How To Use HCPCS Code E0202

HCPCS code E0202 describes the procedure of phototherapy (bilirubin) light with photometer. This code is used to identify the specific service provided by healthcare providers. In this article, we will explore the details of HCPCS code E0202, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and examples of when this code should be billed.

1. What is HCPCS E0202?

HCPCS code E0202 is used to identify the procedure of phototherapy (bilirubin) light with photometer. This code is specifically used for the administration of phototherapy treatment using a photometer to measure the levels of bilirubin in the patient’s blood. It is an important code for medical coders to accurately document and bill for this specific procedure.

2. Official Description

The official description of HCPCS code E0202 is “Phototherapy (bilirubin) light with photometer.” The short description for this code is “Parenteral supp not othrws c.” These descriptions provide a concise summary of the procedure and its purpose.

3. Procedure

1. The provider begins by assessing the patient’s condition and determining the need for phototherapy treatment.
2. A photometer is used to measure the levels of bilirubin in the patient’s blood.
3. Based on the results of the bilirubin measurement, the provider determines the appropriate duration and intensity of the phototherapy treatment.
4. The patient is positioned under the phototherapy light, which emits a specific wavelength of light to help break down the excess bilirubin in the blood.
5. The duration of the phototherapy treatment may vary depending on the patient’s condition and response to the treatment.
6. Throughout the procedure, the provider closely monitors the patient’s vital signs and bilirubin levels to ensure the effectiveness and safety of the treatment.
7. Once the desired bilirubin levels are achieved, the phototherapy treatment is discontinued.

4. When to use HCPCS code E0202

HCPCS code E0202 should be used when healthcare providers perform phototherapy treatment using a photometer to measure the levels of bilirubin in the patient’s blood. This code is applicable for patients who require this specific treatment for conditions related to elevated bilirubin levels, such as neonatal jaundice.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0202, healthcare providers need to ensure proper documentation of the procedure and its medical necessity. The documentation should include the patient’s diagnosis, the reason for the phototherapy treatment, the duration and intensity of the treatment, and the results of the bilirubin measurement. It is important to follow the billing guidelines set by the insurance companies and Medicare to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E0202 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. This code has remained unchanged since its addition to the coding system.

7. Medicare and Insurance Coverage

HCPCS code E0202 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 57, which indicates that it is priced by carriers using other methodologies. The multiple pricing indicator code for this code is A, which means it is not applicable as HCPCS priced under one methodology. Healthcare providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions regarding the coverage and reimbursement of this code.

8. Examples

Here are five examples of when HCPCS code E0202 should be billed:

1. A newborn baby with elevated bilirubin levels requiring phototherapy treatment with a photometer.
2. A premature infant with neonatal jaundice receiving phototherapy treatment using a photometer to monitor bilirubin levels.
3. A patient with a liver disorder requiring phototherapy treatment to manage elevated bilirubin levels.
4. An adult patient undergoing phototherapy treatment for a rare condition causing increased bilirubin production.
5. A pediatric patient with a genetic disorder necessitating regular phototherapy treatment with bilirubin monitoring.