HCPCS A7037: Tubing for positive airway pressure device

Know what documentation and billing requirements you need to meet to properly use and bill for HCPCS code A7037, in our short guide.

Use Code

Frequently asked questions

A7037 is for standard (non-heated) CPAP tubing used with positive airway pressure devices. A4604, on the other hand, is for heated tubing, which is used in conjunction with a humidifier to maintain a set temperature and prevent rainout (condensation) inside the tube. You would typically only bill for one or the other, depending on the type of tubing the patient is prescribed.

Common reasons for denial include billing too frequently, missing KX modifier, lack of valid SWO, and no proof of delivery.

No, for Medicare and most private payers, the maximum allowable replacement schedule for standard tubing (A7037) is one unit every three months. Billing monthly is likely to be denied as being in excess of the statutory replacement schedule.