Summary & Overview
HCPCS A4218: Sterile Saline or Water, Metered Dose Dispenser, 10 ml
HCPCS Level II code A4218 identifies a sterile saline or water product packaged in a metered dose dispenser of 10 ml. Such single-use dispensers are used for topical irrigation, wound cleansing, nasal or mucosal humidification, and other procedures that require sterile isotonic solution in precisely measured sprays or drops. The code captures a common supply item across outpatient, ambulatory, and home-care settings and matters nationally because it is frequently billed with procedural visits and supply claims, affecting supply-line reimbursement and clinical workflows.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the product and typical sites of service, an outline of payer coverage considerations, and benchmark context where available. The publication summarizes common billing modifiers and related administrative considerations, highlights clinical use cases for the supply, and notes when input data is not available. Data not available in the input will be explicitly identified in the relevant sections. This resource is designed for coding, billing, and revenue cycle professionals seeking a clear reference for HCPCS Level II code A4218 and its place in outpatient supply billing practices.
Billing Code Overview
HCPCS Level II code A4218 describes sterile saline or water supplied in a metered dose dispenser, 10 ml. This item is a single-use, premeasured spray or dosing device intended to deliver sterile saline or sterile water for topical or mucosal applications.
Service type: Supplies / DME-related consumable
Typical site of service: Outpatient clinics, physician offices, emergency departments, ambulatory care centers, and home care settings where topical irrigation or mucosal humidification is required.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric outpatient who requires a small-volume sterile saline or sterile water metered dose dispenser for wound irrigation, nasal irrigation, ophthalmic rinsing, or delivery of topical medications in a clinic, emergency department, ambulatory surgery center, or home health setting. The clinician (nurse, physician assistant, physician, respiratory therapist, or home health nurse) selects A4218 — sterile saline or water, metered dose dispenser, 10 ml — when a single-use, pre-measured 10 mL dispenser is provided to cleanse wounds, irrigate surgical sites, rinse mucous membranes (for example nasal or ocular), or dilute/flush small catheters. Typical workflow: assessment and indication documented in the medical record; selection and dispensing of the 10 mL metered saline/water; patient or caregiver instruction on use (when applicable); administration at point of care or supply for take-home use; documentation of lot number/expiration and quantity supplied. Typical sites of service include outpatient clinics, emergency departments, ambulatory surgery centers, and home health visits.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no additional modifier applies |