HCPCS Code A4721

Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
Short DescriptionDialysat sol fld vol > 999cc
Year2026
Coverage CodeD = Special coverage instructions apply
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2015
Code Added DateJanuary 01, 2002
Pricing Indicator00 = Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.)
Type of ServiceL = ESRD supplies (eff 04/95) (renal supplier in the home before 04/95)