Incorrect Use of HCPCS Code A9279 - Correct Coding
Joint DME MAC Publication
The DME MACs have recently been made aware of the inappropriate use of HCPCS code A9279 (MONITORING FEATURE/DEVICE, STAND-ALONE OR INTEGRATED, ANY TYPE, INCLUDES ALL ACCESSORIES, COMPONENTS AND ELECTRONICS, NOT OTHERWISE CLASSIFIED). A9279 is for the feature/device only, whether incorporated into a piece of DME or a stand-alone device.
Code A9279 is not for monitoring services provided by the DME supplier and must not be billed for monitoring services nor should the beneficiary be charged by the DME Supplier for monitoring services as part of the DME equipment under A9279. Monitoring services provided as part of a professional service may fall within the Current Procedural Terminology (CPT) codes under the A/B MAC Jurisdiction. If an Advance Beneficiary Notice of Noncoverage (ABN) was obtained for services rather than the feature/device, the ABN is invalid.
Monitoring devices are described, for example, in the Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (OSA) Policy Article A52467:
Monitoring devices (integrated or modular) are capable of tracking data generated by a RAD or PAP device, which can be subsequently downloaded for further analysis by a healthcare provider, DME supplier, or beneficiary. Such technologies include, but are not limited to:
- Smart cards and readers
- USB/Thumb drive accessories
- Wired telephonic transmission modules
- Wireless modems
Code A9279 (MONITORING FEATURE/DEVICE, STAND-ALONE OR INTEGRATED, ANY TYPE, INCLUDES ALL ACCESSORIES, COMPONENTS AND ELECTRONICS, NOT OTHERWISE CLASSIFIED) describes any type of monitoring technology. Code A9279 is all-inclusive, and is to be used whether the monitoring technology is incorporated as part of a base item, supplied as an add-on module or is a stand-alone item.
For questions about correct coding, contact the PDAC Contact Center at 877-735-1326 during the hours of 9:30 a.m. to 5:00 p.m. ET, Monday through Friday, or email the PDAC by completing the DME PDAC Contact Form located on the PDAC Website.
|06/12/2020||Published on PDAC website|