Question 1

What is HCPCS code T4536?

Accepted Answer

HCPCS code T4536 is "Reusable pull-on any size". Incontinence product, protective underwear/pull-on, reusable, any size, each

Question 2

What category is T4536 in?

Accepted Answer

T4536 belongs to HCPCS Category T (State Medicaid Agency Codes).

Question 3

When should I use HCPCS code T4536?

Accepted Answer

Use T4536 when billing for reusable pull-on any size. 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 T4536 covered by Medicare?

Accepted Answer

Coverage for T4536 (Reusable pull-on any size) 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 T4536?

Accepted Answer

Documentation for T4536 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).