A4672 Drainage Extension Line HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS A4672: Drainage Extension Line for Dialysis

HCPCS Level II code A4672 denotes a sterile drainage extension line used in dialysis procedures. As a supply-line item, it supports safe fluid removal and tubing management during hemodialysis and related extracorporeal treatments. Nationally, such disposable supplies are critical to infection control and operational workflow in outpatient dialysis centers and hospital dialysis units.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. The publication outlines how A4672 is billed and categorized, and it provides a concise overview of payer coverage patterns where available.

Readers will find: a clinical context for why the drainage extension line matters in dialysis care; typical sites of service and supply usage; benchmarking and coverage themes across major payers; and notes on common modifiers and administrative considerations where applicable. Data not available in the input will be noted explicitly in specified sections.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareA4672HCPCS Level IIdialysis supplieshemodialysissterile drainage lineoutpatient dialysismedical suppliesbilling codesupply billing

Billing Code Overview

HCPCS Level II code A4672 describes a drainage extension line, sterile, for dialysis, each. This item is a single-use sterile tubing extension used to facilitate drainage during dialysis procedures. The service type is supply of a sterile medical device accessory for dialysis. The typical site of service is outpatient dialysis centers and hospital dialysis units where patients receive hemodialysis or related extracorporeal therapies.

Clinical & Coding Specifications

Clinical Context

A maintenance hemodialysis patient with an indwelling external dialysis catheter requires a sterile drainage extension line replacement at a dialysis outpatient center. The patient presents for a routine dialysis session; during circuit set-up, staff identify contamination or damage to the existing extension line or the protocol calls for scheduled replacement to prevent infection. A trained dialysis nurse removes the used extension line under sterile technique and connects a new sterile A4672 drainage extension line to the catheter hub and dialysis tubing. The workflow includes verification of provider orders, review of catheter site for infection, hand hygiene and full aseptic technique, connecting the new sterile extension, flushing and ensuring patency, documenting lot number and device label A4672, and monitoring the patient during dialysis for complications such as bleeding or catheter dysfunction. Typical site of service is an outpatient dialysis center (hospital outpatient dialysis unit or freestanding dialysis clinic); the device may also be used in inpatient dialysis settings when clinically indicated. The typical patient scenario involves end-stage renal disease requiring routine hemodialysis via tunneled or non-tunneled central venous dialysis catheter, where an individual sterile drainage extension line is required for safe extracorporeal circuit drainage.

Coding Specifications

Modifier	Description	When to Use

HCPCS A4336: Incontinence Supply, Urethral Insert, Each

HCPCS-A6021-COLLAGEN-DRESSING-16-SQ-IN-OR-LESS

HCPCS A6021: Collagen Dressing, Sterile, ≤16 sq. in.

HCPCS-A6557-THIGH-LENGTH-COMPRESSION-STOCKING-30-40-MMHG-CUSTOM

HCPCS A6557: Thigh-Length Gradient Compression Stocking, 30-40 mmHg, Custom

HCPCS-A6506-COMPRESSION-BURN-GARMENT-GLOVE-TO-AXILLA

HCPCS A6506: Compression Burn Garment Glove to Axilla

HCPCS-A4510-SURGICAL-STOCKINGS-FULL-LENGTH

HCPCS A4510: Surgical Stockings, Full Length, Each

HCPCS-A5122-SKIN-BARRIER-SOLID-8X8-OSTOMY-SUPPLY

HCPCS A5122: Skin Barrier Solid 8 x 8 (Ostomy Supply)

HCPCS-A4596-CRANIAL-ELECTROTHERAPY-STIMULATION-SUPPLIES-MONTHLY

HCPCS A4596: Cranial Electrotherapy Stimulation System Supplies, Monthly

HCPCS-A6445-CONFORMING-BANDAGE-NON-ELASTIC-STERILE-LESS-THAN-3-INCH

HCPCS Level II A6445: Sterile Non-Elastic Conforming Bandage <3" Wide

HCPCS-LEVEL-II-A4404-OSTOMY-RING

HCPCS Level II A4404: Ostomy Ring, Each

HCPCS-A4629-TRACHEOSTOMY-CARE-KIT-ESTABLISHED-TRACHEOSTOMY

HCPCS Level II A4629: Tracheostomy Care Kit for Established Tracheostomy

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Taxonomy Code	Specialty	Notes
`362400000X`	Vascular Access/Interventional Radiology	Interventional radiologists often place or exchange tunneled dialysis catheters and supervise device use
`174400000X`	Nephrology	Nephrologists manage dialysis patients and authorize catheter-related supplies
`363L00000X`	Dialysis Technician	Dialysis nurses/technicians handle supplies and connect sterile drainage extension lines during treatment
`207RC0000X`	General Surgery	Surgeons may be involved in catheter placement/exchange where device is used
`367A00000X`	Nurse Practitioner	Advanced practice clinicians who perform or assist with dialysis access procedures and device management

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N18.6`	End stage renal disease	Primary indication for chronic hemodialysis requiring catheter and sterile drainage extension lines
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter	Applies when catheter-related infection necessitates replacement of extension lines or catheter management
`Z99.2`	Dependence on renal dialysis	Denotes chronic dialysis dependence where drainage extension lines are routinely used
`I82.409`	Acute embolism and thrombosis of unspecified deep veins of lower extremity	Thrombosis of vascular access can require device exchange and use of new sterile extension lines during access procedures
`I50.9`	Heart failure, unspecified	Common comorbidity in dialysis patients; may influence vascular access management and device use

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36556`	Exchange of tunneled central venous catheter, without subcutaneous port or pump, age 5 years or older	May be performed when a tunneled dialysis catheter is exchanged and a new sterile drainage extension line such as `A4672` is attached during the procedure
`36600`	Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older	Initial catheter placement may be followed by connection of a sterile drainage extension line for dialysis circuit drainage
`36800`	Insertion of dialysis catheter, non-tunneled, centrally inserted, with imaging guidance	Use when a dialysis catheter is inserted and sterile extension lines are connected as part of establishing hemodialysis access
`90935`	Hemodialysis procedure with single evaluation by a physician or other qualified health care professional; up to 4 hours	Typical dialysis treatment during which a sterile drainage extension line `A4672` is used for extracorporeal circuit drainage
`90937`	Hemodialysis procedure requiring repeated evaluation(s) by a physician or other qualified health care professional; up to 4 hours	Use when ongoing physician evaluations occur during dialysis sessions that use the sterile drainage extension line
`94002`	Ventilation assist and management, initiation of pressure or volume preset ventilator for assisted or controlled ventilation; inpatient	Data not available in the input.

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