Incontinent Products
Providers must use the appropriate HCPCS code for the size of the recipient.
• Codes T4521 – T4528 small, medium, large, or extra large adult-sized products;
• Codes T4529 – T4532 small/medium, or large pediatric-sized products;
• Codes T4533 and T4534 youth-sized products;
• Code T4543 is only to be used for bariatric-sized adult recipients with waist
size 60” to 90”.
Refer to a HCPCS book for exact sizing (small, med, large, etc.) for each code. If an alternate
size product is medically necessary for a recipient, supportive medical documentation must be obtained and maintained by the provider for audit purposes. Example: a child who needs
an adult-sized diaper.
The use of codes A4520, A4335, and T4535 for incontinent products should only be used
when there is not a more appropriate T code. For underpads, use code T4542 for small-sized
underpads and T4521 for large-sized underpads; or code A4554 for any size underpad.
Medicaid does not pay for products used for menses.
Durable medical equipment (DME ) medical billing. How to do billing for Medicare and what equipment covered by Medicare. DME Modifiers and CPT codes.
Saturday, April 2, 2011
DME - Incontinent Products BILLING - T4521, T4528, T4533, T4534, T4543
Labels:
DME billing basic,
Medicaid DME billing
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