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2025 HCPCS code A4206

Sterile syringe with needle, 1 cc or less, each.

Follow all payer-specific guidelines and coding conventions. The HCPCS code should be used correctly, and the documentation must fully support medical necessity.

Modifiers may be applicable depending on the circumstances of the service.Consult your payer's guidelines.

Medical necessity for the procedure (injection) and the medication administered must be documented, demonstrating that the injection was clinically indicated and appropriate for the patient's condition.The necessity should align with the payer's medical policies and guidelines.

The physician or other qualified healthcare provider is responsible for administering the injection using this syringe and needle. This includes selecting the appropriate medication, determining the correct dosage, selecting the injection site, and administering the injection using aseptic technique.

IMPORTANT For larger syringes, consider A4207 (2 cc), A4208 (3 cc), A4209 (5 cc or greater), or A4213 (20 cc or greater).A4215 codes a sterile needle separately.

In simple words: This code is for a small, sterile syringe and needle used for giving injections.Doctors use it for shots in areas like the arm.

This HCPCS code represents a single, sterile syringe with an attached needle, having a volume capacity of one cubic centimeter or less.It is used for injecting or withdrawing small volumes of fluids. The provider may use this for injecting medications into smaller areas, such as the patient's forearm, or for infusing solutions directly into the bloodstream or body tissue for faster action compared to oral administration.

Example 1: A patient presents with a localized infection requiring intramuscular antibiotic injection. The physician uses code A4206 for the 1cc syringe and needle to administer the medication., During a routine physical examination, a patient requires a subcutaneous injection of a vaccination. The nurse uses code A4206 to bill for the syringe and needle used to deliver the vaccine., In an emergency room setting, a patient needs an intravenous injection of a medication. The physician uses A4206 to bill for the syringe and needle used to prepare and administer the medication intravenously.

* Documentation of the medication administered.* Dosage of the medication.* Route of administration (e.g., intramuscular, subcutaneous, intravenous).* Injection site.* Date and time of administration.* Physician's signature or electronic signature.

** Always verify the specific requirements of your payer for billing this code.The specific requirements for documentation and medical necessity can vary between payers and may also depend on the specific medication or treatment.

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

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