HCPCS Level II A4346: Indwelling Foley Three-Way Catheter for Continuous Irrigation

HCPCS Level II code A4346 describes an indwelling Foley-type urinary catheter with a three-way lumen designed for continuous bladder irrigation; this item is a disposable urological device used in clinical settings such as inpatient hospitals, emergency departments, and surgical suites for continuous irrigation after urologic procedures or to manage gross hematuria, and the service is supply of the three-way Foley catheter for insertion and use.

For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing, Bone Turnover Markers Testing.

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HCPCS Level II A4346: Indwelling Foley Three-Way Catheter for Continuous Irrigation

For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing, Bone Turnover Markers Testing.

Customize your policy alerts

Sign up for hcpcs A4346 policy alerts

Get alerted when payer policies referencing A4346 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult inpatient or emergency department patient with gross hematuria, clot retention, or postoperative bladder irrigation needs following transurethral resection of the prostate (TURP) or bladder tumor resection. The clinical workflow begins with assessment of urinary retention, bladder irrigation requirements, and hemodynamic stability. Indications for insertion of an indwelling three-way Foley catheter (A4346) include ongoing gross bleeding requiring continuous bladder irrigation (CBI), evacuation of bladder clots, or provision of continuous irrigation after urologic procedures.

The procedure is performed by a urologist, advanced practice provider, or trained inpatient nursing staff depending on facility policy. After informed consent and appropriate analgesia or local anesthesia, aseptic catheter insertion is performed. The three-way catheter allows instillation of irrigation fluid through the inflow lumen and drainage through the outflow lumen while a third lumen permits balloon inflation and pressure monitoring. Post-insertion management includes setting continuous irrigation rates, monitoring urine color and output, maintaining catheter patency, and documenting the device code A4346, insertion date/time, manufacturer/size, and clinical indication in the medical record. Typical sites of service are inpatient hospital units (including ICU), the emergency department, and the operating room when placed intraoperatively.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51701`	Irrigation, bladder, simple, with or without instillation; single or multiple instillations	Performed to irrigate bladder post-catheter placement or during continuous irrigation sessions.
`51702`	Instillation of therapeutic agent into bladder (separate procedure)	May be used when therapeutic instillation is performed through an indwelling catheter for chemical cauterization or bladder therapy.
`51703`	Bladder irrigation, via indwelling catheter, for continuous irrigation (does not include placement of catheter)	Describes the continuous irrigation management typically performed using a three-way catheter placed under `A4346`.
`51000`	Cystostomy, open, simple	Alternative urinary drainage procedure when urethral catheterization is not possible; may precede or follow failed urethral attempts.
`52204`	Cystourethroscopy, with removal of foreign body, calculus, or clot (separate procedure)	Performed when clot evacuation or inspection is required in conjunction with three-way catheter placement and irrigation.

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208800000X	Urology Physician	A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has compreh…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
367H00000X	Anesthesiologist Assistant	An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants …
103TF0200X	Forensic Psychologist	A psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial a…
163WR0400X	Rehabilitation Registered Nurse	Nursing Service Providers · Registered Nurse
207VM0101X	Maternal & Fetal Medicine Physician	An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowle…
261QV0200X	VA Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
2085N0904X	Nuclear Radiology Physician	A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the admi…

Related ICD-10-CM Codes

28 rows

ICD-10-CM Code	Description
C67.9	Malignant neoplasm of bladder, unspecified
D62	Acute posthemorrhagic anemia
D68.9	Coagulation defect, unspecified
I83.90	Asymptomatic varicose veins of unspecified lower extremity
N12	Tubulo-interstitial nephritis, not specified as acute or chronic
N13.6	Pyonephrosis
N20.0	Calculus of kidney
N20.1	Calculus of ureter
N21.0	Calculus in bladder
N21.1	Calculus in urethra

Showing 1–10 of 28

Related Payer Policy Updates

Specialty: Endocrinology1 / 3

10 rows

Policy	Payer	Effective Date
Salivary Hormone Testing	Oscar Health	2026-10-01
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing	Oscar Health	2026-10-01
Bone Turnover Markers Testing	Oscar Health	2026-10-01
Testosterone — Coverage Criteria for Measurement and Monitoring	Oscar Health	2026-10-01
Thyroid Disease Testing	Oscar Health	2026-10-01
Diabetes Mellitus Testing — Coverage Criteria	Oscar Health	2026-10-01
Thyroid Disease Testing	blue cross blue shield - louisiana	2026-09-15
Thyroid Disease Testing	Blue Cross Blue Shield - New Mexico	2026-09-04
Parathyroid Hormone, Phosphorous, Calcium and Magnesium Testing	Blue Cross Blue Shield - New Mexico	2026-09-04
Testosterone laboratory testing and measurement (coverage criteria)	Premera Bluecross	2026-09-04

Related Codes

HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

HCPCS Level II A4210: Needle-free Injection Device, Each

HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

HCPCS Level II A4211: Supplies for Self-Administered Injections

HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

HCPCS Level II A4215: Needle, Sterile, Any Size

HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

Showing 1–10 of 633

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51701`	Irrigation, bladder, simple, with or without instillation; single or multiple instillations	Performed to irrigate bladder post-catheter placement or during continuous irrigation sessions.
`51702`	Instillation of therapeutic agent into bladder (separate procedure)	May be used when therapeutic instillation is performed through an indwelling catheter for chemical cauterization or bladder therapy.
`51703`	Bladder irrigation, via indwelling catheter, for continuous irrigation (does not include placement of catheter)	Describes the continuous irrigation management typically performed using a three-way catheter placed under `A4346`.
`51000`	Cystostomy, open, simple	Alternative urinary drainage procedure when urethral catheterization is not possible; may precede or follow failed urethral attempts.
`52204`	Cystourethroscopy, with removal of foreign body, calculus, or clot (separate procedure)	Performed when clot evacuation or inspection is required in conjunction with three-way catheter placement and irrigation.

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208800000X	Urology Physician	A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has compreh…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
367H00000X	Anesthesiologist Assistant	An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants …
103TF0200X	Forensic Psychologist	A psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial a…
163WR0400X	Rehabilitation Registered Nurse	Nursing Service Providers · Registered Nurse
207VM0101X	Maternal & Fetal Medicine Physician	An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowle…
261QV0200X	VA Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
2085N0904X	Nuclear Radiology Physician	A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the admi…

Related ICD-10-CM Codes

28 rows

ICD-10-CM Code	Description
C67.9	Malignant neoplasm of bladder, unspecified
D62	Acute posthemorrhagic anemia
D68.9	Coagulation defect, unspecified
I83.90	Asymptomatic varicose veins of unspecified lower extremity
N12	Tubulo-interstitial nephritis, not specified as acute or chronic
N13.6	Pyonephrosis
N20.0	Calculus of kidney
N20.1	Calculus of ureter
N21.0	Calculus in bladder
N21.1	Calculus in urethra

Showing 1–10 of 28

Related Payer Policy Updates

Specialty: Endocrinology1 / 3

10 rows

Policy	Payer	Effective Date
Salivary Hormone Testing	Oscar Health	2026-10-01
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing	Oscar Health	2026-10-01
Bone Turnover Markers Testing	Oscar Health	2026-10-01
Testosterone — Coverage Criteria for Measurement and Monitoring	Oscar Health	2026-10-01
Thyroid Disease Testing	Oscar Health	2026-10-01
Diabetes Mellitus Testing — Coverage Criteria	Oscar Health	2026-10-01
Thyroid Disease Testing	blue cross blue shield - louisiana	2026-09-15
Thyroid Disease Testing	Blue Cross Blue Shield - New Mexico	2026-09-04
Parathyroid Hormone, Phosphorous, Calcium and Magnesium Testing	Blue Cross Blue Shield - New Mexico	2026-09-04
Testosterone laboratory testing and measurement (coverage criteria)	Premera Bluecross	2026-09-04

Related Codes

HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

HCPCS Level II A4210: Needle-free Injection Device, Each

HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

HCPCS Level II A4211: Supplies for Self-Administered Injections

HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

HCPCS Level II A4215: Needle, Sterile, Any Size

HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

Showing 1–10 of 633

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

HCPCS Level II A4346: Indwelling Foley Three-Way Catheter for Continuous Irrigation

Sign up for hcpcs A4346 policy alerts

HCPCS Level II A4346: Indwelling Foley Three-Way Catheter for Continuous Irrigation

Sign up for hcpcs A4346 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code A4346 represent and where is it typically used?

What clinical situations indicate use of a three-way Foley catheter billed with A4346?

Which related CPT codes should I consider when documenting procedures accompanying A4346?

What modifiers are commonly used with A4346 and when are they used?

Which provider specialties and taxonomy codes are associated with placement and management of A4346?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code A4346 represent and where is it typically used?

What clinical situations indicate use of a three-way Foley catheter billed with A4346?

Which related CPT codes should I consider when documenting procedures accompanying A4346?

What modifiers are commonly used with A4346 and when are they used?

Which provider specialties and taxonomy codes are associated with placement and management of A4346?

References