Summary & Overview
HCPCS A4726: Peritoneal Dialysis Dialysate Solution, >5999 cc
HCPCS Level II code A4726 designates large-volume peritoneal dialysis dialysate — any dextrose concentration with fluid volume greater than 5999 cc. This supply code is relevant nationally for clinicians, dialysis providers, home infusion suppliers, and payers because it identifies high-volume dialysate deliveries used in ambulatory and home peritoneal dialysis regimens. Proper use of A4726 affects billing accuracy, inventory management, and payment consistency across commercial and public plans.
Key payers examined in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national overview of coverage practices and billing benchmarks for this supply code, highlighting variability in authorization, billing frequency, and documentation expectations among major payers.
Readers will learn the clinical context for use of A4726, typical sites of service (home and outpatient peritoneal dialysis), and operational implications for providers and suppliers. The report also summarizes common modifier usage where applicable, outlines encounters and service-line considerations tied to peritoneal dialysis supplies, and flags areas where policy updates or payer-specific rules commonly affect reimbursement. Data not available in the input for specific payer rates, taxonomies, ICD-10 pairings, and related codes is noted elsewhere.
Billing Code Overview
HCPCS Level II code A4726 describes dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis. This code covers large-volume peritoneal dialysis dialysate supplied for use in ambulatory peritoneal dialysis therapies.
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Service type: Supply of dialysis solution for peritoneal dialysis
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Typical site of service: Home or outpatient peritoneal dialysis settings
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with end-stage renal disease (ESRD) is receiving chronic peritoneal dialysis at home using automated peritoneal dialysis (APD) cycler exchanges. The patient requires dialysate solution with dextrose in large-volume bags (greater than 5999 cc total fluid volume per billing unit) for a weekly supply delivered to the home. The clinical workflow begins with the nephrology team prescribing the concentration and total weekly volume of dialysate based on solute clearance goals and ultrafiltration needs. The prescription is communicated to the home infusion supplier, who prepares and ships A4726 dialysate solution. A peritoneal dialysis nurse performs patient education on exchange technique, monitors for signs of peritonitis or exit-site infection, and documents supply delivery and patient tolerance. During routine follow-up visits, the nephrologist reviews weight, dialysis adequacy, and any complications; orders are adjusted and communicated to the supplier as needed. Billing for the dialysate solution uses A4726 for dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis, with appropriate modifiers applied for payer reporting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default billing |