Question 1

What is HCPCS code S5523?

Accepted Answer

HCPCS code S5523 is "Hip midline cath insert kit". Home infusion therapy, insertion of midline venous catheter, nursing services only (no supplies or catheter included)

Question 2

What category is S5523 in?

Accepted Answer

S5523 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S5523?

Accepted Answer

Use S5523 when billing for hip midline cath insert kit. 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 S5523 covered by Medicare?

Accepted Answer

Coverage for S5523 (Hip midline cath insert kit) 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 S5523?

Accepted Answer

Documentation for S5523 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).