Question 1

What is HCPCS code S5036?

Accepted Answer

HCPCS code S5036 is "Hit device repair". Home infusion therapy, repair of infusion device (e.g., pump repair)

Question 2

What category is S5036 in?

Accepted Answer

S5036 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S5036?

Accepted Answer

Use S5036 when billing for hit device repair. 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 S5036 covered by Medicare?

Accepted Answer

Coverage for S5036 (Hit device repair) 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 S5036?

Accepted Answer

Documentation for S5036 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).