Summary & Overview
HCPCS A4355: Irrigation Tubing Set for Continuous Bladder Irrigation
HCPCS Level II code A4355 identifies an irrigation tubing set used for continuous bladder irrigation through a three-way indwelling Foley catheter. This disposable supply item supports continuous post-operative or therapeutic bladder irrigation to prevent clot retention and maintain catheter patency. As a supply-level HCPCS item, A4355 is relevant to hospitals, ambulatory surgical centers, urology clinics, and durable medical equipment and supply billing workflows nationwide.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical use, typical sites of service, and the billing context for supply coding. The publication also summarizes common modifiers used with supply and procedural claims, payer coverage patterns, and typical billing practice considerations for supply-level HCPCS items.
This summary provides clinicians, billing staff, and policy analysts with the essential clinical and billing context for A4355, including where it is commonly used and why accurate supply coding matters for care coordination and claims processing. Data not available in the input will be labeled as such in the detailed sections.
Billing Code Overview
HCPCS Level II code A4355 describes an irrigation tubing set for continuous bladder irrigation intended for use with a three-way indwelling Foley catheter. The item is supplied on a per-unit basis (each).
Service Type: Continuous bladder irrigation supply
Typical Site of Service: Hospital inpatient or outpatient settings where continuous bladder irrigation is performed, including urology procedural suites and post-operative recovery areas.
Clinical & Coding Specifications
Clinical Context
A typical patient is a hospitalized adult requiring continuous bladder irrigation (CBI) after urologic procedures such as transurethral resection of the prostate (TURP) or transurethral resection of bladder tumor (TURBT), or for management of gross hematuria with clot retention. The patient arrives to a monitored inpatient ward or post-anesthesia care unit with a three-way indwelling Foley catheter placed. Nursing personnel connect an A4355 irrigation tubing set to the catheter and an irrigation solution bag to provide continuous closed-system bladder irrigation. The clinical workflow includes verifying physician orders, aseptic technique for connections, setting irrigation flow rates, monitoring urine color and output, assessing for patency and abdominal/bladder discomfort, and documenting irrigation start time, solution used, and hourly assessments. The tubing set is typically used for the duration of CBI and replaced per facility protocol or manufacturer guidance, or when contamination or malfunction occurs. Typical site of service is an inpatient hospital room, post-anesthesia care unit, or outpatient surgical recovery area where continuous bladder irrigation is indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |