HCPCS A7035: Headgear used with positive airway pressure device

A7035 is only for the headgear (the straps that secure the mask). The mask itself (the interface) has its own separate code (e.g., A7030 for a full face mask, A7034 for a nasal mask).

Billing more frequently than the established replacement schedule (typically 1 per 6 months for A7035 under Medicare) will likely result in a denial, as the item would be considered not medically necessary or exceeding the quantity limits.

No. Replacement accessories like A7035 are only covered if the base PAP equipment continues to meet the medical necessity requirements and the patient is compliant with and actively using the device. Compliance is generally checked using objective data (e.g., machine download).