HCPCS Code A4648: Tissue Marker, Implantable, Any Type, Each

Guidance on billing HCPCS code A4648 for implantable tissue markers, including documentation and Medicare billing requirements.

Use Code

Frequently asked questions

No. In hospital settings under OPPS/IPPS or in ASCs, A4648 (tissue marker, implantable, any type, each) is bundled and not separately payable to the facility. It is maintained by CMS and falls under packaged supply codes. Only physicians billing in non-facility settings (e.g., office) may bill code A4648 for tissue separately, and only when paired with qualifying CPT placement codes.

The claim will be denied. Medicare requires linkage with a qualifying CPT code (e.g., 55876, 32553, 49411). If billed alone, denials typically cite Claim Adjustment Reason Code B15 (“service requires qualifying service”) and MSN message 21.21 (“denied because only covered under certain circumstances”). This reinforces that appropriate diagnosis codes and procedure codes must always be present.

Yes. Medicare may determine payment for A4648 based on submitted invoice documentation to establish cost, particularly under the Outpatient Prospective Payment System (OPPS).