Question 1

What is HCPCS code A7028?

Accepted Answer

HCPCS code A7028 is "Repl oral cushion combo mask". Oral cushion for combination oral/nasal mask, replacement only, each

Question 2

What category is A7028 in?

Accepted Answer

A7028 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A7028?

Accepted Answer

Use A7028 when billing for repl oral cushion combo mask. 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 A7028 covered by Medicare?

Accepted Answer

Coverage for A7028 (Repl oral cushion combo mask) 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 A7028?

Accepted Answer

Documentation for A7028 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).