Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

A4310 - A4355  Incontinence Appliances and Care Supplies

A4310
Insertion tray without drainage bag and without catheter (accessories only)
shortInsert tray w/o bag/cath
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4311
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
shortCatheter w/o bag 2-way latex
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4312
Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone
shortCath w/o bag 2-way silicone
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4313
Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
shortCatheter w/bag 3-way
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4314
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
shortCath w/drainage 2-way latex
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4315
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone
shortCath w/drainage 2-way silcne
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4316
Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
shortCath w/drainage 3-way
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4320
Irrigation tray with bulb or piston syringe, any purpose
shortIrrigation tray
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
A4321
Therapeutic agent for urinary catheter irrigation
shortCath therapeutic irrig agent
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction
OPH1.03 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4322
Irrigation syringe, bulb or piston, each
shortIrrigation syringe
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
A4326
Male external catheter with integral collection chamber, any type, each
shortMale external catheter
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
A4327
Female external urinary collection device; meatal cup, each
shortFem urinary collect dev cup
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
A4328
Female external urinary collection device; pouch, each
shortFem urinary collect pouch
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
A4330
Perianal fecal collection pouch with adhesive, each
shortStool collection pouch
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
DME0.03 Date of Service Edit: ClinicalCMS Policy
A4331
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each
shortExtension drainage tubing
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: Data
OPH3.03 Date of Service Edit: ClinicalClinical: Data
DME6.03 Date of Service Edit: ClinicalClinical: Data
A4332
Lubricant, individual sterile packet, each
shortLube sterile packet
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA2.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
OPH2.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
DME600.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4333
Urinary catheter anchoring device, adhesive skin attachment, each
shortUrinary cath anchor device
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
A4334
Urinary catheter anchoring device, leg strap, each
shortUrinary cath leg strap
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4335
Incontinence supply; miscellaneous
shortIncontinence supply
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.03 Date of Service Edit: ClinicalClinical: Data
A4336
Incontinence supply, urethral insert, any type, each
shortUrethral insert
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
OPH1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
DME1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
A4337
Incontinence supply, rectal insert, any type, each
shortIncontinent rectal insert
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
DME0.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4338
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each
shortIndwelling catheter latex
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH3.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4340
Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each
shortIndwelling catheter special
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4344
Indwelling catheter, foley type, two-way, all silicone, each
shortCath indw foley 2 way silicn
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4346
Indwelling catheter; foley type, three way for continuous irrigation, each
shortCath indw foley 3 way
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4349
Male external catheter, with or without adhesive, disposable, each
shortDisposable male external cat
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
A4351
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each
shortStraight tip urine catheter
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
A4352
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each
shortCoude tip urinary catheter
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
A4353
Intermittent urinary catheter, with insertion supplies
shortIntermittent urinary cath
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: Data
OPH3.03 Date of Service Edit: ClinicalClinical: Data
A4354
Insertion tray with drainage bag but without catheter
shortCath insertion tray w/bag
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data
DME3.03 Date of Service Edit: ClinicalPublished Contractor Policy
A4355
Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each
shortBladder irrigation tubing
RVU
CPT ModifierPhysician ComponentFacility PracticeNonfacility PracticeProfessional Liability InsuranceTotal FacilityTotal NonfacilityGlobal Period
0.00.00.00.00.00.0XXX
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalClinical: Data