Summary & Overview
HCPCS A4706: Bicarbonate Concentrate Solution for Hemodialysis, Per Gallon
HCPCS Level II code A4706 denotes bicarbonate concentrate solution furnished for hemodialysis, billed per gallon. Bicarbonate concentrate is a core consumable in the preparation of dialysate and is essential to safe and effective extracorporeal renal replacement therapy. Nationally, supplies such as bicarbonate concentrate are significant components of dialysis facility operating costs and reimbursement structures.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the product, common billing considerations, and the types of benchmarks and policy references typically associated with dialysis supply reimbursement. The publication outlines expected service lines and sites of service, summarizes payer coverage landscape, and highlights where readers can expect variability in payment and claim adjudication approaches across major commercial and public payers.
This summary provides the foundational coding information and context needed by billing managers, revenue cycle staff, and policy analysts to locate HCPCS Level II code A4706 in contracting, claims submission, and audit workflows. Data not available in the input is noted where relevant in detailed sections.
Billing Code Overview
HCPCS Level II code A4706 describes bicarbonate concentrate, solution, for hemodialysis, per gallon. This supply is used to prepare dialysate for patients undergoing hemodialysis and is classified as a dialysis fluid concentrate supply.
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Service type: Dialysis supply (bicarbonate concentrate solution)
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Typical site of service: Outpatient dialysis centers and hospital-based dialysis units
Clinical & Coding Specifications
Clinical Context
A typical patient for A4706 is an adult with end-stage renal disease (ESRD) receiving maintenance outpatient hemodialysis at a dialysis center. The facility pharmacy or dialysis nurse prepares dialysis concentrate solutions; A4706 is billed when bicarbonate concentrate solution is dispensed per gallon for use in hemodialysis treatments. A common workflow: the patient arrives for a scheduled three-times-weekly hemodialysis session; nursing verifies the dialysis prescription, medication administration record, and machine settings; the dialysis machine is connected to the treated water system and concentrate mixing system; the technician or nurse attaches a gallon of bicarbonate concentrate solution to the machine’s concentrate port or mixing system; the concentrate is mixed with acid concentrate and purified water to produce dialysate; the patient is monitored throughout the 3–5 hour treatment for hemodynamic stability and electrolyte balance; after treatment completion, used disposables are discarded and supply usage, including the number of gallons of bicarbonate concentrate consumed, is documented for billing with A4706.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier |