HCPCS Code A4629: Tracheostomy care kit for established tracheostomy
HCPCS Code A4629 is a Level II supply code for a tracheostomy care kit billed to a patient with an established tracheostomy. The rule that decides whether A4629 is the correct code is timing, not clinical status: Medicare only allows A4629 once a patient is more than two weeks past their tracheostomy procedure. Kits supplied […]
HCPCS Code A4616: Tubing (oxygen), per foot
HCPCS Code A4616 is a Medicare DMEPOS supply code for tubing used with oxygen or respirator equipment, billed per foot rather than per length purchased or per patient episode. That per-foot unit is where most A4616 claims go wrong. A supplier who bills one unit for a six-foot tube has underbilled by five units. One […]
HCPCS code H0019: Behavioral health long-term residential billing guide
HCPCS code H0019 describes behavioral health long-term residential treatment: non-medical, non-acute care in a residential program where the stay typically exceeds 30 days, billed per diem. The code excludes room and board, which is billed separately or, for programs that bundle housing into the per-diem rate, captured instead under T2048. This guide covers the official […]
HCPCS code A4624: Tracheal suction catheter billing guide
HCPCS code A4624 is a billable Level II code for a tracheal suction catheter, any type other than closed system, billed per unit under Medicare Part B as a durable medical equipment supply. Most claim denials trace back to one of three mistakes: Billing the wrong catheter code, submitting without a physician order, or missing […]
HCPCS Code A4351: Intermittent urinary catheter billing guide
HCPCS Code A4351: Definition and clinical description HCPCS Code A4351 is a Level II HCPCS code for an intermittent urinary catheter with a straight tip, billed under Medicare Part B and other payers as durable medical equipment (DME). Teflon, silicone, and uncoated straight-tip catheters bill under A4351; hydrophilic-coated straight-tip catheters bill separately under new code […]
HCPCS code A4634: Replacement bulb for therapeutic light box
HCPCS code A4634 describes a replacement bulb for a therapeutic light box, tabletop model. Medicare classifies it as non-covered, so any practice billing this supply needs a signed Advance Beneficiary Notice of Noncoverage (ABN) on file before the claim goes out. This guide covers the full A4634 descriptor, Medicare and private payer coverage, billing guidelines […]
HCPCS Code S0166: Injection, olanzapine, 2.5 mg
HCPCS Code S0166 describes Injection, olanzapine, 2.5 mg – a Temporary National S-code that Medicaid managed care organizations and select private payers used to bill the short-acting antipsychotic injection. Medicare generally doesn’t recognize S-codes, including this one. S0166 was deleted effective October 1, 2023, per the Q4 2023 HCPCS quarterly update. CMS established J2359 (Injection, […]
HCPCS Code J3420: Vitamin B-12 Injection Billing Guide
HCPCS code J3420 reports the injection of vitamin B-12 cyanocobalamin, up to 1000 mcg, administered by any non-oral route. It covers the drug only, not the work of giving the injection, which is why practices pair it with CPT 96372 and a covered ICD-10 diagnosis code on every claim. This guide covers the code definition, […]
HCPCS Code L0625: Lumbar orthosis billing guide
HCPCS code L0625 bills for a lumbar orthosis that is flexible, prefabricated, and off-the-shelf, supporting the lumbar spine from L-1 to below L-5. Medicare Part B may cover it as a DMEPOS benefit when the beneficiary meets the criteria in CMS Policy Article A52500. This guide covers the 2026 fee schedule, required modifiers, the CG-versus-GY […]
HCPCS code A4252: Blood ketone test or reagent strip billing guide
HCPCS code A4252 is the Level II supply code for a blood ketone test or reagent strip, billed one unit per strip through the DMEPOS claim pathway. Most denials on this code trace back to one of three issues: the wrong DME MAC jurisdiction, missing diagnosis documentation, or a supplier who wasn’t enrolled before the […]