Summary & Overview
HCPCS A4719: Peritoneal Dialysis "Y Set" Tubing
HCPCS Level II code A4719 denotes a disposable "y set" tubing assembly used for peritoneal dialysis. This supply supports the safe delivery and drainage of dialysate in ambulatory and home peritoneal dialysis therapy. Nationally, proper coding of dialysis supplies impacts payment accuracy for durable medical equipment and home dialysis programs and supports program reporting and patient access.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of this supply, typical settings of use (home and outpatient dialysis clinics), and considerations relevant to billing and coverage. The publication summarizes benchmark topics such as common billing practices, payer coverage patterns, and coding clarity for supply claims. Policy updates that affect durable medical equipment and home dialysis supply reimbursement are summarized, along with clinical context explaining why the tubing set is integral to peritoneal dialysis exchanges.
If specific payer policies, taxonomies, ICD-10 pairings, or related code mappings are needed, this report indicates availability or notes when source details were not provided. The content is intended for coding managers, revenue cycle professionals, and policy analysts seeking a national perspective on HCPCS Level II code A4719.
Billing Code Overview
HCPCS Level II code A4719 describes a "y set" tubing for peritoneal dialysis. This item is a disposable tubing set configured in a Y shape that facilitates connection between dialysis solution bags, the patient’s peritoneal dialysis catheter, and drainage lines.
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Service type: Durable medical supply for peritoneal dialysis fluid management
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Typical site of service: Home dialysis or outpatient dialysis clinic
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Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD) presents for routine exchange supplies and tubing replacement. The patient is managed at an outpatient dialysis clinic and receives peritoneal dialysis at home. The clinical workflow includes verification of prescription and orders, supply dispensing, patient education on aseptic technique, and documentation of supply use. A sterile y set tubing for peritoneal dialysis (A4719) is provided to connect the dialysate bag to the patient’s peritoneal dialysis catheter during manual exchanges or automated cycler setups. The supply is typically used in the clinic when teaching patients or when clinicians perform an exchange, and it is also dispensed for home use with instructions. Nursing documents supply lot numbers, expiration dates, and patient acknowledgment. Billing for A4719 is submitted by the supplier or facility to the patient’s primary payor for durable medical equipment/supplies associated with peritoneal dialysis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | When no special circumstances apply to the billed supply |