Summary & Overview
HCPCS A4312: Insertion Tray with Silicone Foley Catheter, No Drain Bag
HCPCS Level II code A4312 identifies an insertion tray without drainage bag containing a two-way, all-silicone Foley indwelling catheter. This supply-level code is used in encounters requiring sterile catheter insertion or replacement where the drainage bag is supplied separately. Nationally, accurate reporting of such HCPCS supplies matters for correct facility and DME billing, inventory tracking, and clinical documentation for urinary catheterization procedures.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coding intent and clinical context for A4312, payer coverage themes, and common billing practices associated with Foley catheter insertion supplies. The publication highlights benchmark considerations for facility and durable medical equipment billing lines, common modifiers used with supply and procedure claims, and typical sites of service for this kit.
The content provides operational clarity for coding staff, revenue cycle teams, and clinical leaders: defining the supply represented by A4312, explaining where it is commonly used, and summarizing what to expect when preparing claims and documentation. Data not available in the input is identified where applicable.
Billing Code Overview
HCPCS Level II code A4312 describes an insertion tray without drainage bag with indwelling catheter, Foley type, two-way, all silicone. The item represents a sterile supply kit used to insert and secure a Foley urinary catheter (two-way) composed entirely of silicone, supplied without an accompanying drainage bag.
Service Type: Urological catheter insertion supply / durable medical supply
Typical Site of Service: Hospital inpatient or outpatient settings, ambulatory surgical centers, long-term care facilities, and skilled nursing facilities where urinary catheterization or catheter replacement is performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult requiring short-term bladder decompression in an outpatient clinic, emergency department, or inpatient ward. Indications include acute urinary retention from benign prostatic hyperplasia, postoperative urinary retention after abdominal or orthopedic surgery, or neurogenic bladder exacerbation. The clinical workflow: patient assessment and indication confirmation, informed consent, sterile catheter insertion using the A4312 insertion tray containing an all-silicone two-way Foley catheter (without drainage bag), sterile lubricant and antiseptic, balloon inflation, securement, documentation of urine output and any complications, and post-procedure monitoring for hematuria or infection. The tray is used when the facility supplies the catheter insertion kit but not the drainage bag; the drainage bag may be supplied separately or not required for short-term use.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | General default when no specific modifier applies |
11 | Office or other outpatient service by the same physician |