2025 HCPCS Code A4720
Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
TAGS: volume dialysate concentration peritoneal greater equal dialysis fluid| Short Description | Dialysat sol fld vol > 249cc | 
| Product Note | 0017 | 
| HCPCS Action Code | N - No maintenance for this code | 
| HCPCS Coverage Code | D - Special coverage instructions apply | 
| HCPCS Code Added Date | January 01, 2002 | 
| HCPCS Action Effective Date | January 01, 2015 | 
| 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 Type Of Service Code | L - ESRD supplies (eff 04/95) (renal supplier in the home before 04/95) | 
| 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 Anesthesia Base Unit Quantity | 0 | 
| HCPCS Coverage Issues Manual Reference Section Number | 
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