Question 1

What is HCPCS code A4290?

Accepted Answer

HCPCS code A4290 is "Sacral nerve stim test lead". Sacral nerve stimulation test lead, each

Question 2

What category is A4290 in?

Accepted Answer

A4290 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A4290?

Accepted Answer

Use A4290 when billing for sacral nerve stim test lead. 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

What ICD-10 codes are commonly used with A4290?

Accepted Answer

Common ICD-10 diagnosis codes used with A4290 include: N30.10 (Interstitial cystitis (chronic) without hematuria), N30.11 (Interstitial cystitis (chronic) with hematuria), N32.81 (Overactive bladder), N36.44 (Muscular disorders of urethra). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is A4290 covered by Medicare?

Accepted Answer

Coverage for A4290 (Sacral nerve stim test lead) 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 6

What documentation is required for A4290?

Accepted Answer

Documentation for A4290 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).