HCPCS Code Details - A4722

HCPCS Level II Code
Transportation Services Including Ambulance, Medical & Surgical Supplies
HCPCS Code A4722
Description

Long description:
Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis

Short description:
Dialys sol fld vol > 1999cc

HCPCS Modifier1
HCPCS Pricing indicator 00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
Multiple pricing indicator 9 - Not applicable as HCPCS not priced separately by part B or value is not established
Coverage code D - Special coverage instructions apply
BETOS2 code P9B - Dialysis services (non-medicare fee schedule)
HCPCS Action code N - No maintenance for this code
Type of service L - ESRD supplies
Effective date Effective Jan 01, 2015
Date added Added Jan 01, 2002
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

See also

  • HCPCS A4720 · Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis

  • HCPCS A4721 · Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis

  • HCPCS A4723 · Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis

  • HCPCS A4724 · Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis

  • HCPCS A4725 · Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis

  • HCPCS A4726 · Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”