Question 1

What is HCPCS code A4351?

Accepted Answer

HCPCS code A4351 is "Straight tip urine catheter". Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each

Question 2

What category is A4351 in?

Accepted Answer

A4351 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A4351?

Accepted Answer

Use A4351 when billing for straight tip urine catheter. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is A4351 covered by Medicare?

Accepted Answer

Coverage for A4351 (Straight tip urine catheter) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for A4351?

Accepted Answer

Documentation for A4351 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).