CPAP Masks
A7044 HCPCS Code Description and Medicare Billing
A7044 is a HCPCS Level II code for oral interface. It describes an oral interface used with PAP therapy. The reviewed PAP LCD applies refill requirements but does not assign A7044 a usual maximum in its accessory-frequency table, so verify current policy and medical necessity rather than assuming a fixed interval. Review Medicare coverage, documentation, modifiers, frequency, fee references, policy links, and denial risks.
Coverage status
conditional
Documentation required
Yes
F2F/WOPD required list
unknown
Prescription/order
yes
Prior authorization list
unknown
Rental or purchase
supply
Fee schedule
Available
Same/similar risk
Review required
Code Summary
Oral interface
PAP accessories are conditionally covered when the coverage criteria for the related PAP device are met and the item remains reasonable and necessary.
Before billing, verify medical necessity, order requirements, proof of delivery, supplier eligibility, correct modifiers, frequency limits, and any applicable LCD or policy article.
Official Sources
officialPositive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (L33718)
CMS Medicare Coverage Database / Effective 2024-01-01 / Reviewed 2026-08-09
Initial and continued coverage, replacement, accessory frequency, refill, order, and proof-of-delivery requirements.
Positive Airway Pressure (PAP) Devices Policy Article (A52467)
CMS Medicare Coverage Database / Reviewed 2026-08-09
Coding, modifier, documentation, and policy-specific PAP billing instructions.
Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426)
CMS Medicare Coverage Database / Reviewed 2026-08-09
General order, medical record, continued need/use, refill, and proof-of-delivery requirements.
July 2026 DMEPOS Fee Schedule (DME26-C)
Centers for Medicare & Medicaid Services / Effective 2026-07-01 / Reviewed 2026-08-09
Official state and rural/non-rural fee schedule amounts and payment category codes.
Is A7044 a CPT code?
No. A7044 is a HCPCS Level II code, although people often search for "A7044 CPT code." CPT is HCPCS Level I and is maintained separately by the American Medical Association. Always verify the code set and payer instructions effective for the date of service.
Reimbursement Status
Coverage is marked conditional. Publication status is verified. This describes the source record, not a claim-specific coverage decision.
Documentation Requirements
Standard written order
A completed SWO must be communicated to the supplier before the claim is submitted.
Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (L33718)Proof of delivery
Maintain proof of delivery that supports the item, quantity, delivery method, and date furnished.
Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426)Affirmative refill request and utilization
Document beneficiary contact and an affirmative refill response before dispensing. Do not deliver earlier than policy timing or exceed expected utilization.
Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (L33718)Standard Written Order / Prescription
A standard written order is required before claim submission.
Clinical Evaluation / Conditions of Payment
Verify the related PAP device coverage and any applicable continued-use documentation.
Rental, Purchase, Replacement, or Supply Logic
Payment category: supply. Confirm the base PAP device remains covered and the refill is not duplicative.
A7044 Frequency and Replacement Limits
Frequency and replacement limits are pending research.
The PAP LCD describes usual maximum quantities, not automatic shipment schedules. Document an affirmative refill request, remaining supply, continued need, and delivery timing.
Modifiers
NU New equipment
Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.
RR Rental
Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.
UE Used durable medical equipment
Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.
KX Requirements specified in medical policy have been met
Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.
GA Waiver of liability statement issued
Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.
GY Item or service statutorily excluded
Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.
GZ Item or service expected to be denied
Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.
RA Replacement of DME item
Verify the current licensed code set, CMS guidance, payer policy, and claim documentation before use.
Fee Schedule
DME26-C / Effective 2026-07-01
- Non-rural range across fee rows and states
- $98.74 - $146.47
- Rural range where listed
- $131.93
Fee schedule amounts are payment references and do not prove coverage or guarantee payment.
Common Denials
CARC 16: Missing or Invalid Claim Information
Validate required claim loops, provider roles, identifiers, diagnosis pointers, modifiers, units, charges, and payer-specific companion-guide edits before release.
CARC 18: Duplicate Claim or Service
Lock resubmission while a claim is pending, reconcile clearinghouse and payer claim IDs, and require replacement or void indicators for true corrections.
CARC 22: Coordination of Benefits and Payer Order
Ask current coverage and employment questions, verify payer order for the date of service, and transmit complete primary adjudication data on secondary claims.
CARC 29: Timely Filing Denial
Track deadlines from the service-date rule, reconcile payer receipt rather than only transmission, and escalate unaccepted claims well before expiration.
CARC 97: Service Included in Another Payment
Check code-pair edits, global periods, status indicators, payment packaging, and modifier documentation before submitting separate lines.
CARC 109: Claim Sent to the Wrong Payer or Contractor
Validate plan, network, product, payer ID, contractor jurisdiction, and date-specific routing before submission.
Frequently Asked Questions
What is HCPCS code A7044?
A7044 is the HCPCS Level II code for an oral interface used with PAP therapy. It is not a CPT code.
Does Medicare publish a standard A7044 replacement frequency?
The reviewed PAP LCD includes A7044 in its refill requirements but does not list A7044 in the usual-maximum frequency table. Verify current policy, medical necessity, utilization, and payer instructions for the claim.
Can A7044 be shipped automatically?
No. Medicare PAP refill rules require documented beneficiary contact and an affirmative refill response before dispensing; suppliers may not rely on a predetermined automatic shipment schedule.
Publication and Review Status
Code-level statements have attached official sources. Last reviewed: Aug 9, 2026.