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    v1.0.30
    OpenPayerBilling CodesAdministrative, Miscellaneous and InvestigationalHCPCS hcpcs-a9270-non-covered-item-or-service
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    HCPCS A9270: Non-covered Item or Service

    HCPCS Level II code A9270 describes a non-covered item or service, indicating that a billed supply or procedure is not eligible for coverage under the payer’s policy; the service type is non-covered supply/service and the typical site of service is variable depending on the item or service billed (e.g., outpatient facility, physician office, or other care settings).

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Patient Lifts, Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure.

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    Table of contents

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    • Billing CodesCPT, HCPCS, DRG & more
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    Clinical & Coding Specifications

    Clinical Context

    A patient presents to an outpatient clinic or ambulatory surgical center requesting reimbursement documentation for an item or service that is not covered by the patient’s insurer. Typical scenario: a patient receives an elective, non-covered durable medical equipment item, an experimental treatment supply, or a cosmetic service component during a visit. The clinical workflow includes: patient counseling about the non-covered nature of the item or service, documentation of informed financial responsibility, itemized encounter documentation describing the item or service and medical rationale (if any), application of modifier GY when applicable to indicate an item or service statutorily excluded or non-covered by Medicare, and submission of claims with A9270 on the CMS-1500 or UB-04 as an HCPCS Level II code to report a non-covered item or service for informational or billing purposes. Typical sites of service include outpatient clinics, physician offices, ambulatory surgical centers, and hospital outpatient departments. The patient scenario commonly involves elective or supplemental supplies (for example, cosmetic dressings, non-covered over-the-counter supplies, or items explicitly excluded by the payer), and the visit notes document that the service is not payable by a third-party payor and that the patient was informed of financial responsibility.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedureCommonly billed when non-covered supplies are furnished alongside services reported with A9270 to document provider-supplied items
    99000Handling and/or conveyance of specimen for transfer from the office to a laboratoryMay be reported when non-covered specimen transport is separately billed in support of a non-covered service
    99072Additional supplies, materials, and clinical staff time over a continuous period beyond the usual office visit (e.g., during a declared public health emergency)Used in rare situations when extra non-covered supplies or extended services are provided
    S9986Supplies; noncovered item, not otherwise classified (HCPCS Level II crosswalk)Sometimes used by payers to classify specific non-covered supply items in conjunction with A9270

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    207R00000X
    208D00000X
    207L00000X
    261Q00000X
    261QD0000X
    163WD0400X
    252Y00000X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    E11.9Type 2 diabetes mellitus without complications
    E78.5Hyperlipidemia, unspecified
    F32.9Major depressive disorder, single episode, unspecified
    F41.9Anxiety disorder, unspecified
    G43.909Migraine, unspecified, not intractable, without status migrainosus
    G44.209Tension-type headache, unspecified, not intractable
    G47.00Insomnia, unspecified
    I10Essential (primary) hypertension
    I20.9Angina pectoris, unspecified
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Patient Liftsuniverahealthcare2026-11-16
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15
    Positive Airway Pressure Devices for Pulmonary Disorders Continued RentalCareSource Georgia2026-10-01
    Bone Growth StimulatorsProvidence Health Plan2026-10-01
    Durable Medical Equipment (DME) Medical Necessity and CoverageMass General Brigham Health Plan2026-10-01
    Speech Generating DevicesMass General Brigham Health Plan2026-10-01
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01

    Related Codes

    HCPCS-A9150-NON-PRESCRIPTION-DRUGS

    HCPCS Level II A9150: Non-prescription Drugs

    HCPCS-A9152-SINGLE-ORAL-VITAMIN-MINERAL-DOSE

    HCPCS A9152: Single Oral Vitamin/Mineral/Trace Element

    HCPCS-A9153-MULTIVITAMIN-ORAL-PER-DOSE

    HCPCS A9153: Multiple Vitamins, Oral, Per Dose

    HCPCS-A9154-ARTIFICIAL-SALIVA-1ML

    HCPCS Level II A9154: Artificial saliva, 1 ml

    HCPCS-A9155-ARTIFICIAL-SALIVA-30ML

    HCPCS Level II A9155: Artificial Saliva, 30 mL

    HCPCS-A9156-ORAL-MUCOADHESIVE-PER-1ML

    HCPCS Level II A9156: Oral Mucoadhesive, Per 1 ml

    HCPCS-A9180-PEDICULOSIS-TOPICAL-TREATMENT-PATIENT-ADMINISTRATION

    HCPCS Level II A9180: Pediculosis Topical Treatment for Patient/Caretaker

    HCPCS-A9268-PROGRAMMER-TRANSIENT-INGESTED-CAPSULE

    HCPCS Level II A9268: Programmer for Transient Orally Ingested Capsule

    HCPCS-A9269-PROGRAMMABLE-TRANSIENT-ORAL-CAPSULE

    HCPCS Level II A9269: Programmable Orally Ingested Capsule, Per Month

    HCPCS-A9272-DISPOSABLE-WOUND-SUCTION-DEVICE-KIT

    HCPCS Level II A9272: Wound Suction, Disposable, Complete Kit

    Showing 1–10 of 138

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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