## **What is HCPCS code A4351?**
HCPCS code A4351 describes a single-use straight-tip intermittent urinary catheter, available with or without coatings (e.g., hydrophilic silicone, silicone elastomer). It's used for non-reusable, straight-tipped catheters used for self-catheterization.
This device is used by patients with permanent urinary retention, recurrent urinary tract infections, permanent urinary incontinence, neurogenic bladder, or other voiding dysfunctions who require clean intermittent catheterization (CIC).
A4351 covers basic, non-specialty catheters that do not meet criteria for coded alternatives (e.g., coude tip catheter or specialized design).
Do note that changes to HCPCS codes for intermittent catheters with hydrophilic coatings are taking effect on January 1, 2026. At that time, a new code, A4295, will be used specifically for straight-tip catheters with a hydrophilic coating. The description for A4351 will be revised to exclude hydrophilic coatings.
## **A4351 documentation requirements**
To justify payment for items like those covered by A4351, suppliers must meet several documentation requirements, including:
- Standard written order (SWO) from a qualified practitioner, specifying catheter type (straight tip), frequency of use, and rationale (e.g., neurogenic bladder ICD-10 N31.x).
- Patient history of UTIs, bladder dysfunction, or retention should be documented.
- Supplier invoices and delivery records must clearly indicate the quantity of the straight tip urine catheter and the date supplied.
## **A4351 billing requirements**
To ensure proper reimbursement, the following billing requirements must be considered:
- A4351 is billed per catheter supplied, not per use event. A common maximum for A4351 is up to 200 units per month, though the specific number should be based on the frequency prescribed by the physician. The billing should reflect the actual number of catheters used per day as documented in the medical record.
- Claims should include the SWO or prescription, proof of delivery, and rationale for frequency.
- As A4351 falls under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) category, suppliers must comply with competitive bidding or fee schedule pricing limits.
- Specific modifiers may be required for certain services and supplies, such as an "AU" modifier for sterile water or saline used with urological supplies.
The new codes for hydrophilic catheters are set to be effective on January 1, 2026. Suppliers and providers should be aware of this change and ensure they are using the correct codes for services rendered on or after this date. This will also require new written orders for beneficiaries using hydrophilic catheters.
## **Other relevant codes**
- A4352: Intermittent urinary catheter, coude tip, each
- A4332: Catheter lubrication/single-use packet
Frequently asked questions
