How To Use HCPCS Code A4259

HCPCS code A4259 describes the supply of lancets, which are small, sharp needles used to prick the skin for blood sampling or glucose monitoring purposes. This code is used to identify the specific type of lancets provided in a box containing 100 units. Lancets are commonly used by individuals with diabetes or other medical conditions that require regular blood testing.

1. What is HCPCS A4259?

HCPCS code A4259 is used to identify the supply of lancets in a box containing 100 units. Lancets are small, disposable needles that are used to prick the skin for blood sampling or glucose monitoring. This code specifically refers to the packaging of lancets in a box of 100.

2. Official Description

The official description of HCPCS code A4259 is “Lancets, per box of 100”. The short description is “Lancets per box”. This accurately represents the supply of lancets in a box containing 100 units.

3. Procedure

1. Ensure that the lancets are sterile and undamaged.
2. Open the box of lancets.
3. Remove a lancet from the box.
4. Prepare the area of the skin where the lancet will be used.
5. Hold the lancet firmly against the skin and press the release button or trigger to activate the lancet.
6. Dispose of the used lancet in a sharps container.
7. Repeat the process for each blood sampling or glucose monitoring procedure.

4. When to use HCPCS code A4259

HCPCS code A4259 should be used when billing for the supply of lancets in a box containing 100 units. This code is applicable for patients who require regular blood sampling or glucose monitoring, such as individuals with diabetes. It is important to ensure that the specific packaging of 100 lancets is provided to accurately use this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A4259, healthcare providers should include the following documentation:

• Date of service
• Patient’s medical record number
• Description of the service provided (supply of lancets in a box of 100)
• Quantity of lancet boxes provided
• Provider’s name, address, and National Provider Identifier (NPI)

Providers should follow the appropriate billing guidelines and submit the claim with the necessary documentation to ensure accurate reimbursement for the supply of lancets.

6. Historical Information and Code Maintenance

HCPCS code A4259 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code A4259 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 34 indicates that this code is classified as DME supplies, with pricing subject to floors and ceilings. The multiple pricing indicator code A signifies that this code is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code A4259 should be billed:

1. A patient with diabetes requires lancets for regular blood glucose monitoring. The provider supplies the patient with a box of 100 lancets.
2. An individual with a medical condition that requires frequent blood sampling needs lancets for self-testing. The provider provides the patient with a box of 100 lancets.
3. A healthcare facility orders lancets in bulk for use in their laboratory. They receive multiple boxes of 100 lancets, and each box is billed using HCPCS code A4259.
4. A home healthcare agency supplies lancets to multiple patients who require blood sampling. Each patient receives a box of 100 lancets, and the agency bills for each box using HCPCS code A4259.
5. A pharmacy dispenses lancets to customers who require them for self-monitoring of blood glucose levels. Each customer purchases a box of 100 lancets, and the pharmacy bills for each box using HCPCS code A4259.