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2025 HCPCS code A4766

Dialysate concentrate, solution, for peritoneal dialysis, 10 ml

Medical necessity for peritoneal dialysis using dialysate solution must be supported by documentation of the patient's end-stage renal disease (ESRD) and the prescription for the prescribed dialysis regimen.

In simple words: This code represents 10 milliliters of a special fluid concentrate used in peritoneal dialysis. This fluid, called dialysate, is mixed with water and used to clean the blood of patients whose kidneys are not working.

Dialysate concentrate, in solution form, used for peritoneal dialysis, per 10 ml. The provider mixes this liquid concentrate with water before instilling it into the peritoneal cavity.

Example 1: A patient with end-stage renal disease receives 2 liters of dialysate solution for peritoneal dialysis. The solution is prepared from a concentrate, and 200 units of A4766 (10 ml each) would be billed (200 x 10 ml = 2000 ml = 2 liters)., A patient experiences complications during peritoneal dialysis requiring a change in the concentration of the dialysate. The new solution is prepared using the appropriate amount of A4766., A pediatric patient receives a smaller volume of dialysate prepared from concentrate for peritoneal dialysis. The amount of A4766 billed corresponds to the volume of concentrate used.

Documentation should include the total volume of dialysate solution used and the concentration of the dialysate, which allows calculation of the volume of concentrate used and therefore the number of units of A4766 to be billed.

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