2025 HCPCS Code A4721
Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
TAGS: concentration dialysis greater equal volume dialysate fluid peritoneal| Short Description | Dialysat sol fld vol > 999cc |
| 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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