Summary & Overview
HCPCS A4860: Disposable Catheter Tips for Peritoneal Dialysis, per 10
HCPCS Level II code A4860 represents disposable catheter tips for peritoneal dialysis, packaged and billed per 10 units. These single-use accessories are essential components of peritoneal dialysis delivery, supporting safe catheter connections during exchanges and reducing infection risk. Nationally, supplies like A4860 contribute to the cost structure of home and clinic-based peritoneal dialysis programs and are relevant for supply chain planning, durable medical equipment (DME) management, and outpatient dialysis billing.
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 A4860 is used clinically, typical sites of service, and the payer landscape affecting coverage and claims processing. The publication also outlines common modifiers and typical billing considerations, benchmarking context where available, and links to related supply and dialysis billing topics.
This summary targets clinicians, billing professionals, and health policy stakeholders seeking a focused reference on coding and billing implications for peritoneal dialysis supplies at a national level.
Billing Code Overview
HCPCS Level II code A4860 describes disposable catheter tips for peritoneal dialysis, supplied per 10. This item is a single-use consumable used in peritoneal dialysis therapy to connect or extend dialysis catheters and tubing during exchanges and procedures.
Service Type: Dialysis supply — peritoneal dialysis accessory
Typical Site of Service: Home dialysis and outpatient dialysis clinics
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with end-stage renal disease on chronic peritoneal dialysis who presents for routine home-supplies resupply or clinic-based exchange supply replenishment. The clinician orders disposable catheter tips used for connecting the peritoneal dialysis transfer set to dialysis solution bags and drainage systems. A common workflow: a nurse or dialysis supply coordinator verifies prescription and quantity (units billed per 10 catheter tips as A4860), confirms patient identity and dialysis modality, documents the indication (routine supply, replacement after contamination, or breakage), and arranges shipment or in-clinic handoff. In an acute scenario, a patient reports contamination of the transfer set; the dialysis nurse supplies a replacement kit including disposable catheter tips, instructs on aseptic exchange technique, documents the incident, and updates the durable medical equipment record for billing with A4860 per manufacturer packaging (per 10). Typical site of service is outpatient dialysis clinic, home infusion/supply delivery, or durable medical equipment supplier location. Typical patient scenario: a 58-year-old patient performing nightly continuous ambulatory peritoneal dialysis (CAPD) requests replacement supplies after a suspected touch contamination of the transfer set; the dialysis nurse provides a package of disposable catheter tips (billed as A4860), documents quantity, and updates the patient’s supply order for future deliveries.
Coding Specifications
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