MyMedi-AI

A4346 — Indwelling catheter; foley type, three way for continuous irrigation, each

HCPCS Level II A-code · short descriptor: “Cath indw foley 3 way”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Ostomy, tracheostomy & urological supplies
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
3
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

A4346 Medicare fee schedule (October 2026)

Base (no modifier) Ostomy, tracheostomy & urological supplies

Medicare allowable ranges from $23.72 to $29.23 depending on state and rural status.

Former-CBA payment limits: ceiling $27.91 · floor $23.72

StateNon-ruralRural
AK$27.33—
AL$27.91—
AR$23.72—
AZ$27.44—
CA$27.07—
CO$27.91—
CT$27.91—
DC$24.29—
DE$24.29—
FL$27.91—
GA$23.72—
HI$29.23—
IA$27.91—
ID$23.72—
IL$27.91—
IN$27.91—
KS$27.91—
KY$27.91—
LA$27.91—
MA$27.91—
MD$27.62—
ME$23.72—
MI$27.91—
MN$27.91—
MO$23.72—
MS$24.74—
MT$25.42—
NC$23.72—
ND$27.91—
NE$27.91—
NH$23.72—
NJ$24.29—
NM$27.91—
NV$27.44—
NY$25.30—
OH$27.91—
OK$27.91—
OR$27.91—
PA$24.29—
PR$24.64—
RI$23.72—
SC$23.72—
SD$27.91—
TN$27.91—
TX$23.72—
UT$27.91—
VA$27.91—
VI$25.30—
VT$23.72—
WA$23.72—
WI$27.71—
WV$27.91—
WY$27.91—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps A4346 at 3 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Published Contractor Policy.

Common denial codes to watch

Related A-codes

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