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.