A4267 Male condom
Also known as: condom, prophylactic, male sheath
Male condom, a latex, polyisoprene, or polyurethane sheath worn over the penis during sexual intercourse to prevent pregnancy and sexually transmitted infections.
In Plain Language
protection during sex; birth control and disease prevention
Clinical Context
Widely used for contraception and STI prevention. Recommended as first-line protection against sexually transmitted infections. Often provided in healthcare settings.
RVU Information
CPT A4267 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 A4267?
CPT A4267 (Male condom) is a A Codes code. Male condom, a latex, polyisoprene, or polyurethane sheath worn over the penis during sexual intercourse to prevent pregnancy and sexually transmitted infections.
Does Medicare cover A4267?
Medicare coverage for A4267 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Widely used for contraception and STI prevention. Recommended as first-line protection against sexually transmitted infections. Often provided in healthcare settings. A physician order is typically required.
When is CPT A4267 used?
Widely used for contraception and STI prevention. Recommended as first-line protection against sexually transmitted infections. Often provided in healthcare settings.
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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.