Neurology & Pain Management Coding Alert

Question: One safety measure our pain management office has implemented during the COVID-19 pandemic is providing N95 masks to patients during their visits. What CPT^® or HCPCS Level II code can we bill for these masks?

South Carolina Subscriber

Answer: The current HCPCS Level II code book does not include a specific code for N95 masks. The manual does include code A4928 (Surgical mask, per 20), but that only applies to masks that you purchase in bulk for use by your own staff during procedures — not masks that you will be billing to patients.

One potential option is T5999 (Supply, not otherwise specified) — but there’s a lot working against that code. For starters, it is explicitly not payable by Medicare. Further, most payers want thorough explanations of why you might report an unlisted or “not otherwise specified” code, so be sure to include that with the claim. You might also benefit from talking with insurers beforehand to ask for their guidance.