How To Use HCPCS Code A9901

HCPCS code A9901 describes the delivery, set up, and/or dispensing service component of another HCPCS code. This code is used to identify the specific service provided by a healthcare provider in relation to the delivery, set up, or dispensing of durable medical equipment (DME) or other medical items or services. In this article, we will explore the details of HCPCS code A9901, 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 A9901?

HCPCS code A9901 is used to identify the delivery, set up, and/or dispensing service component of another HCPCS code. It represents the specific service provided by a healthcare provider in relation to the delivery, set up, or dispensing of DME or other medical items or services. This code is essential for accurately documenting and billing for these services.

2. Official Description

The official description of HCPCS code A9901 is “DME delivery, set up, and/or dispensing service component of another HCPCS code.” The short description is “Delivery/set up/dispensing.”

3. Procedure

1. The provider begins by delivering the DME or medical item to the patient’s location.
2. Next, the provider sets up the equipment or item, ensuring it is properly installed and functioning.
3. If necessary, the provider may also provide instructions to the patient or caregiver on how to use the equipment or item correctly.
4. Finally, the provider dispenses any necessary supplies or accessories related to the DME or medical item.

4. When to use HCPCS code A9901

HCPCS code A9901 should be used when a healthcare provider delivers, sets up, and/or dispenses DME or other medical items or services as part of another HCPCS code. It is important to use this code to accurately document and bill for these specific services.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9901, healthcare providers need to document the delivery, set up, and/or dispensing of the DME or medical item. This documentation should include details such as the date of service, the specific equipment or item delivered, any instructions provided to the patient or caregiver, and any supplies or accessories dispensed. It is important to follow the billing guidelines set forth by the payer to ensure proper reimbursement for these services.

6. Historical Information and Code Maintenance

HCPCS code A9901 was added to the Healthcare Common Procedure Coding System on January 01, 2000. 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 an effective date of January 01, 2001.

7. Medicare and Insurance Coverage

The coverage of HCPCS code A9901 may vary depending on the payer. Medicare considers this code as carrier judgment, meaning the coverage determination is made by the Medicare carrier. Other insurers may have their own coverage policies for this code. The pricing indicator code for HCPCS code A9901 is 46, which indicates that it is carrier priced. This means that the pricing for this code is determined by the carrier based on factors such as individual determination, carrier discretion, and gap-filled amounts. The multiple pricing indicator code for this code is A, indicating that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code A9901 should be billed:

1. A healthcare provider delivers and sets up a wheelchair for a patient at their home, providing instructions on how to use it and dispensing any necessary accessories.
2. A provider delivers and sets up a continuous positive airway pressure (CPAP) machine for a patient with sleep apnea, ensuring it is properly installed and functioning, and providing instructions on its use.
3. A healthcare provider delivers and sets up a hospital bed for a patient who requires home care, ensuring it is properly assembled and providing instructions on its use. They also dispense any necessary bedding or accessories.
4. A provider delivers and sets up a nebulizer for a patient with respiratory issues, ensuring it is functioning correctly and providing instructions on how to use it. They also dispense any necessary medications or supplies.
5. A healthcare provider delivers and sets up a mobility scooter for a patient with limited mobility, ensuring it is properly adjusted and functioning. They also provide instructions on its use and dispense any necessary accessories.