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Billing for Tape Codes (A4450 and A4452) and Modifiers (AU, AV and AW)

Policy specific informational modifiers can be located in the local medical policies. When submitting claims that require policy specific informational modifiers, suppliers must be mindful of the coverage criteria that may be tied to the policy specific modifiers.

By submitting these types of modifiers suppliers are indicating to the durable medical equipment Medicare administrative contractor DME MAC criteria regarding the code at issue have been met. Suppliers are encouraged to review the local medical policies in their entirety to ensure that all documentation requirements are met prior to submitting a claim to the Medicare program for payment.

Tape codes identified as A4450 and A4452 are routinely denied as a noncovered supply when the tape is not used in conjunction with another covered benefit. For items such as surgical dressings, ostomy, tracheostomy or urological supplies, or prosthetic or orthotic devices, Medicare will make a separate payment for tape when it is furnished in conjunction with any of these services.

Suppliers are reminded that the following modifiers must be appended to tape codes A4450 and A4452 when the tape is being furnished with one of the corresponding items:

  • AU -  Items furnished in conjunction with a ostomy, tracheostomy or urological supply
  • AV -  Items furnished in conjunction with a prosthetic device, prosthetic or orthotics
  • AW - Items furnished in conjunction with a surgical dressing

Failure to append the appropriate AU, AV, or AW modifier to Healthcare Common Procedure Coding System (HCPCS) codes A4450 or A4452 will result in the denial of claim. Payment for tape is based on the presence of aforementioned modifiers.

For additional information regarding payment and coverage of tape, please review the local medical policies located in the Medical Policy Center.

For additional information regarding the Medicare fee schedule allowance for tape, please visit the Pricing, Data Analysis, and Coding Contractor’s (PDAC) Website.