Question 1

What is HCPCS code A4223?

Accepted Answer

HCPCS code A4223 is "Infusion supplies w/o pump". Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)

Question 2

What category is A4223 in?

Accepted Answer

A4223 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A4223?

Accepted Answer

Use A4223 when billing for infusion supplies w/o pump. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is A4223 covered by Medicare?

Accepted Answer

Coverage for A4223 (Infusion supplies w/o pump) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for A4223?

Accepted Answer

Documentation for A4223 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).