A4360 Disposable Urethral Clamp | HCPCS Reimbursement

HCPCS Level II code A4360 denotes a disposable external urethral clamp or compression device, with pad and/or pouch, for single use. The code captures a noninvasive continence supply used to manage urinary leakage by applying external compression to the urethra. Nationally, supplies for continence management are a routine component of outpatient and home health care for patients with stress urinary incontinence or other voiding dysfunction where external devices are appropriate.

Payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how this supply code is classified, common sites of service, and the clinical context in which the device is used. The publication summarizes national benchmarks for utilization and payment patterns where available, highlights relevant policy considerations applicable to payers and suppliers, and outlines coding and billing contexts to help ensure correct claim submission.

This resource is intended for revenue cycle managers, billing staff, clinicians involved in continence care, and policy analysts who need a clear, national-level briefing on the use and billing of disposable external urethral clamps under HCPCS Level II code A4360. Data not available in the input are noted where applicable.

Billing Code Overview

HCPCS Level II code A4360 describes a disposable external urethral clamp or compression device, with pad and/or pouch, each. This device is used to provide external mechanical compression of the urethra to manage urinary leakage or incontinence when a noninvasive external solution is appropriate.

Service type: Supply of a disposable urinary compression device
Typical site of service: Outpatient clinic, home health, or other ambulatory settings where durable medical supplies and continence aids are provided

Clinical Context

A typical patient is an adult with persistent urinary stress incontinence or postoperative temporary urinary leakage who is managed with noninvasive external devices. The clinician (urologist, urogynecologist, or continence nurse specialist) evaluates the patient in an outpatient clinic or ambulatory surgery center to determine suitability for a disposable external urethral clamp or compression device. The patient presents with symptoms such as stress-related urine loss during cough, sneeze, or exertion, or needs temporary daytime continence support after pelvic surgery. Clinical workflow: history and focused pelvic/urologic exam; review of prior conservative measures (pelvic floor therapy, pads, pessaries); patient education on device types, placement, skin protection, and disposal; selection and fitting of an appropriately sized disposable external urethral clamp or compression device with pad and/or pouch; documentation of device code A4360, quantity supplied, and any counseling provided; follow-up plan for device tolerance, skin integrity checks, and transition to other continence management as needed. Typical site of service: outpatient clinic, physician office, urology or urogynecology clinic, or ambulatory surgery center when supplied at time of discharge.

Coding Specifications

Modifier	Description	When to Use
`NU`	New equipment	Use when the disposable device is being provided as new, first-time issue to the patient.

Taxonomy Code	Specialty	Notes
`261QM0800X`	Female Pelvic Medicine & Reconstructive Surgery (Urogynecology)	Common specialist prescribing and fitting external continence devices.
`208000000X`	Urology	Primary specialty managing urinary incontinence and prescribing external clamps.
`173E00000X`	Nursing - Urology	Continence nurse specialists who educate and fit devices in clinic.
`2083P0207X`	Male Urology	Urologists who treat male stress or post-prostatectomy incontinence where external clamps may be used.
`261QQ0500X`	Pelvic Floor Physical Therapy	Physical therapists who may recommend adjunctive external devices as part of conservative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N39.3`	Stress incontinence (female)	Primary indication for an external urethral clamp in women with activity-associated leakage.
`N39.46`	Post-void dribbling	External compression devices can reduce dribbling by improving urethral coaptation.
`N39.41`	Urinary retention	In select male patients with overflow incontinence, external compression devices are used cautiously; relevance depends on clinical judgment.
`N39.44`	Vaginal fistula with urinary incontinence	External devices may be used temporarily when surgical repair is delayed or contraindicated.
`N99.81`	Postprocedural urinary incontinence	Temporary management after pelvic or prostate surgery when noninvasive devices are appropriate.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51701`	Insertion of non-indwelling bladder catheter (e.g., straight catheterization)	May be performed in the same visit to assess post-void residual or to manage urinary retention prior to fitting an external clamp.
`51702`	Change of non-indwelling bladder catheter	Related when intermittent catheterization training or supplies are addressed in the same clinical encounter.
`97161`	Physical therapy evaluation (low complexity)	Performed by pelvic floor therapists evaluating suitability for external continence devices and planning therapy.
`57454`	Colposcopy of the cervix with biopsy (when applicable in urogynecologic evaluation)	Occasionally performed in a broader pelvic evaluation visit; not directly related to the supply but may occur in the same specialty clinic.
`99070`	Supplies and materials (e.g., dressings, devices) provided by the physician over and above those usually included with the office visit	Billed when additional non-covered supplies are provided alongside `A4360`.

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Summary & Overview

HCPCS A4360: Disposable External Urethral Clamp or Compression Device