HCPCS codes and insurance billing information for all Huggers and accessories. Huggers are eligible for coverage by most public & private insurance.
Typical HCPCS Codes utilized for billing / reimbursement, to be confirmed specific to your patient/customer requirements, are:
L - Codes - Post-Surgical Pocketed Compression Bra / Binder with Chest Pads
A - Codes - Lymphedema Gradient Compression Bra and Gradient Compression Garment
- A6568, A6528, A6549, A6519 (all Huggers)
- A6589 (HuggerARIA)
- A6593 (Prima/Vida Extenders)
- A - Codes require a Lymphedema Diagnosis & Prescription: I89.0, I97.2, 197.89, Q82.0
- FDA Registration # 3030926968 - Huggers - Class 1, Therapeutic Medical Binder
- Referral Form - one stop shop form to use with your patients' Huggers (either through you or a referral) with required billing information in one place 🫶🏼.
L & A - Code Pro-Tips:
- L & A - Codes for Huggers do not require a PDAC Letter
- MAP/MSRP Pricing - While a supplier cannot go below MAP/MSRP pricing when billing, you can fairly bill above the MAP/MSRP based on your overhead costs, etc. per your Jurisdiction guidelines.
- Links to additional Medicare information resources:
- CMS.GOV - Fee Schedule ,CGSMEDICARE.COM - Codes, DMEPDAC.COM
- Jurisdiction Fees & Contacts: Jurisdiction A, Jurisdiction B, Jurisdiction C, Jurisdiction D. Suppliers are responsible for following appropriate and accurate billing practices.
- Understanding CMS Rules and Medicare Compliance - Presentation by Noridian & CGS - March 2024
- Uniform Allowance
- Eligible for Uniform Allowance coverage (First Responder, Airline, Med Pro, etc.) - ask your Provider!
Do you have a patient that you need to refer (you don't process insurance)?
- Check out our Insurance Article for patients HERE
- Provide your patient with our Referral Form to ensure they receive the Hugger you are recommending
Please note: Prairie Wear does not coordinate, verify or process insurance requests. This article is for educational purposes only and not legal advice. We just make really awesome compression bras to help you & your patients feel better & get better 💛
