A4264 Permanent implantable contraceptive intratubal occlusion device(s) and delivery system

Billable / valid for submission HCPCS Release 2026Q3

Short description: Intratubal occlusion device

Version history

Related codes in A42

• A4206 Syringe with needle, sterile, 1 cc or less, each
• A4207 Syringe with needle, sterile 2 cc, each
• A4208 Syringe with needle, sterile 3 cc, each
• A4209 Syringe with needle, sterile 5 cc or greater, each
• A4210 Needle-free injection device, each
• A4211 Supplies for self-administered injections
• A4212 Non-coring needle or stylet with or without catheter
• A4213 Syringe, sterile, 20 cc or greater, each
• A4215 Needle, sterile, any size, each
• A4216 Sterile water, saline and/or dextrose, diluent/flush, 10 ml
• A4217 Sterile water/saline, 500 ml
• A4218 Sterile saline or water, metered dose dispenser, 10 ml
• A4220 Refill kit for implantable infusion pump
• A4221 Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)
• A4222 Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)
• A4223 Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
• A4224 Supplies for maintenance of insulin infusion catheter, per week
• A4225 Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
• A4226 Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week
• A4230 Infusion set for external insulin pump, non needle cannula type

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