How To Use HCPCS Code A4406

HCPCS code A4406 describes an ostomy skin barrier that is pectin-based and comes in the form of a paste. This code is used to identify and bill for the specific product used in ostomy care. In this article, we will explore the details of HCPCS code A4406, 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 A4406?

HCPCS code A4406 is used to identify a pectin-based ostomy skin barrier paste. This code is specific to the product used in ostomy care and is not applicable to other types of supplies or services. It is important for medical coders to correctly assign this code when billing for ostomy care supplies.

2. Official Description

The official description of HCPCS code A4406 is “Ostomy skin barrier, pectin-based, paste, per ounce.” This description accurately reflects the nature of the product and its composition. The short description of this code is “Pectin based ostomy paste.”

3. Procedure

1. Ensure the patient’s ostomy site is clean and dry.
2. Take a small amount of the pectin-based ostomy paste.
3. Apply the paste around the stoma, creating a seal between the skin and the ostomy appliance.
4. Gently smooth the paste to ensure proper adhesion.
5. Allow the paste to dry before attaching the ostomy appliance.

It is important for healthcare providers to follow proper technique and guidelines when using the pectin-based ostomy paste to ensure optimal patient outcomes.

4. When to use HCPCS code A4406

HCPCS code A4406 should be used when billing for the pectin-based ostomy paste. This code is specific to the product and should not be used for other types of ostomy supplies or services. It is important to review the documentation and ensure that the product used matches the description of HCPCS code A4406 before assigning it for billing purposes.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A4406, healthcare providers should ensure that the following documentation is included:

• Medical record indicating the need for ostomy care
• Prescription or order for the pectin-based ostomy paste
• Documentation of the quantity of paste used
• Date of service

It is important to accurately document and bill for the pectin-based ostomy paste to ensure proper reimbursement and compliance with coding guidelines.

6. Historical Information and Code Maintenance

HCPCS code A4406 was added to the Healthcare Common Procedure Coding System on January 01, 2003. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has remained unchanged since its inception.

7. Medicare and Insurance Coverage

HCPCS code A4406 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 A4406 should be billed:

1. A patient with an ileostomy requires the use of pectin-based ostomy paste to create a secure seal around the stoma.
2. A healthcare provider applies pectin-based ostomy paste to a patient’s colostomy site to prevent leakage and skin irritation.
3. An ostomy nurse provides a demonstration on the proper application of pectin-based ostomy paste to a patient who recently underwent a colostomy procedure.
4. A patient with a urostomy uses pectin-based ostomy paste to ensure a tight seal between the stoma and the urostomy appliance.
5. A home healthcare nurse visits a patient with an ileostomy and provides a supply of pectin-based ostomy paste for their ongoing care.