A9273 — Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- A Standard Written Order (SWO) must be communicated to the supplier before a claim is submitted.
- For DMEPOS items requiring a Written Order Prior to Delivery (WOPD), the supplier must have a signed WOPD before delivery; the WOPD must list the base item and may list separately billed accessories/supplies.
- Proof of delivery (POD) documentation must be maintained by the supplier and made available to the Medicare contractor upon request.
- Claims must be correctly coded per CMS HCPCS guidelines, LCDs, LCD-related Policy Articles, and DME MAC articles and must meet the LCD-related Standard Documentation Requirements article.
Key Coverage Criteria
- Item must be eligible for a defined Medicare benefit category to be covered.
- Item must be reasonable and necessary for diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
- Item must meet all other applicable Medicare statutory and regulatory requirements, including LCD-related Standard Documentation Requirements and LCD-related Policy Article.
- An item is covered only if it is in a defined Medicare benefit category, is reasonable and necessary for diagnosis/treatment or to improve function of a malformed body member, and meets applicable Medicare statutory and regulatory requirements.
- A standard electric heating pad (HCPCS E0210) is covered when used to relieve pain, decrease joint or soft tissue stiffness, relax muscles, or reduce inflammation.
- ICD-10 G50.0: Trigeminal neuralgia (covered if selection criteria are met)
4 Active Policies
L33735 — Cold Therapy
J19
L33784 — Heating Pads and Heat Lamps
J19
AETNA-CPB-0297 — Cryoanalgesia and Therapeutic Cold
AETNA-CPB-0540 — Heating Devices
Related Codes
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