HCPCS A9900 is officially defined as "Miscellaneous dme supply, accessory, and/or service component of another hcpcs code." HCPCS A9900 is referenced in 3 tracked payer policy changes from Sentara Health Plans and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS A9900 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Starting January 1, 2027, Sentara Health Plans will require prior authorization for a long list of codes on Virginia commercial plans, including self-funded (ASO) plans, and for code 88380 on commercial, Medicaid and Medicare products, plus code 22860 on Medicare products. Sentara will also stop covering a separate list of codes on Virginia commercial and self-funded plans.
Transcutaneous electrical nerve stimulation (TENS) is considered medically necessary for chronic intractable back pain (lumbar, cervical, or thoracic) where other modalities have failed. The policy considers TENS investigational for chronic intractable or acute postoperative pain, for pain of labor and vaginal delivery, and for any other condition, including dementia and prevention of migraine headaches. Sympathetic Therapy delivered using the Dynatron STS and Dynatron STS Rx device is also considered investigational.
Tumor treating fields therapy is considered medically necessary as an adjunct to standard maintenance therapy with temozolomide in individuals with newly diagnosed glioblastoma multiforme following initial treatment with surgery, radiotherapy, and/or chemotherapy, under these conditions: age 18 years or older, a supratentorial tumor, a Karnofsky Performance Status score of 70% or higher, and an individual who understands device use, including the requirement for a shaved head, and is willing to comply with use criteria according to the FDA label. Tumor treating fields therapy is considered investigational in all other conditions, including as an adjunct or alternative to standard medical therapy for progressive or recurrent glioblastoma multiforme, for brain metastases, for cancer in areas other than the brain, and as an adjunct to standard medical therapy for malignant pleural mesothelioma or non-small cell lung cancer (NSCLC).
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