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A4728 Dialysate solution, non-dex

A Codes

Also known as: non-dextrose dialysate, glucose-free solution, zero-dex solution

Dialysate solution specifically formulated without dextrose (glucose), used for peritoneal dialysis in patients requiring dialysate-free periods or with glucose intolerance.

In Plain Language

dialysis fluid without sugar; special dialysate without dextrose

Clinical Context

Used in peritoneal dialysis protocols allowing periods without glucose-based osmotic agents. May be used for specific exchanges or in alternating regimens.

RVU Information

CPT A4728 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

NephrologyDialysis

Frequently Asked Questions

What is CPT code A4728?

CPT A4728 (Dialysate solution, non-dex) is a A Codes code. Dialysate solution specifically formulated without dextrose (glucose), used for peritoneal dialysis in patients requiring dialysate-free periods or with glucose intolerance.

Does Medicare cover A4728?

Medicare coverage for A4728 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Used in peritoneal dialysis protocols allowing periods without glucose-based osmotic agents. May be used for specific exchanges or in alternating regimens. A physician order is typically required.

When is CPT A4728 used?

Used in peritoneal dialysis protocols allowing periods without glucose-based osmotic agents. May be used for specific exchanges or in alternating regimens.

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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.