How To Use HCPCS Code A4619

HCPCS code A4619 describes a face tent, which is a medical device used to deliver oxygen or other gases to a patient. This code is used to identify and bill for the provision of a face tent, which is a type of oxygen delivery system. In this article, we will explore the details of HCPCS code A4619, 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 A4619?

HCPCS code A4619 is used to identify a face tent, which is a device used to deliver oxygen or other gases to a patient. It is a flexible mask that covers the nose and mouth, allowing the patient to breathe in the supplied gas. The face tent is typically used for patients who require a high flow of oxygen or for those who cannot tolerate other types of oxygen delivery systems.

2. Official Description

The official description of HCPCS code A4619 is “Face tent.” The short description is also “Face tent.” This description accurately represents the purpose and function of the device.

3. Procedure

1. Position the patient comfortably in a sitting or semi-reclined position.
2. Ensure that the face tent is clean and in good condition.
3. Attach the face tent to the oxygen source, such as an oxygen concentrator or cylinder.
4. Place the face tent over the patient’s nose and mouth, ensuring a secure and comfortable fit.
5. Adjust the oxygen flow rate according to the patient’s prescribed requirements.
6. Monitor the patient’s oxygen saturation levels and respiratory status throughout the duration of use.
7. Remove the face tent and clean it after each use, following proper infection control protocols.

4. When to use HCPCS code A4619

HCPCS code A4619 should be used when providing a face tent to a patient for the delivery of oxygen or other gases. It is typically used for patients who require a high flow of oxygen or for those who cannot tolerate other types of oxygen delivery systems. The use of this code is subject to specific coverage instructions, as indicated by the coverage code D.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A4619, healthcare providers should ensure that the following documentation is included:

• Prescription or order for the face tent from a qualified healthcare professional.
• Documentation of the patient’s medical necessity for the use of a face tent.
• Date of service and duration of use.
• Any additional relevant documentation, such as the patient’s oxygen saturation levels or respiratory status.

6. Historical Information and Code Maintenance

HCPCS code A4619 was added to the Healthcare Common Procedure Coding System on January 01, 1990. It has an action code N, which indicates that no maintenance actions have been taken for this code. The code’s pricing indicator is 32, which signifies that it is considered an inexpensive and routinely purchased durable medical equipment (DME) item, subject to pricing floors and ceilings. The code is not priced under multiple methodologies.

7. Medicare and Insurance Coverage

HCPCS code A4619 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 32 indicates that Medicare considers it an inexpensive and routinely purchased DME item. However, coverage may vary depending on the specific insurance plan and the patient’s medical necessity for the face tent.

8. Examples

Here are five examples of when HCPCS code A4619 should be billed:

1. A patient with severe chronic obstructive pulmonary disease (COPD) requires a high flow of oxygen and is unable to tolerate a nasal cannula or mask.
2. A patient with respiratory failure due to pneumonia requires oxygen therapy using a face tent.
3. A patient with end-stage lung disease is receiving palliative care and requires oxygen supplementation through a face tent for comfort.
4. A patient with a facial injury or deformity cannot wear a traditional oxygen mask and requires a face tent for oxygen delivery.
5. A patient with a neuromuscular disorder has difficulty maintaining a seal with a nasal cannula or mask and requires a face tent for effective oxygen therapy.