2025 HCPCS code A4261
(Active) Effective Date: N/A Revision Date: N/A Medical Supplies - Other Supplies Including Diabetes Supplies and Contraceptives Medical and Surgical Supplies Feed
Supply of a cervical cap for contraception.
Medical necessity is established based on the patient's request and the physician's determination of the suitability of the cervical cap as a birth control option for the patient. This must be documented along with any patient counseling and education.
The clinical responsibility involves providing the patient with a cervical cap for contraceptive purposes, ensuring proper fitting and education on its use.
- Medical and Surgical Supplies
- A4206-A8004 > Other Supplies Including Diabetes Supplies and Contraceptives
In simple words: This code covers the cost of a cervical cap, a small cup-shaped device used by women to prevent pregnancy.It's placed over the cervix to block sperm.
HCPCS code A4261 reports the supply of a cervical cap used as a barrier method of contraception.The cervical cap is a silicone cap that fits over the cervix, preventing sperm from reaching the egg.It's often used with spermicide.
Example 1: A 25-year-old female patient requests a cervical cap as a birth control method. The physician provides the cervical cap and educates the patient on proper insertion and use., A 30-year-old female patient, already using a cervical cap, needs a replacement. The physician supplies the replacement cap and confirms proper fitting., During a routine gynecological check-up, a 28-year-old female patient discusses birth control options. The physician recommends a cervical cap and supplies one after confirming its suitability.
Patient's medical history, including relevant allergies and contraindications; Documentation of the fitting and education provided to the patient on the proper use of the cervical cap; Documentation of the type and quantity of cervical cap supplied.
** Medicare does not typically cover this code.Third-party payer coverage varies; check with the specific payer before billing.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Family Medicine
- Place of Service:Office