RETIRED - Correct Coding Reminder - Monitoring Technology Used with Positive Airway Pressure Devices (PAP) and Respiratory Assist Devices (RAD)

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.

Posted November 15, 2013

Many manufacturers of medical devices are now incorporating technology for monitoring and/or downloading various types of patient data. This information is then made available for review by the healthcare provider, DME supplier or in some cases, the beneficiary. This technology may be incorporated into the device itself or added as a separate module. Such technologies include, but are not limited to:

  • Smart cards and readers
  • USB/Thumb drive accessories
  • Wired telephonic transmission modules
  • Wireless modems

For example, Positive Airway Pressure Devices and Respiratory Assist Devices include technology to monitor compliance. This article serves as a reminder for the correct coding of these features.

Suppliers who elect to bill separately for monitoring technology must use HCPCS code A9279 (MONITORING FEATURE/DEVICE, STAND-ALONE OR INTEGRATED, ANY TYPE, INCLUDES ALL ACCESSORIES, COMPONENTS AND ELECTRONICS, NOT OTHERWISE CLASSIFIED). Code A9279 is to be used whether the monitoring technology is incorporated as part of the base item, supplied as an add-on module or is a stand-alone item. Claims for A9279 are denied as statutorily noncovered.

A9279 is all-inclusive. Use of multiple instances of A9279 to bill separately for individual features is incorrect coding.

Claims billed for monitoring technologies using other NOC codes such as E1399 [DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS] will be denied as incorrect coding.

Refer to the applicable Local Coverage Determination and related Policy Article for additional information on the coverage and coding of PAP and RAD items.

 

            Last Updated Thu, 10 Jan 2019 12:25:33 +0000