Question 1

What is HCPCS code S9123?

Accepted Answer

HCPCS code S9123 is "Nursing care in home rn". Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)

Question 2

What category is S9123 in?

Accepted Answer

S9123 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S9123?

Accepted Answer

Use S9123 when billing for nursing care in home rn. 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 S9123 covered by Medicare?

Accepted Answer

Coverage for S9123 (Nursing care in home rn) 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 S9123?

Accepted Answer

Documentation for S9123 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).