## **What is the HCPCS code K0606 for?**
The HCPCS code K0606 is meant to designate the provision of a garment-type automatic external defibrillator with integrated electrocardiogram analysis.
This is a nifty wearable cardioverter-defibrillator. It is a self-contained garment-worn device equipped with an external defibrillation system, capable of continuous ECG monitoring, detecting life-threatening ventricular fibrillation/arrhythmias, and automatically delivering defibrillation shocks without user intervention when there is an acute myocardial infarction.
This can be used for patients who are at high risk of sudden cardiac death while awaiting recovery, escalation to an implantable cardioverter-defibrillator, or a transplant.
This device will continuously monitor cardiac rhythms and store data, which ensures providers can assess adherence and device function.
The use of this wearable cardioverter defibrillator requires proper fitting and instruction, including vest sizing based on chest circumference. It also includes maintenance, delivery, and compliance monitoring features, all bundled into a daily rental.
## **Documentation requirements for K0606**
As with any HCPCS code, you must have sufficient documentation before filing a claim. Here are some of what you need:
- The full name of the patient/beneficiary
- The full name and credentials of the healthcare professional(s) handling the patient/beneficiary
- Medical history, diagnoses, and tests to support medical necessity (e.g., patient has coronary artery disease; they have sustained ventricular tachycardia; if they had a previously implanted defibrillator)
- Documented prior myocardial infarction
- Documented ejection fractions measured by angiography, radionuclide scanning, or echocardiography
- Documentation of transient or reversible causes
- External defibrillator prescription
## **Billing requirements for K0606**
Besides the documentation requirements, you'll need to take note of or have the following:
- The necessary ICD code(s) tied to the patient's condition
- A signed, dated standard written order (SWO) or a written order prior to delivery (WOPD) that was obtained prior to device delivery
- Prior approval documentation and informed consent of the patient
- Proof of delivery or dispensation at initial request
- Compliance download data capturing wear-time (continuation requests require cumulative wear time greater than 90% of the prior rental period (excluding extenuating circumstances)
- Use the KF modifier or else this will be instantly rejected
- Rental includes all component costs, supplies, maintenance, and instruction. These can't be billed separately
## **Other similar codes**
- **C1882** - Cardioverter-defibrillator, other than single or dual chamber (implantable)
- **C1722** - Cardioverter-defibrillator, single chamber (implantable)
- **C1721** - Cardioverter-defibrillator, dual chamber (implantable)
- **K0609** - Replacement electrodes for use with automated external defibrillator, garment type only, each
- **K0607** - Replacement battery for automated external defibrillator, garment type only, each
- **K0608** - Replacement garment for use with automated external defibrillator, each
Frequently asked questions
