How To Use HCPCS Code A4719

HCPCS code A4719 describes the “y set” tubing used for peritoneal dialysis. This code is specifically used to identify and bill for the supply of “y set” tubing in the context of peritoneal dialysis procedures. In this article, we will explore the details of HCPCS code A4719, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS A4719?

HCPCS code A4719 is a specific code used to identify and bill for the supply of “y set” tubing for peritoneal dialysis. This code is used to indicate the provision of the tubing required for the peritoneal dialysis procedure.

2. Official Description

The official description of HCPCS code A4719 is “y set” tubing for peritoneal dialysis. The short description for this code is also “y set” tubing.

3. Procedure

1. The provider prepares the peritoneal dialysis solution according to the patient’s needs.
2. The “y set” tubing is connected to the peritoneal dialysis solution bag.
3. The other end of the “y set” tubing is connected to the peritoneal dialysis catheter.
4. The peritoneal dialysis solution flows through the “y set” tubing into the peritoneal cavity.
5. The tubing allows for the drainage of the used dialysis solution from the peritoneal cavity.
6. The “y set” tubing is disconnected and properly disposed of after the procedure.

4. When to use HCPCS code A4719

HCPCS code A4719 should be used when providing the “y set” tubing for peritoneal dialysis procedures. It is important to ensure that the tubing is specifically intended for peritoneal dialysis and not for any other purpose.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A4719, healthcare providers need to document the provision of the “y set” tubing for peritoneal dialysis. This documentation should include the date of service, the quantity of tubing provided, and any relevant patient information. The billing should be done according to the guidelines and requirements of the specific insurance provider or Medicare.

6. Historical Information and Code Maintenance

HCPCS code A4719 was added to the Healthcare Common Procedure Coding System on January 01, 2002. 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.

7. Medicare and Insurance Coverage

HCPCS code A4719 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that the value for pricing is not established. The specific pricing and coverage details may vary depending on the insurance provider and the patient’s eligibility.

8. Examples

Here are some examples of when HCPCS code A4719 should be billed:

1. Example 1: A patient undergoes peritoneal dialysis and requires the “y set” tubing for the procedure. The healthcare provider supplies the tubing and bills using HCPCS code A4719.
2. Example 2: A patient with end-stage renal disease receives peritoneal dialysis at home. The provider regularly delivers the “y set” tubing for the patient’s dialysis sessions and bills using HCPCS code A4719.
3. Example 3: A peritoneal dialysis clinic orders a bulk supply of “y set” tubing for their patients. The clinic receives the tubing and bills using HCPCS code A4719.
4. Example 4: A healthcare facility provides peritoneal dialysis services and includes the cost of the “y set” tubing in their overall billing for the procedure using HCPCS code A4719.
5. Example 5: A patient undergoes peritoneal dialysis while traveling and requires the “y set” tubing. The healthcare provider supplies the tubing and bills using HCPCS code A4719.