Question 1

What is HCPCS code A4725?

Accepted Answer

HCPCS code A4725 is "Dialys sol fld vol > 4999cc". Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis

Question 2

What category is A4725 in?

Accepted Answer

A4725 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A4725?

Accepted Answer

Use A4725 when billing for dialys sol fld vol > 4999cc. 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 A4725 covered by Medicare?

Accepted Answer

Coverage for A4725 (Dialys sol fld vol > 4999cc) 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 A4725?

Accepted Answer

Documentation for A4725 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).