A4258 — Spring-powered device for lancet, each
A4258 is a HCPCS Level II code for spring-powered device for lancet, each. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusP
Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A4258 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1 unit MAI 2 — Date of Service Edit: Policy · Published Contractor Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A4258
- Long descriptor
- Spring-powered device for lancet, each
- Short descriptor
- Lancet device each
- Added
- January 1, 1996
- BETOS
- D1E
- Pricing indicator
- 34 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
DME supplies. Price subject to floors and ceilings.
Codes adjacent to A4258
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4258 is not quite right, the correct code is very often within a few positions of it.
- A4247Betadine or iodine swabs/wipes, per box
- A4248Chlorhexidine containing antiseptic, 1 ml
- A4250Urine test or reagent strips or tablets (100 tablets or strips)
- A4252Blood ketone test or reagent strip, each
- A4253Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
- A4255Platforms for home blood glucose monitor, 50 per box
- A4256Normal, low and high calibrator solution / chips
- A4257Replacement lens shield cartridge for use with laser skin piercing device, each
- A4259Lancets, per box of 100
- A4261Cervical cap for contraceptive use
- A4262Temporary, absorbable lacrimal duct implant, each
- A4263Permanent, long term, non-dissolvable lacrimal duct implant, each
- A4264Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
- A4265Paraffin, per pound
- A4266Diaphragm for contraceptive use
- A4267Contraceptive supply, condom, male, each
Questions about A4258
What is HCPCS code A4258?
A4258 is a HCPCS Level II code for spring-powered device for lancet, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4258?
The CMS HCPCS file marks A4258 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is A4258 paid under the physician fee schedule?
A4258 carries PFS status code P. Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.