Tracheostomy Supplies

The Standard Written Order (SWO) requirements are in effect for dates of service January 1, 2020 and after.
Refer to the SWO page for the elements needed in this streamlined order.

Coverage

Documentation

Reviews/Audits

  • Medical Review – View notifications/findings or pre/post claim reviews completed by Noridian Medical Review

Bundling

Per the bundling table listed in Policy Article A52492

  • When the bundled code listed in Column I is billed, the codes in Column II are not separately payable.
  • When the codes in Column II are provided at the same time, it must be billed with the bundled code listed in Column I.
Column I Column II
A4625 A4626
A4629 A4626

 

Last Updated Jan 10, 2020