How To Use HCPCS Code A4720

HCPCS code A4720 describes a dialysate solution used in peritoneal dialysis. This code is specifically for dialysate solutions with a fluid volume greater than 249 cc, but less than or equal to 999 cc, and any concentration of dextrose. In this article, we will explore the details of HCPCS code A4720, 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 A4720?

HCPCS code A4720 is used to identify dialysate solutions used in peritoneal dialysis. Peritoneal dialysis is a type of renal replacement therapy that involves the use of the peritoneal membrane in the abdomen as a dialyzing membrane. The dialysate solution is infused into the peritoneal cavity and then drained out, allowing for the removal of waste products and excess fluid from the body.

2. Official Description

The official description of HCPCS code A4720 is “Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis.” The short description is “Dialysat sol fld vol > 249cc.”

3. Procedure

1. Prepare the dialysate solution according to the specific concentration of dextrose required for the patient’s peritoneal dialysis treatment.
2. Ensure that the fluid volume of the dialysate solution is greater than 249 cc, but less than or equal to 999 cc.
3. Administer the dialysate solution into the peritoneal cavity through a catheter.
4. Allow the dialysate solution to dwell in the peritoneal cavity for a specified period of time, as determined by the healthcare provider.
5. Drain the used dialysate solution from the peritoneal cavity and discard it appropriately.

4. When to use HCPCS code A4720

HCPCS code A4720 should be used when billing for dialysate solutions used in peritoneal dialysis. This code is applicable when the fluid volume of the dialysate solution is greater than 249 cc, but less than or equal to 999 cc, and any concentration of dextrose. It is important to ensure that the specific requirements of the code are met in order to accurately bill for the service.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A4720, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the patient’s medical necessity for peritoneal dialysis and the use of dialysate solutions.
• Documentation of the specific concentration of dextrose used in the dialysate solution.
• Documentation of the fluid volume of the dialysate solution, which should be greater than 249 cc, but less than or equal to 999 cc.

Providers should also follow the appropriate billing guidelines and submit the claim with the necessary supporting documentation to ensure accurate reimbursement for the service.

6. Historical Information and Code Maintenance

HCPCS code A4720 was added to the Healthcare Common Procedure Coding System on January 01, 2002. As of the effective date of January 01, 2015, 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 a pricing indicator code of 00, which indicates that the service is not separately priced by Part B.

7. Medicare and Insurance Coverage

HCPCS code A4720 is eligible for coverage by Medicare. The multiple pricing indicator code for this code is 9, which means it is not applicable as HCPCS is not priced separately by Part B. The Medicare Carriers Manual Reference Section Number for this code is 4270. It is important to check with individual insurance providers to determine coverage and reimbursement policies for HCPCS code A4720.

8. Examples

Here are some examples of when HCPCS code A4720 should be billed:

1. A patient with end-stage renal disease (ESRD) undergoes peritoneal dialysis using a dialysate solution with a fluid volume of 300 cc and a concentration of 1.5% dextrose.
2. A patient with ESRD receives peritoneal dialysis using a dialysate solution with a fluid volume of 500 cc and a concentration of 2.5% dextrose.
3. A patient with ESRD undergoes peritoneal dialysis using a dialysate solution with a fluid volume of 800 cc and a concentration of 4.25% dextrose.
4. A patient with ESRD receives peritoneal dialysis using a dialysate solution with a fluid volume of 600 cc and a concentration of 3.0% dextrose.
5. A patient with ESRD undergoes peritoneal dialysis using a dialysate solution with a fluid volume of 400 cc and a concentration of 2.0% dextrose.