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2025 HCPCS code A4218

10 ml of sterile saline or water using a metered dose dispenser with an inhaler for inhalation medications.

Follow HCPCS coding guidelines for supplies and the specific instructions for the relevant inhalation medication.

Modifiers may apply depending on the circumstances of service. Consult the HCPCS manual and payer-specific guidelines for modifier application.

Medical necessity is established by the diagnosis of a respiratory condition requiring the use of inhaled medications, and the use of a metered dose dispenser with sterile saline or water to aid in medication delivery and improve effectiveness.

The provider administers the saline or water solution using the metered dose dispenser in conjunction with the inhaler medication.

IMPORTANT:A4217 (Sterile water or saline, 500 ml) may be used if the patient receives 500 ml of sterile water or saline.

In simple words: This code covers using a special device to give a patient 10 milliliters of sterile saline or water along with their inhaler medicine. This helps the medicine work better.

Reports the administration of 10 ml of sterile saline or water, via a metered dose dispenser, used in conjunction with an inhaler to deliver inhalation medications to patients with respiratory conditions.The metered dose dispenser helps accurately dispense the solution, diluting the medication for easier aerosol delivery.

Example 1: A patient with asthma is prescribed an inhaler medication. The physician uses code A4218 to bill for the 10ml of sterile saline solution used with the metered dose inhaler to administer the medication., A patient with COPD is given an albuterol nebulizer treatment and the physician uses code A4218 to bill for 10ml of sterile saline solution used in the nebulizer., A patient with cystic fibrosis receives a combination of inhaled medications using a metered dose inhaler and the physician bills for 10ml of sterile water used with the inhaler.

Documentation should include the diagnosis supporting medical necessity, the type and amount of saline or water dispensed, the method of administration (metered dose dispenser), and the specific medication used with the solution.

** This code should only be used when 10 ml of sterile saline or water is used with a metered dose inhaler. If a different volume is used, a different HCPCS code may be appropriate.Always refer to the most current HCPCS codebook.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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