A4458 — Enema bag with tubing, reusable
A4458 is a HCPCS Level II code for enema bag with tubing, reusable. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A4458 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · Published Contractor Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A4458
- Long descriptor
- Enema bag with tubing, reusable
- Short descriptor
- Reusable enema bag
- Added
- January 1, 2003
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to A4458
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4458 is not quite right, the correct code is very often within a few positions of it.
- A4437Irrigation supply; sleeve, disposable, per month
- A4438Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
- A4450Tape, non-waterproof, per 18 square inches
- A4452Tape, waterproof, per 18 square inches
- A4453Rectal catheter with or without balloon, for use with any type transanal irrigation system, each
- A4455Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
- A4456Adhesive remover, wipes, any type, each
- A4457Enema tube, with or without adapter, any type, replacement only, each
- A4459Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type
- A4461Surgical dressing holder, non-reusable, each
- A4463Surgical dressing holder, reusable, each
- A4465Non-elastic binder for extremity
- A4466Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, eachterminated
- A4467Belt, strap, sleeve, garment, or covering, any type
- A4468Exsufflation belt, includes all supplies and accessories
- A4470Gravlee jet washer
Questions about A4458
What is HCPCS code A4458?
A4458 is a HCPCS Level II code for enema bag with tubing, reusable. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4458?
The CMS HCPCS file marks A4458 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A4458 paid under the physician fee schedule?
A4458 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.