Question 1

What is HCPCS code S5560?

Accepted Answer

HCPCS code S5560 is "Insulin reuse pen 1.5 ml". Insulin delivery device, reusable pen; 1.5 ml size

Question 2

What category is S5560 in?

Accepted Answer

S5560 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S5560?

Accepted Answer

Use S5560 when billing for insulin reuse pen 1.5 ml. 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 S5560 covered by Medicare?

Accepted Answer

Coverage for S5560 (Insulin reuse pen 1.5 ml) 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 S5560?

Accepted Answer

Documentation for S5560 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).