How To Use HCPCS Code A4221

HCPCS code A4221 describes the supplies for the maintenance of a non-insulin drug infusion catheter on a weekly basis. This code is used to identify the specific supplies needed for the ongoing care and management of the infusion catheter, excluding any insulin-related drugs. In this article, we will explore the details of HCPCS code A4221, 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 A4221?

HCPCS code A4221 is used to identify the supplies required for the maintenance of a non-insulin drug infusion catheter on a weekly basis. It is important to note that this code specifically excludes any insulin-related drugs. The supplies covered by this code are essential for the ongoing care and management of the infusion catheter.

2. Official Description

The official description of HCPCS code A4221 is “Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)”. The short description for this code is “Supp non-insulin inf cath/wk”.

3. Procedure

1. Ensure that the patient’s non-insulin drug infusion catheter is in place and functioning properly.
2. Gather the necessary supplies for the maintenance of the catheter.
3. Follow the specific instructions provided by the manufacturer for the maintenance of the catheter.
4. Administer any required medications or solutions through the catheter as prescribed by the healthcare provider.
5. Monitor the patient for any adverse reactions or complications during and after the maintenance procedure.

4. When to use HCPCS code A4221

HCPCS code A4221 should be used when billing for the supplies needed to maintain a non-insulin drug infusion catheter on a weekly basis. It is important to ensure that the drugs used in conjunction with the catheter are listed separately when submitting the claim.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A4221, healthcare providers need to document the specific supplies used for the maintenance of the non-insulin drug infusion catheter. It is important to list the drugs separately and provide any necessary supporting documentation, such as the manufacturer’s instructions for use and any relevant medical records.

6. Historical Information and Code Maintenance

HCPCS code A4221 was added to the Healthcare Common Procedure Coding System on January 01, 1997. As of the effective date of January 01, 2017, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code A4221 is covered by Medicare and other insurance providers. The pricing indicator code 34 indicates that this code is classified as DME supplies, with the price subject to floors and ceilings. The multiple pricing indicator code A signifies that this code is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code A4221 should be billed:

1. A patient with a non-insulin drug infusion catheter requires weekly supplies for the maintenance of the catheter.
2. A healthcare provider administers medications through a non-insulin drug infusion catheter on a weekly basis and requires the necessary supplies for the procedure.
3. A patient with a non-insulin drug infusion catheter experiences a malfunction and requires replacement supplies for the catheter maintenance.
4. A healthcare provider performs routine maintenance on a non-insulin drug infusion catheter and utilizes the supplies covered by HCPCS code A4221.
5. A patient with a non-insulin drug infusion catheter undergoes a change in medication and requires new supplies for the maintenance of the catheter.