2024 HCPCS Code A4725
Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis
TAGS: concentration dialysis greater equal volume dialysate fluid peritoneal
| Short Description | Dialys sol fld vol > 4999cc |
| Product Note | 0017 |
| HCPCS Coverage Code | D - Special coverage instructions apply |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Action Effective Date | January 01, 2015 |
| HCPCS Code Added Date | January 01, 2002 |
| HCPCS Pricing Indicator Code | 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) |
| HCPCS Multiple Pricing Indicator Code | 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') |
| HCPCS Coverage Issues Manual Reference Section Number | |
| HCPCS Type Of Service Code | L - ESRD supplies (eff 04/95) (renal supplier in the home before 04/95) |
| HCPCS Anesthesia Base Unit Quantity | 0 |
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- A4720 - Dialysat sol fld vol > 249cc
- A4721 - Dialysat sol fld vol > 999cc
- A4722 - Dialys sol fld vol > 1999cc
- A4723 - Dialys sol fld vol > 2999cc
- A4724 - Dialys sol fld vol > 3999cc