2025 HCPCS code A9155
(Active) Effective Date: N/A Revision Date: N/A Medical Supplies - Salivary Substitutes Miscellaneous Supplies and Equipment Feed
Artificial saliva (30ml) for treatment of xerostomia (dry mouth).
Modifiers may be applicable depending on the circumstances of service delivery. Consult local payer guidelines for specific modifier usage.
Medical necessity for A9155 is established when a patient presents with xerostomia, causing significant discomfort, impacting speech and swallowing abilities, and posing a risk for dental issues.The artificial saliva should be considered a medically necessary treatment when less invasive methods have proven ineffective.
The clinical responsibility for using artificial saliva rests with the physician or other qualified healthcare provider who diagnoses and treats the patient's xerostomia.The provider determines the appropriateness of artificial saliva as a treatment, monitors the patient's response, and adjusts the treatment plan as needed.
In simple words: This code covers the use of 30 milliliters of artificial saliva to help people with dry mouth. Dry mouth can make it hard to talk, swallow, and can even hurt teeth.Artificial saliva is like a replacement for natural saliva.
HCPCS code A9155 represents the provision of 30 milliliters of artificial saliva, a salivary substitute used to manage xerostomia (dry mouth).Xerostomia is characterized by abnormally dry mouth due to insufficient saliva production, leading to discomfort, difficulties with speech and swallowing, and potential tooth decay. Artificial saliva aims to mimic the properties of natural saliva, typically having a neutral pH and composition similar to that of a patient's natural saliva.The product may be available in various forms such as sprays, gels, or lozenges. This code specifically denotes a 30ml quantity.
Example 1: A 65-year-old female patient presents with complaints of persistent dry mouth, impacting her speech and comfort. The physician diagnoses xerostomia and prescribes artificial saliva (A9155) as a symptomatic treatment, instructing the patient on proper use and follow-up., A 50-year-old male patient undergoing radiation therapy for head and neck cancer experiences severe xerostomia as a side effect.The oncologist recommends the use of artificial saliva (A9155) to alleviate dryness and discomfort and improve quality of life. The patient is monitored for any adverse reactions., A 70-year-old patient with Sjögren's syndrome suffers from chronic dry mouth. A rheumatologist incorporates the use of artificial saliva (A9155) into the patient's long-term management plan to improve oral comfort and reduce dental complications.
* Patient's medical history documenting the diagnosis of xerostomia.* Physician's order specifying the type and quantity of artificial saliva (A9155).* Documentation of patient education on proper use of the artificial saliva.* Notes on the patient's response to treatment, including any improvements in symptoms or adverse effects.
** This HCPCS code is for artificial saliva in a 30ml quantity.Different packaging sizes may require different codes or may need to be bundled appropriately. Always check payer specific guidelines for proper reimbursement.
- Payment Status: Active
- Specialties:Dentistry, Oncology, Rheumatology
- Place of Service:Office, Hospital Outpatient, Pharmacy