HCPCS Code A4520: Incontinence Garment, Any Type (e.g., Brief, Diaper), Each

Learn billing and documentation rules for HCPCS A4520 incontinence garments. Read coding tips, payer coverage, and related codes here.

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Frequently asked questions

No. Medicare classifies incontinence garments as non-covered hygienic supplies; claims will be denied if billed under A4520.

Yes, in some Medicaid or commercial payer scenarios, A4520 may be covered under benefit schedules, subject to prior authorization and documentation requirements. For example, WV Medicaid limits the supply to 200 per month and requires a PA for coverage.

Alternative codes may be used when billing for related incontinence supplies. A4554 applies to disposable underpads, A4553 to non-disposable underpads, and A9286 to hygienic items such as wipes. Always match the code to the exact item supplied to prevent miscoding and claim denials.