCPCS code:
- A9286 - HYGIENIC ITEM OR DEVICE, DISPOSABLE OR NON-DISPOSABLE, ANY TYPE, EACH
This article provides additional examples of products that are included in HCPCS code A9286. Products included in this code include, but are not limited to:
- Cleansing wipes (including those used on wounds)
- Washcloth of any type
- Hand held shower heads
- Cleansing solutions
- Special soaps for sensitive skin
- Liquid body wash
- Sanitizer hand wash
- Antiseptic towelettes
- Perineal cleansers
- Incontinent wipes
- Soap towelettes
- Toothettes (oral swabs)
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.
Published by Noridian as the PDAC, August 2018. Republished by Palmetto GBA as the PDAC, January 2019