Summary & Overview
HCPCS Level II A4313: Insertion Tray for Three-Way Foley Catheter, Continuous Irrigation
HCPCS Level II code A4313 designates an insertion tray without drainage bag for an indwelling Foley-type three-way catheter intended for continuous bladder irrigation. The code identifies a specific supply item used in urological procedures where continuous irrigation is required to prevent clot retention or maintain catheter patency. Nationally, accurate coding of supplies such as A4313 matters for supply chain tracking, facility billing, and clinical documentation when continuous irrigation is performed.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise orientation to the clinical context and service settings for A4313, along with what typical benchmarking and policy viewers expect to see: supply description and clinical use, common service locations, and where coding clarity affects billing and documentation. The publication also outlines which payer policies are most commonly relevant for facilities billing supply items and identifies areas where policy updates or documentation standards can influence reimbursement and auditing. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A4313 describes an insertion tray without drainage bag designed for use with an indwelling Foley-type three-way catheter intended for continuous irrigation. The code denotes the specific supply kit used to insert and manage a three-way Foley catheter that allows for ongoing bladder irrigation without an included drainage bag.
Service type: Urological catheter insertion and continuous bladder irrigation supply
Typical site of service: Hospital inpatient, hospital outpatient, ambulatory surgery center, or other facility-based settings where indwelling urinary catheters and continuous irrigation are performed
Clinical & Coding Specifications
Clinical Context
A 72-year-old male inpatient with chronic urinary retention and recurrent gross hematuria from benign prostatic hyperplasia is admitted for inpatient urologic management. The urology team places a sterile three-way Foley indwelling catheter using an A4313 insertion tray to enable continuous bladder irrigation after transurethral resection of the prostate (TURP) or for management of clot retention. The procedure is performed at the bedside in an inpatient medical-surgical unit or in the operating room as needed. The standard workflow includes informed consent, sterile catheter insertion using the A4313 tray (which contains supplies but no drainage bag), placement of the three-way Foley, connection to an irrigation system or drainage bag (supplied separately), verification of correct balloon inflation and catheter position, initiation of continuous irrigation, documentation of catheter size, balloon volume, and urine character, and ongoing nursing irrigation and monitoring for patency, bleeding, and infection. Typical clinicians involved include urologists, emergency physicians, or trained advanced practice clinicians for insertion, and bedside nursing staff for ongoing irrigation management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician professional component if applicable to a service that has separate professional and technical components (rare for supply-only HCPCS). |