How To Use HCPCS Code A4367

HCPCS code A4367 describes an ostomy belt, each. This code is used to identify and bill for the specific medical supply of an ostomy belt. In this article, we will explore the details of HCPCS code A4367, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A4367?

HCPCS code A4367 is used to identify an ostomy belt, each. An ostomy belt is a specialized belt that is designed to provide support and security for individuals who have undergone ostomy surgery. It is typically used to hold the ostomy pouch in place and prevent it from shifting or becoming dislodged. The ostomy belt helps to improve comfort and confidence for individuals with an ostomy.

2. Official Description

The official description of HCPCS code A4367 is “Ostomy belt, each.” This description accurately reflects the purpose and function of the medical supply.

3. Procedure

1. Before using the ostomy belt, ensure that the ostomy pouch is properly attached to the stoma.
2. Place the ostomy belt around the waist, positioning it securely over the ostomy pouch.
3. Adjust the belt to achieve a comfortable fit, ensuring that it is not too tight or too loose.
4. Secure the belt using the provided fasteners or closures.
5. Ensure that the ostomy belt provides adequate support and stability for the ostomy pouch.

4. When to use HCPCS code A4367

HCPCS code A4367 should be used when billing for the provision of an ostomy belt. It is important to note that the use of an ostomy belt may be medically necessary for some individuals with an ostomy, while others may not require it. The decision to use an ostomy belt should be based on the individual’s specific needs and the recommendations of their healthcare provider.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A4367, healthcare providers should ensure that the following documentation requirements are met:

• A detailed description of the ostomy belt provided, including the brand, model, and size.
• The quantity of ostomy belts provided.
• The date of service.
• The patient’s medical record should include documentation supporting the medical necessity of the ostomy belt.

6. Historical Information and Code Maintenance

HCPCS code A4367 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. No maintenance actions have been 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 A4367 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 37, which indicates that it falls under the category of ostomy, tracheostomy, and urological supplies, with pricing subject to floors and ceilings. The multiple pricing indicator code is A, which means it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code A4367 should be billed:

1. A patient with an ostomy requires an ostomy belt for support and security.
2. An individual with an ostomy is experiencing issues with their current ostomy belt and requires a replacement.
3. A healthcare provider prescribes an ostomy belt for a patient following ostomy surgery.
4. An individual with an ostomy participates in physical activities and requires an ostomy belt for added stability.
5. A patient with an ostomy experiences discomfort and irritation from their ostomy pouch and requires an ostomy belt for improved comfort.