2025 HCPCS code A4561
(Active) Effective Date: N/A Revision Date: N/A Medical and Surgical Supplies - Various Medical Supplies Including Tapes and Surgical Dressings Medical and Surgical Supplies Feed
Reusable, rubber pessary of any type.
Medical necessity for a pessary is established by documenting the patient's symptoms, physical exam findings (pelvic organ prolapse), and the failure of conservative management, if applicable.
The clinician is responsible for selecting, fitting, and inserting the appropriate pessary for the patient's condition, typically a physician or other qualified healthcare professional.
In simple words: This code covers the cost of a reusable, rubber device inserted into the vagina to support internal organs.
This code represents a reusable pessary made of rubber, used for pelvic organ support.It can be any type of rubber pessary.
Example 1: A 55-year-old woman presents with symptomatic uterine prolapse.A rubber ring pessary (A4561) is fitted and inserted to provide support and alleviate symptoms., A 60-year-old woman with cystocele and rectocele is fitted with a Gellhorn pessary (A4561) to support the vaginal walls and improve bladder and bowel function., Following a hysterectomy, a patient experiences vaginal vault prolapse.A rubber cube pessary (A4561) is inserted to support the vaginal apex.
Documentation should include the type of pessary used, the reason for insertion (diagnosis), the fitting process, and patient education provided.
** Pessaries are considered both a supply and a prosthetic device by Medicare.When billed by a physician's office, they should be billed to the local carrier, not the DME carrier.
- Payment Status: Active
- Specialties:Urogynecology, Obstetrics and Gynecology, Family Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital