Summary & Overview
HCPCS A4364: Adhesive, Liquid, per Ounce
HCPCS Level II code A4364 denotes a billed supply of liquid adhesive (per ounce) used for topical wound closure, device attachment, or other minor procedural purposes. Nationally, supply codes like A4364 matter because they impact facility and outpatient cost reporting, inventory management, and payer coverage determinations for consumable products used in ambulatory 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 how this supply code is classified, typical sites of service where it is billed, and the clinical contexts in which liquid adhesive is used. The publication outlines benchmarks for supply utilization and billing, summarizes relevant policy or coverage considerations for major payers, and situates the code within clinical workflows that use topical adhesives.
This summary provides practical context for billing staff, revenue cycle professionals, and policy analysts seeking a clear understanding of what A4364 represents, which payers commonly encounter the code, and what areas—such as billing practices and payer coverage—readers should review when managing claims for liquid adhesive supplies.
Billing Code Overview
HCPCS Level II code A4364 describes adhesive, liquid or equal, any type, per oz. This HCPCS item represents a billed supply of liquid adhesive product measured by the ounce and intended for clinical or procedural use.
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Service type: Supply of topical or procedural adhesive for wound closure, device attachment, or minor procedural uses
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Typical site of service: Outpatient clinics, physician offices, ambulatory surgery centers, and other non-inpatient settings where supplies are billed per unit
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old outpatient who presents to a wound care clinic after sustaining a small laceration to the forearm while gardening. The wound is cleaned, debris is irrigated, and superficial edges are approximated. The clinician elects to apply a topical tissue adhesive to close the epidermal layer instead of or in addition to sutures. The adhesive used is a liquid skin adhesive billed with A4364 (adhesive, liquid or equal, any type, per oz). The workflow includes wound assessment, cleansing, local anesthesia if needed, approximation of wound edges, application of the liquid adhesive in a thin layer over the approximated edges, drying time, and patient aftercare instructions. Typical sites of service include ambulatory surgical centers, emergency departments, urgent care clinics, physician offices, and wound care clinics. Common payer interactions include primary carrier verification and documentation of product quantity (ounces) applied, medical necessity tied to the wound closure, and any applicable modifiers to indicate unusual circumstances or billing circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Professional component | Use when billing only the professional component of a service when split billing applies (rare for supply-only codes). |