On April 7, 2020, the DOL implemented a change to the HCPC A6250 Skin Ointment payment schedule. EWMS has utilized the A6250 code to cover items like:

  • Anti-bacterial hand soap
  • Hand sanitizer
  • Zinc oxide (to prevent rashes from oxygen tubing)
  • Nasal gel (to provide moisture in the nasal cavity for those using cannulas)
  • Rash cream

The DOL decided they would no longer be providing over-the-counter items for providers to use in the patient home. They considered these items something that patients or providers could pay for themselves.

We of course complained to the DOL on how necessary these items are for many patients, especially during the outbreak of the coronavirus. So, in early May 2020, the DOL decided to allow 3 units of skin ointment to be sent out during every 6-month home health authorization period. (Yes, we absolutely agree that 3 units is not a lot in a 6-month period.) The DOL also stated that we could submit prior authorization requests for skin ointment for those with conditions and needs of that type of product.

Then we found another problem. Because A6250 is coded as a Priority 1 in the CNSI / OWCP System it cannot be submitted as a prior authorization code. The system automatically takes it out and labels it as “Prior Authorization Not Required”. The DOL Medical Benefit Examiners never even get a chance to look at it as a part of the overall prior authorization. We have alerted the DOL to this issue. They have acknowledged the receipt of our request and are currently working to find a solution. We do not know when that solution will be implemented, however we will let you know as soon as it is.

For now, patients or providers will need to purchase their own skin ointment items. We are hopeful the DOL will reconsider their position. Stay tuned for more information.