A4321 — Therapeutic agent for urinary catheter irrigation
A4321 is a HCPCS Level II code for therapeutic agent for urinary catheter irrigation. 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 statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
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 A4321 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
- 1 unit MAI 3 — Date of Service Edit: Clinical · Code Descriptor / CPT Instruction
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Code Descriptor / CPT Instruction
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · 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 A4321
- Long descriptor
- Therapeutic agent for urinary catheter irrigation
- Short descriptor
- Cath therapeutic irrig agent
- Added
- January 1, 1997
- BETOS
- D1F
- Pricing indicator
- 37 — 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.
Ostomy, tracheostomy and urological supplies. Price subject to floors and ceilings.
Codes adjacent to A4321
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4321 is not quite right, the correct code is very often within a few positions of it.
- A4311Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
- A4312Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone
- A4313Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
- A4314Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
- A4315Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone
- A4316Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
- A4318Female external urinary collection cup, with or without ring attachment, per day
- A4320Irrigation tray with bulb or piston syringe, any purpose
- A4322Irrigation syringe, bulb or piston, each
- A4326Male external catheter with integral collection chamber, any type, each
- A4327Female external urinary collection device; meatal cup, each
- A4328Female external urinary collection device; pouch, each
- A4330Perianal fecal collection pouch with adhesive, each
- A4331Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each
- A4332Lubricant, individual sterile packet, each
- A4333Urinary catheter anchoring device, adhesive skin attachment, each
Questions about A4321
What is HCPCS code A4321?
A4321 is a HCPCS Level II code for therapeutic agent for urinary catheter irrigation. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4321?
The CMS HCPCS file marks A4321 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 A4321 paid under the physician fee schedule?
A4321 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.