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Breast Milk Storage Bags: Billing Update

Tuesday, March 17, 2020

Last year, TRICARE revised its breast pump/breast pump supplies benefit to include limits on what is covered. As a result, Health Net Federal Services, LLC (HNFS) requested providers include specific modifiers when billing unlisted Healthcare Common Procedure Coding System (HCPCS) codes A9900 or A9999. This lets us know which supplies were being provided to beneficiaries. Please be advised we are implementing new billing guidelines specific to milk storage bags as of April 1, 2020.

What’s new?
Beginning April 1, HNFS will only accept procedure code K1005 on claims for breast milk storage bags with dates of service on or after Jan. 1, 2020. Claims received on or after April 1 with the unlisted HCPCS code A9900 or A9999 and modifier XH will be denied. Note, this update does not pertain to other breast pump supplies

As a reminder, providers must bill for the number of bags provided and not the number of boxes. Additionally, when using unlisted HCPCS codes A9900 or A9999 for other additional covered breast pump supplies, the following modifiers are still valid: 

Supply Type Modifier
Replacement valves/membranes XG
Replacement nipple shields XD
Supplemental nursing system XN
Breast pump kit XR

 

Please visit our Breast Pumps and Supplies Billing tips for additional breast pump and related supplies billing information. 

We appreciate your cooperation with these guidelines. Thank you for your continued partnership in caring for our military service members, retirees and their families.