Correct Coding - A9286 - Hygienic Item or Device Disposable or Non-Disposable - JD DME

DME MAC Joint Publication

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. 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.

Publication History