Summary & Overview
HCPCS K0552: Syringe-Type Cartridge for External Non-Insulin Infusion Pump
HCPCS Level II code K0552 represents a sterile syringe-type cartridge used as a disposable supply for external non-insulin drug infusion pumps. The code is used to bill the single cartridge component that interfaces with an external infusion device to deliver non-insulin medications in ambulatory and home infusion settings. Nationally, this code matters because infusion supplies are critical to expanding home-based care, managing chronic conditions requiring parenteral therapies, and aligning billing for durable medical equipment and supplies.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for K0552, typical sites of service (home health and outpatient infusion), and the role this supply plays in external infusion therapy. The publication also covers benchmarking and policy-related considerations relevant to billing and coverage for infusion supplies, procedural coding alignment with external pump therapy, and implications for providers and suppliers delivering home infusion services.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, specific payer reimbursement rates, and related codes.
Billing Code Overview
HCPCS Level II code K0552 describes supplies for an external non-insulin drug infusion pump, specifically a syringe-type cartridge, sterile, each. This code covers the single-use sterile cartridge component used with external infusion pump systems that deliver non-insulin medications.
Service type: Durable medical supply for drug infusion (syringe-type cartridge)
Typical site of service: Home health, outpatient infusion centers, and other non-inpatient settings where external infusion pumps are used
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a chronic condition requiring continuous subcutaneous or intermittent bolus administration of a non‑insulin medication (for example, pain management with opioid or non-opioid infusions, chemotherapy supportive agents, or other specialty biologic agents) delivered via an external syringe‑type cartridge infusion pump. The device is a non‑insulin, syringe‑type cartridge pump supplied sterile and replaced per manufacturer guidance. Clinical workflow: a prescriber documents medical necessity and orders the external non‑insulin drug infusion pump supplies (K0552). The supplier prepares the sterile syringe‑type cartridge and provides patient education on pump operation, infusion rates, and safe handling. Nursing or durable medical equipment (DME) staff may assist with initial setup in an outpatient clinic, ambulatory infusion center, or the patient’s home. Follow‑up visits assess infusion site, device function, therapy tolerance, and supply replenishment. Typical sites of service include outpatient infusion centers, ambulatory surgical centers for procedures requiring short-term non‑insulin infusion, and patient homes when DME services are delivered.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Rarely used; default when no specific modifier applies |