Question 1

What is HCPCS code S1016?

Accepted Answer

HCPCS code S1016 is "Non-pvc intravenous administ". Non-pvc (polyvinyl chloride) intravenous administration set, for use with drugs that are not stable in pvc e.g., paclitaxel

Question 2

What category is S1016 in?

Accepted Answer

S1016 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S1016?

Accepted Answer

Use S1016 when billing for non-pvc intravenous administ. 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 S1016 covered by Medicare?

Accepted Answer

Coverage for S1016 (Non-pvc intravenous administ) 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 S1016?

Accepted Answer

Documentation for S1016 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).