Summary & Overview
HCPCS A4634: Replacement Bulb for Therapeutic Light Box, Tabletop
HCPCS Level II code A4634 identifies a replacement bulb for a tabletop therapeutic light box used in light therapy. The code designates a DME accessory item that supports treatment workflows in outpatient clinics, behavioral health settings, and home use where light therapy is administered. Nationally, clear coding for replacement parts affects continuity of care and accurate supply reimbursement for providers and suppliers.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coverage considerations and payer inclusion, plus context on service setting and clinical purpose. The publication also summarizes typical billing line-item classification and where to expect this item on a claim.
This overview helps billing managers, DME suppliers, and clinical administrators understand the code's purpose, how it maps to service delivery environments, and which major payers are relevant to coverage discussions. Data not available in the input is noted where applicable for payer-specific policy details and utilization benchmarks.
Billing Code Overview
HCPCS Level II code A4634 describes a replacement bulb for a therapeutic light box, tabletop model. This item is a durable medical equipment (DME) accessory intended to restore or maintain the function of a tabletop therapeutic light box used for light therapy treatments.
Service type: Durable Medical Equipment accessory — replacement part for therapeutic light therapy device
Typical site of service: Clinic outpatient, behavioral health clinic, or patient residence when the device is used at home
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult diagnosed with seasonal affective disorder (SAD) or circadian rhythm sleep-wake disorder who uses a therapeutic light box at home or in an outpatient behavioral health clinic. The therapeutic light box is a tabletop model and requires periodic replacement of the bulb to maintain adequate light intensity (typically 10,000 lux at recommended distance) and spectral output. A patient may present to a behavioral health clinic, primary care office, or durable medical equipment (DME) supplier reporting diminished light output or a burned-out bulb. Workflow: clinician documents the clinical diagnosis and medical necessity for continued light therapy, the DME supplier or clinic verifies device model and orders A4634 as the replacement bulb for the tabletop light box, shipping and installation instructions are provided if applicable, and the supplier bills the payor using HCPCS code A4634. Follow-up includes patient education on bulb replacement intervals and safety precautions, and documentation of device model, serial number (if applicable), and the replaced part in the medical record.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no specific modifier applies. |