How To Use HCPCS Code A4206

HCPCS code A4206 describes a sterile syringe with a needle that has a capacity of 1 cc or less. This code is used to identify and bill for the supply of a 1 cc sterile syringe with a needle. In this article, we will explore the details of HCPCS code A4206, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A4206?

HCPCS code A4206 is used to identify a specific type of medical supply – a sterile syringe with a needle that has a capacity of 1 cc or less. This code is essential for accurately documenting and billing for the provision of this particular syringe and needle combination.

2. Official Description

The official description of HCPCS code A4206 is “Syringe with needle, sterile, 1 cc or less, each.” This description clearly indicates that the code represents a single unit of a sterile syringe with a needle, with a maximum capacity of 1 cc.

3. Procedure

1. Ensure that the syringe and needle are sterile and in proper packaging.
2. Verify that the syringe has a capacity of 1 cc or less.
3. Prepare the syringe and needle for use by removing any protective caps or covers.
4. Administer the syringe and needle as required for the specific medical procedure or treatment.
5. Dispose of the used syringe and needle safely and in accordance with applicable regulations.

4. When to use HCPCS code A4206

HCPCS code A4206 should be used when billing for the supply of a 1 cc sterile syringe with a needle. It is important to note that this code is specific to syringes with a capacity of 1 cc or less. If a different capacity syringe is used, a different HCPCS code should be utilized.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A4206, healthcare providers should ensure that the following documentation requirements are met:

• Clearly indicate the use of a 1 cc sterile syringe with a needle in the medical record.
• Include the date and time of the syringe and needle administration.
• Specify the medical procedure or treatment for which the syringe and needle were used.
• Provide any additional relevant information or details related to the use of the syringe and needle.

6. Historical Information and Code Maintenance

HCPCS code A4206 was added to the Healthcare Common Procedure Coding System on January 01, 1985. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has been in use since its inception, and there have been no significant changes or updates to its description or usage.

7. Medicare and Insurance Coverage

HCPCS code A4206 is eligible for coverage and reimbursement by Medicare and other insurance providers. However, it is important to note that the pricing indicator code for this code is 00, which means that the service is not separately priced by Part B. This indicates that the cost of the syringe and needle may be bundled with other services or supplies provided during the same encounter.

8. Examples

Here are five examples of scenarios in which HCPCS code A4206 should be billed:

1. A patient requires a 1 cc sterile syringe with a needle for the administration of a subcutaneous medication.
2. A healthcare provider performs a minor surgical procedure that requires the use of a 1 cc sterile syringe with a needle for local anesthesia.
3. A patient with diabetes needs a 1 cc sterile syringe with a needle for insulin administration.
4. A healthcare professional administers a 1 cc sterile syringe with a needle for a vaccination.
5. A patient receives a 1 cc sterile syringe with a needle for a blood draw.