How To Use HCPCS Code E1399

HCPCS code E1399 describes a specific category of durable medical equipment (DME) that is not otherwise classified under a more specific code. This code is used to identify miscellaneous enteral supplies that are not covered by any other specific HCPCS code. In this article, we will explore the details of HCPCS code E1399, 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 E1399?

HCPCS code E1399 is used to identify durable medical equipment that falls under the category of miscellaneous enteral supplies. This code is specifically designed for items that do not have a more specific code assigned to them. It is important to note that this code should only be used when there is no other appropriate code available to accurately describe the item being billed.

2. Official Description

The official description of HCPCS code E1399 is “Durable medical equipment, miscellaneous.” This code is used to identify and bill for enteral supplies that are not otherwise classified under a more specific code.

3. Procedure

1. When using HCPCS code E1399, the healthcare provider should ensure that the item being billed falls under the category of miscellaneous enteral supplies.
2. The provider should accurately document the specific item being provided and its purpose or function.
3. The item should meet the criteria for durable medical equipment and be necessary for the patient’s medical condition.
4. The provider should follow all applicable documentation and billing guidelines to ensure proper reimbursement.

4. When to use HCPCS code E1399

HCPCS code E1399 should be used when billing for enteral supplies that do not have a more specific code assigned to them. This code is typically used for items that are not commonly used or do not fit into any other existing code category. It is important to ensure that the item being billed meets the criteria for durable medical equipment and is medically necessary for the patient’s condition.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E1399, healthcare providers should ensure that they meet all necessary documentation and billing requirements. This includes:

• Accurately documenting the specific item being provided and its purpose or function.
• Ensuring that the item meets the criteria for durable medical equipment.
• Providing any additional supporting documentation, such as medical records or prescriptions, if required.
• Following all applicable guidelines and regulations set forth by Medicare or other insurance payers.

6. Historical Information and Code Maintenance

HCPCS code E1399 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has been in use since then to identify miscellaneous enteral supplies that do not have a more specific code assigned to them. As of the 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.

7. Medicare and Insurance Coverage

HCPCS code E1399 is eligible for coverage by Medicare and other insurance payers. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means that it is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions on billing and reimbursement for HCPCS code E1399.

8. Examples

Here are five examples of when HCPCS code E1399 should be billed:

1. A patient requires a specialized enteral feeding tube that does not have a specific code assigned to it.
2. A provider supplies a unique enteral nutrition formula that is not covered by any other specific code.
3. A patient needs a custom-made enteral feeding pump that does not fit into any other existing code category.
4. A provider provides a miscellaneous enteral supply, such as a feeding syringe, that does not have a more specific code assigned to it.
5. A patient requires a specialized enteral feeding accessory that is not covered by any other specific code.