How To Use HCPCS Code E1520

HCPCS code E1520 describes the heparin infusion pump for hemodialysis. This code is used to identify the specific equipment used for administering heparin during hemodialysis procedures. In this article, we will explore the details of HCPCS code E1520, 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 E1520?

HCPCS code E1520 is used to identify the heparin infusion pump for hemodialysis. This code specifically refers to the equipment used for administering heparin, a medication that prevents blood clotting, during hemodialysis procedures. It is important to use this code accurately to ensure proper documentation and billing for the heparin infusion pump.

2. Official Description

The official description of HCPCS code E1520 is “Heparin infusion pump for hemodialysis.” The short description is “Enteral supp not otherwise c.” This description accurately represents the purpose and use of the heparin infusion pump in the context of hemodialysis procedures.

3. Procedure

1. The provider ensures that the heparin infusion pump is properly set up and calibrated.
2. The provider connects the heparin infusion pump to the patient’s intravenous line.
3. The provider programs the pump with the appropriate heparin dosage and infusion rate.
4. The heparin infusion pump delivers a continuous infusion of heparin throughout the hemodialysis procedure.
5. The provider monitors the patient’s response to the heparin infusion and adjusts the dosage or infusion rate as necessary.
6. After the hemodialysis procedure is complete, the provider disconnects the heparin infusion pump from the patient’s intravenous line.
7. The provider ensures proper cleaning and maintenance of the heparin infusion pump for future use.

4. When to use HCPCS code E1520

HCPCS code E1520 should be used when documenting and billing for the use of a heparin infusion pump during hemodialysis procedures. This code is specific to the administration of heparin and should not be used for other types of infusions or procedures. It is important to ensure that the heparin infusion pump is medically necessary and appropriately prescribed for the patient’s condition.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E1520, healthcare providers should ensure that the following documentation is included:

• Prescription or order for the heparin infusion pump
• Documentation of medical necessity for the heparin infusion pump
• Documentation of the heparin dosage and infusion rate
• Documentation of the patient’s response to the heparin infusion
• Any additional relevant documentation supporting the use of the heparin infusion pump

Providers should also follow the specific billing guidelines and requirements of the payer, such as Medicare or private insurance, to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code E1520 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 HCPCS.

7. Medicare and Insurance Coverage

HCPCS code E1520 is eligible for coverage under Medicare. 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 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 regarding the coverage and reimbursement of HCPCS code E1520.

8. Examples

Here are five examples of when HCPCS code E1520 should be billed:

1. A patient with end-stage renal disease undergoing hemodialysis requires heparin infusion to prevent blood clotting during the procedure. The heparin infusion pump is used to administer the heparin, and HCPCS code E1520 should be billed for this service.
2. A physician prescribes heparin infusion for a patient with a clotting disorder who requires regular hemodialysis. The heparin infusion pump is used to deliver the heparin, and HCPCS code E1520 should be billed for this service.
3. A patient with a history of blood clotting complications during hemodialysis requires continuous heparin infusion. The heparin infusion pump is used to administer the heparin, and HCPCS code E1520 should be billed for this service.
4. A healthcare facility provides heparin infusion as part of a comprehensive hemodialysis treatment plan. The heparin infusion pump is used to deliver the heparin, and HCPCS code E1520 should be billed for this service.
5. A patient with a known sensitivity to heparin requires an alternative anticoagulant during hemodialysis. The heparin infusion pump is used to administer the alternative anticoagulant, and HCPCS code E1520 should be billed for this service.