Question 1

What is HCPCS code S9474?

Accepted Answer

HCPCS code S9474 is "Enterostomal therapy by a re". Enterostomal therapy by a registered nurse certified in enterostomal therapy, per diem

Question 2

What category is S9474 in?

Accepted Answer

S9474 belongs to HCPCS Category S (Temporary National Codes (Non-Medicare)).

Question 3

When should I use HCPCS code S9474?

Accepted Answer

Use S9474 when billing for enterostomal therapy by a re. 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 S9474 covered by Medicare?

Accepted Answer

Coverage for S9474 (Enterostomal therapy by a re) 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 S9474?

Accepted Answer

Documentation for S9474 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).