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A4725 — Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis

HCPCS Level II A-code · short descriptor: “Dialys sol fld vol > 4999cc”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Special coverage instructions apply
Prior authorization
Not on Medicare required-PA list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Common denial codes to watch

CO-50 medical necessity

Related A-codes

A4706A4707A4708A4709A4714A4719A4720A4721A4722A4723A4724A4726

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