A4266 Diaphragm
Also known as: diaphragm, cervical barrier
Contraceptive diaphragm, a dome-shaped barrier device inserted into the vagina to cover the cervix and prevent sperm from entering the uterus.
In Plain Language
birth control barrier; cervical cap
Clinical Context
Used for contraception in women who prefer non-hormonal methods. Often prescribed during gynecological visits and fitted for proper sizing.
RVU Information
CPT A4266 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
HCPCS A-codes cover medical supplies, equipment, and transport services. Documentation must establish medical necessity and include a physician order. For durable medical equipment (DME), a Certificate of Medical Necessity (CMN) or detailed written order may be required.
Specialties
Frequently Asked Questions
What is CPT code A4266?
CPT A4266 (Diaphragm) is a A Codes code. Contraceptive diaphragm, a dome-shaped barrier device inserted into the vagina to cover the cervix and prevent sperm from entering the uterus.
Does Medicare cover A4266?
Medicare coverage for A4266 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Used for contraception in women who prefer non-hormonal methods. Often prescribed during gynecological visits and fitted for proper sizing. A physician order is typically required.
When is CPT A4266 used?
Used for contraception in women who prefer non-hormonal methods. Often prescribed during gynecological visits and fitted for proper sizing.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.