Summary & Overview
HCPCS Level II A4351: Intermittent Straight-Tip Urinary Catheter
HCPCS Level II code A4351 represents an intermittent straight-tip urinary catheter, available with or without various coatings, used for periodic bladder drainage. Nationally, this durable medical equipment item is a common supply for patients requiring intermittent catheterization due to retention, neurogenic bladder, or other voiding dysfunctions; it affects supply-chain decisions, billing workflows, and DMEPOS coverage policies across payers. Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
Readers will gain a concise briefing on what the code denotes, typical clinical contexts where intermittent catheters are used, and how this supply is categorized for billing and site-of-service purposes. The publication outlines payer coverage landscape and common administrative considerations such as rental versus purchase distinctions and related catheter codes. It highlights benchmarks and policy updates relevant to DME urological supplies, coding relationships to neighboring HCPCS entries, and documentation touchpoints used by suppliers and clinical teams. Data not available in the input is noted where applicable. The summary is oriented to billing managers, DME suppliers, and clinicians involved in care coordination and reimbursement processes.
Billing Code Overview
HCPCS Level II code A4351 describes an intermittent urinary catheter, straight tip, with or without coating (for example, Teflon, silicone, silicone elastomer, or hydrophilic), each. This item is classified as durable medical equipment (urological supplies) and is intended for use in managing bladder drainage needs.
Typical site of service is a durable medical equipment supplier or home use (DMEPOS) setting where patients or caregivers obtain the catheter for intermittent bladder catheterization.
Clinical & Coding Specifications
Clinical Context
A patient with chronic urinary retention who performs intermittent self-catheterization receives supplies from a durable medical equipment supplier for home use. The patient presents after a urology visit documenting difficulty emptying the bladder due to neuromuscular bladder dysfunction and recurrent urinary tract infections. A urology physician or authorized clinician orders single-use straight-tip intermittent urinary catheters for ongoing clean intermittent catheterization at home. The DMEPOS supplier dispenses HCPCS Level II code A4351 catheters, documents the order, verifies medical necessity with the payer, and provides patient instruction on catheter insertion, storage, and safe disposal. Follow-up care may include monitoring for urinary tract infection symptoms and reassessment of catheter type (e.g., straight vs. coude) during clinic visits.
Coding Specifications
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HCPCS Level II code:
A4351— Intermittent urinary catheter; straight tip, with or without coating, each. -
Common modifiers:
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NU— New Equipment -
Use when the item is initial issue to the patient as new equipment from the DME supplier.
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RR— Rental -
Use when the catheter or related supply is furnished as a rental per payer/rental policy.