Summary & Overview
HCPCS A4265: Paraffin, Per Pound
HCPCS Level II code A4265 represents the billing descriptor for paraffin wax supplied and billed by weight (per pound). Paraffin is widely used in therapeutic heat treatments, including paraffin baths for hands and feet, and is a routine supply in outpatient rehabilitation, physical therapy, and home health settings. Nationally, accurate reporting of supply codes like A4265 supports proper claims adjudication, inventory tracking, and cost accounting for therapy services.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of reimbursement benchmarks where available, common billing contexts, and the clinical scenarios in which paraffin is typically supplied. The publication outlines typical sites of service, billing considerations for supply reporting, and common modifiers used with HCPCS Level II supplies (modifier list provided elsewhere).
This summary is intended for billing managers, revenue cycle specialists, and clinicians involved in therapy services who need a concise reference to the purpose and typical use of A4265. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A4265 denotes paraffin, billed per pound. This supply code is used to report the provision of paraffin wax commonly used in therapeutic applications such as heat therapy and paraffin baths for pain relief, hand and foot treatments, and softening of tissues.
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Service type: Therapeutic supply
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Typical site of service: Outpatient clinics, physical therapy departments, rehabilitation centers, and home health settings where paraffin baths or heat therapy are provided
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult or a person with chronic peripheral neuropathy, peripheral vascular disease, or rheumatologic hand conditions who receives paraffin bath treatments to soften skin, reduce stiffness, and provide superficial heat during outpatient occupational therapy or physical therapy sessions. The patient presents to an outpatient rehabilitation clinic or skilled nursing facility with complaints of joint stiffness, limited range of motion, and skin dryness of the hands. The therapist warms and applies paraffin (billed as A4265 per pound) to the patient’s hands using a paraffin bath, often followed by therapeutic exercises and home program instruction. Documentation includes the diagnosis driving the therapy, the quantity of paraffin used, treatment date, site of service (outpatient rehab clinic, hospital outpatient department, or skilled nursing facility), and any applicable modifiers for payment reporting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Procedure code without categorization of professional/technical components | Rarely used; default for HCPCS supplies when no split components apply |