Full Answer
Breast Pumps Breast Pumps HCPCS Code range E0602-E0604 The HCPCS codes range Breast Pumps E0602-E0604 is a standardized code set necessary for Medicare and other health insurance providers to provide healthcare claims. Subscribe to Codify and get the code details in a flash.
To be accurately reimbursed, providers billing for breast pump supplies using unlisted Healthcare Common Procedure Coding System (HCPCS) codes A9900 or A9999. You must also include the following modifiers. These modifiers will let HNFS know specifically which supplies were provided to the beneficiary.
Standard electric breast pumps or manual breast pumps may be necessary to initiate breast feeding in the postpartum period, within the first eight weeks following delivery. Manual breast pumps are sufficient for continuation of breastfeeding following the postpartum period.
A certificate of medical necessity is not required unless you exceed the quantity limits listed below. To be accurately reimbursed, providers billing for breast pump supplies using unlisted Healthcare Common Procedure Coding System (HCPCS) codes A9900 or A9999.
HCPCSE0603Breast pump, electric (AC and/or DC), any typeE0604Breast pump, hospital grade, electric (AC and/or DC), any typeE1399Durable medical equipment, miscellaneous [when specified as a wireless or wearable breast pump]ICD-10 Diagnosis2 more rows
HCPCS Code for Breast pump, electric (AC and/or DC), any type E0603.
A replacement manual or standard electrical breast pump is considered medically necessary for each subsequent pregnancy, for initiation or continuation of breastfeeding during pregnancy or following delivery.
What Breast Pumps Does TRICARE Cover? With great insurance breast pump coverage, TRICARE moms have a big selection of fully-covered, free breast pumps from the best breast pump brands: Medela, Spectra, Lansinoh, Ameda, Freemie, Ardo and Motif - as well as the hands free, wireless Elvie and Willow breast pumps.
Short Description: Electric breast pump. Long Description: BREAST PUMP, ELECTRIC (AC AND/OR DC), ANY TYPE.
E0603 is a valid 2022 HCPCS code for Breast pump, electric (ac and/or dc), any type or just “Electric breast pump” for short, used in Other medical items or services.
Most insurance plans will cover one pump for each pregnancy as a preventive benefit under the Affordable Care Act (ACA). More broadly, the ACA requires health insurance plans to provide coverage for breastfeeding support, counseling and equipment.
Coverage of breast pumps Your health insurance plan must cover the cost of a breast pump. It may be either a rental unit or a new one you'll keep. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when you'll receive it (before or after birth).
In most cases, yes, but it's never a guarantee. This also has to do with your allowable amount. If your insurance's allowable amount is enough to cover a breast pump in full, then you will likely be able to get one (or a few choices of pumps) at no cost.
Submitting Claims Beneficiaries who purchase breast pumps/supplies from non-network providers, civilian stores or retail pharmacies can submit claims to HNFS for reimbursement. A copy of the prescription must be included with the claim. Please use the purchase date as the date of service.
Upgrade options - including the Medela Sonata, portable Medela Freestyle Flex and hands free, wireless Elvie Pump - are also available to TRICARE moms.
Elvie, the innovative, woman-owned fem-tech company has delivered a new hands-free pump to the market, and this one is 100% covered by TRICARE for active duty servicemembers and mil-spouses!
Aetna considers purchase of a manual or standard electric breast pump medically necessary during pregnancy or at any time following delivery for breastfeeding. Aetna considers purchase of a manual or standard electric breast pump medically necessary for women who plan to breastfeed an adopted infant when the above listed criteria are met.
The most commonly reported problem was that the pump did not extract enough milk and the most commonly reported injury was sore nipples. Using a battery-operated pump and intending to breast-feed less than 12 months were associated with higher risks of pump-related problems and injury.
Garments or other products that allow hands-free pump operation. Nursing bras, bra pads, breast shells, nipple shields, and other similar products. Travel bags, and other similar travel or carrying accessories.
Aetna considers purchase of heavy duty electrical (hospital grade) breast pumps not medically necessary. Background. Breast-fed infants have a lower risk of diarrhea and otitis media than bottle-fed infants during the first year of life.
For women using a breast pump from a prior pregnancy, a new set of breast pump supplies is considered medically necessary with each subsequent pregnancy for initiation or continuation of breastfeeding during pregnancy or following delivery. A replacement manual or standard electrical breast pump is considered medically necessary for each subsequent ...
For the period of time that a newborn is detained in the hospital after the mother is discharged; breast pump rental is not considered medically necessary once the newborn is discharged; or.
Additional replacement supplies for comfort and convenience are not covered. Aetna does not cover the following breast pump-related items: Baby weight scales. Batteries, battery-powered adaptors, and battery packs. Breast milk storage bags, ice-packs, labels, labeling lids, and other similar products.
The prescription must be included when submitting claims for breast pumps and supplies (when applicable) to HNFS. This prescription must specify the type of breast pump and indicate the number of weeks the beneficiary is pregnant or the age of the infant.
To be accurately reimbursed, providers billing for breast pump supplies using unlisted Healthcare Common Procedure Coding System (HCPCS) codes A9900 or A9999. You must also include the following modifiers. These modifiers will let HNFS know specifically which supplies were provided to the beneficiary.