Summary & Overview
HCPCS A4209: Syringe with Needle, Sterile 5 cc or Greater
HCPCS Level II code A4209 represents a sterile disposable syringe with an attached needle, 5 cc or greater. Nationally, this supply-level code is used across a range of outpatient and home care settings for parenteral medication administration, immunizations, and procedures requiring larger-volume syringes. Unit-level supply codes like A4209 matter because they affect billing for infusion services, home health supply claims, and ambulatory procedure reimbursement.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find national benchmarks for unit pricing and utilization trends, payer coverage patterns, common billing modifiers and compliance considerations, and clinical context on when larger-volume sterile syringes are clinically indicated. The publication also outlines coding practice notes and typical sites of service where A4209 is billed.
This summary provides a concise reference for coding staff, revenue cycle professionals, and policy analysts seeking clarity on HCPCS Level II code A4209, its use cases, and the payer landscape for supply billing in outpatient and home-based care.
Billing Code Overview
HCPCS Level II code A4209 describes a sterile syringe with needle, 5 cc or greater, each. This item is a single-use, sterile disposable syringe that includes an attached needle and is intended for parenteral administration of medications or fluids.
Service type: Durable medical/supply item for injection/aspiration procedures
Typical site of service: Outpatient clinics, physician offices, ambulatory surgical centers, infusion centers, and home health settings
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Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with insulin-dependent diabetes mellitus presents to an outpatient endocrinology clinic for routine insulin administration training and supplies. The clinician provides a single-use sterile syringe with attached needle, volume 5 cc or greater, to draw and administer a large-volume subcutaneous medication or to aspirate fluid for bedside procedures. Typical workflow: clinician verifies order, confirms patient identity and indication, prepares a sterile field, selects A4209 syringe with needle (5 cc or greater), performs hand hygiene and appropriate injection or aspiration technique, disposes of the syringe in a sharps container, documents the supply dispensing or use in the medical record including lot number and quantity, and bills the supply using HCPCS Level II code A4209 alongside any clinical service codes for the encounter.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Not typically used; placeholder for systems requiring a second modifier field when no modifier applies |
22 |