HCPCS A4216: Sterile Diluent/Flush, 10 ml

HCPCS Level II code A4216 represents a 10 ml sterile diluent/flush (sterile water, saline, and/or dextrose) used for medication preparation and device flushing. Nationally, small-volume sterile flushes are a routine consumable across ambulatory care, infusion therapy, and inpatient settings; accurate reporting affects supply tracking, clinical documentation, and payer adjudication. This code matters because it standardizes billing for commonly used single‑use diluents and flushes, supporting consistent claims processing and inventory management.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for A4216, typical sites of service, and commonly observed billing considerations. The publication outlines payer coverage patterns and benchmarking where available, highlights common modifier considerations, and summarizes relevant coding relationships and use cases for infusion and procedural workflows.

The content is geared to billing managers, revenue cycle staff, and clinicians involved in outpatient and infusion services who need clarity on when and how this supply code is used on service lines and claims. Data not available in the input is identified explicitly where applicable.

Billing Code Overview

HCPCS Level II code A4216 describes sterile water, saline and/or dextrose, diluent/flush, 10 ml. The code is used to report small-volume sterile diluent or flush solutions supplied for clinical use.

Service Type: Diluent / Flush solution for medication preparation or catheter/device flushing

Typical Site of Service: Outpatient clinics, physician offices, infusion centers, and hospital settings where small-volume sterile flushes or diluents are used

Data not available in the input.

Clinical Context

A typical patient scenario involves an outpatient or inpatient encounter where a clinician or nursing staff needs a sterile diluent or flush for intravenous access, medication reconstitution, or tube/line flushing. Example: a 68-year-old hospitalized patient receiving intermittent IV antibiotics via peripheral IV requires a 10 mL sterile saline flush before and after medication administration to maintain catheter patency and prevent occlusion. The clinical workflow: nursing obtains a single-use 10 mL sterile syringe or ampule of sterile saline (A4216), verifies patient identity and IV line, performs hand hygiene and aseptic technique, flushes the IV line pre- and post-medication, documents lot number and amount used in the medication administration record, and disposes of the single-use container per facility policy. Typical sites of service include inpatient hospital wards, skilled nursing facilities, ambulatory infusion centers, emergency departments, and physician offices. Common scenarios also include use during medication reconstitution for injections, flushing central or peripheral venous catheters, and bedside procedures requiring a small-volume sterile diluent or flush.

Coding Specifications

Modifier	Description	When to Use
`JW`	Drug/biological discarded (unused)	Report when part of the single-use sterile solution is discarded per payer rules for single-use items

Taxonomy Code	Specialty	Notes
`364S00000X`	Hospitalist	Hospital-based clinicians ordering and overseeing IV therapies
`207RH0000X`	Emergency Medicine	Emergency department clinicians using flushes for acute IV access
`363L00000X`	Nursing	Registered nurses who administer IV medications and use sterile flushes
`208D00000X`	Internal Medicine	Outpatient and inpatient physicians managing IV therapies
`261QM0800X`	Infusion Therapy	Clinicians in infusion centers preparing and administering IV medications

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z45.2`	Encounter for adjustment and management of vascular access device	Sterile flushes are used routinely for maintenance and management of vascular access devices
`T82.7`	Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts	Flushing of access devices can be part of management to maintain patency and prevent device-related complications
`Z79.2`	Long term (current) use of antibiotics	Patients on long-term IV antibiotics often require intermittent flushes to maintain IV access
`I82.409`	Acute embolism and thrombosis of unspecified deep veins of lower extremity	Post-procedural or ongoing IV access management may include flushes to maintain catheters used for therapy
`R65.20`	Severe sepsis without septic shock	Critically ill patients require frequent IV access maintenance including sterile flushes during therapy

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	A 10 mL sterile flush (`A4216`) is commonly used before and after administration to maintain catheter patency during an infusion
`96374`	Therapeutic, prophylactic, or diagnostic injection (specify route) when administered by a physician or other qualified health care professional	Small-volume diluent may be used to reconstitute or flush after intramuscular or subcutaneous injections
`36415`	Collection of venous blood by venipuncture	Sterile saline flushes are used when establishing or maintaining IV access associated with blood collection or line placement
`36556`	Implantation of non-tunneled centrally inserted central venous catheter (e.g., PICC)	Post-procedure and catheter maintenance include 10 mL sterile flushes to confirm patency and prevent occlusion
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	A small sterile diluent/flush may be used when preparing or clearing lines associated with injectable therapies

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Summary & Overview