A4520 HCPCS code: Incontinence garment, any type, (e.g., brief, diaper), each
A4520 is the HCPCS Level II code for incontinence garment, any type, (e.g., brief, diaper), each. Its Medicare coverage code is M (Non-covered by Medicare): Medicare does not cover this item or service.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | M — Non-covered by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | D1A — Medical/surgical supplies |
| Added | 2005-01-01 |
| Last action effective | 2005-01-01 |
Related codes Medicare does pay
Medicare does not pay under A4520. These codes in the same A45 family carry a current DMEPOS fee:
- A4541 — Monthly supplies for use of device coded at e0733: $40.40–$49.25
- A4542 — Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist: $526.85–$526.85
- A4544 — Electrode for external lower extremity nerve stimulator for restless legs syndrome: $6.34–$6.34
- A4545 — Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month: $38.21–$55.51
Medicare policy articles for this code
- A52521: Urological Supplies - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A54516: Bowel Management Devices - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (1 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| N39.3 | Stress incontinence (female) (male) | 1 |
What changed for A4520
- 2005-01-01: A4520 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A4520?
A4520 is the HCPCS Level II code for incontinence garment, any type, (e.g., brief, diaper), each. Short descriptor: "Incontinence garment anytype".
Does Medicare cover A4520?
Coverage code M — Non-covered by Medicare. Medicare does not cover this item or service.
Which related codes does Medicare pay instead of A4520?
Codes in the same A45 family with a DMEPOS fee include A4541 ($40.40–$49.25), A4542 ($526.85–$526.85), A4544 ($6.34–$6.34). Check the item matches the code's descriptor before billing.
Which diagnoses support coverage for A4520?
Medicare policy articles that cite A4520 list 1 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include N39.3 (Stress incontinence (female) (male)). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Related A45 codes
- A4500 — Surgical stockings below knee length, each
- A4510 — Surgical stockings full length, each
- A4540 — Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
- A4541 — Monthly supplies for use of device coded at e0733 ($40.40–$49.25)
- A4542 — Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist ($526.85–$526.85)
- A4543 — Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month
- A4544 — Electrode for external lower extremity nerve stimulator for restless legs syndrome ($6.34–$6.34)
- A4545 — Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month ($38.21–$55.51)
- A4550 — Surgical trays
- A4553 — Non-disposable underpads, all sizes
- A4554 — Disposable underpads, all sizes
- A4555 — Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under A4520
- Watch A4520 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4520
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.