Question 1

What is HCPCS code A5505?

Accepted Answer

HCPCS code A5505 is "Diab shoe w/metatarsal bar". For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe

Question 2

What category is A5505 in?

Accepted Answer

A5505 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A5505?

Accepted Answer

Use A5505 when billing for diab shoe w/metatarsal bar. 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 A5505 covered by Medicare?

Accepted Answer

Coverage for A5505 (Diab shoe w/metatarsal bar) 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 A5505?

Accepted Answer

Documentation for A5505 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).