Summary & Overview
HCPCS A4338: Indwelling Foley Catheter, Two-Way Latex with Coating
HCPCS Level II code A4338 represents a two-way, latex indwelling Foley catheter with a protective coating (e.g., Teflon, silicone, silicone elastomer, or hydrophilic). This supply-line durable medical equipment item is commonly used for continuous urinary drainage in patients who require short- or long-term catheterization. Nationally, accurate coding of indwelling catheters affects device coverage, claims processing, and quality monitoring for urinary care.
Key payers covered 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 device use, the typical sites of service where A4338 is supplied or managed, and the administrative considerations that influence coverage and billing. The publication outlines common payer approaches to catheter supplies, typical documentation elements expected on claims, and how A4338 is positioned among related urology supply codes.
This piece provides operational benchmarks and policy-relevant details needed by billing managers, revenue cycle staff, and clinical procurement teams to align supply coding with payer requirements. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A4338 describes an indwelling Foley-type urinary catheter, two-way, made of latex with a coating such as Teflon, silicone, silicone elastomer, or hydrophilic materials. The code applies to a single catheter item, furnished for indwelling urinary drainage.
Service Type: Durable medical equipment (urology supply) — indwelling urinary catheter
Typical Site of Service: Home, long-term care facility, outpatient clinic, or inpatient hospital setting where indwelling catheters are placed or maintained
Clinical & Coding Specifications
Clinical Context
A typical adult patient presents to an outpatient urology clinic with urinary retention secondary to benign prostatic hyperplasia. The clinician determines intermittent voiding attempts have failed and places an indwelling Foley catheter to decompress the bladder. The device used is a two-way latex Foley catheter with a coating (eg, silicone elastomer) consistent with A4338 and is supplied per patient during the clinic visit. The clinical workflow includes informed consent, sterile catheter insertion using standard precautions, positioning of the balloon, confirmation of urine return, securing the catheter to the thigh, patient and caregiver education on catheter care, documentation of catheter size and type, and ordering of supplies for home use or short-term hospital stay. Typical sites of service include outpatient clinics, physician offices, hospital inpatient units, long-term care facilities, and emergency departments when same-day catheter placement is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier—standard reporting | Rarely used as a billing modifier; present in list but not typically appended to supplier HCPCS claims |
11 | Professional component | Use when reporting only the professional component of a related service (not typical for disposable supply ).