HCPCS Code A4927: Non-sterile gloves billing guide

Key Takeaways

HCPCS Code A4927 describes gloves, non-sterile, per 100, classified under Dialysis Equipment and Supplies by CMS.

Coverage Code D means special coverage instructions apply; Medicare does not automatically reimburse A4927 without LCD verification.

The VA Community Care fee schedule sets reimbursement at $15.57 per 100 gloves; Medicare rates vary by DME MAC jurisdiction.

Pabau’s claims management software helps dialysis and ESRD facilities track supply billing codes and reduce A4927 claim errors.

HCPCS code A4927: Definition, coverage, and billing requirements

HCPCS Code A4927 describes gloves, non-sterile, per 100, classified under Dialysis Equipment and Supplies in CMS’s HCPCS Level II code set. Coverage Code D flags this code for special coverage instructions that vary by payer and jurisdiction — meaning LCD verification is required before billing, and quantity units must be applied precisely.

This guide covers the code properties, Medicare coverage rules, VA reimbursement rate, modifiers, related codes, and documentation requirements for claims management workflows involving A4927.

A4927 code properties

HCPCS Code A4927 has been active since January 1, 1986, one of the longer-standing supply codes in the HCPCS Level II set. Its Action Code is N (no maintenance for this code), with an Action Effective Date of January 1, 2015, meaning CMS requires no active maintenance or annual updates.

The Coverage Code D signals that special coverage instructions apply, so billers must not assume blanket Medicare coverage without first consulting the applicable Local Coverage Determination.

The code is classified as a medical and surgical supply, specifically within the dialysis supplies subcategory maintained by the Centers for Medicare and Medicaid Services. While its primary home is the dialysis context, A4927 can appear on claims for other settings where non-sterile examination gloves are a separately billable supply, subject to payer LCD policies.

Medicare coverage for A4927

Coverage Code D means reimbursement depends on local coverage determinations set by each DME MAC (Durable Medical Equipment Medicare Administrative Contractor), with policies that differ by jurisdiction rather than a blanket denial.

A facility in one region may receive approval under a specific LCD that a facility in another region does not. Always verify the applicable DME MAC LCD before submitting claims, and document the clinical necessity that satisfies the local policy.

For ESRD and dialysis facilities, non-sterile gloves are a recognized consumable supply category. However, glove costs may be bundled into the ESRD prospective payment system rate rather than billed separately.

This bundling distinction is critical: billing A4927 as a separate line item when gloves are already included in a bundled facility payment creates an overpayment risk. Confirm with your DME MAC whether gloves remain separately billable under your facility’s payment structure before each billing cycle.

National Coverage Determination policies from CMS do not specifically address A4927 as of current guidance, which places the determination entirely at the local level. Review the HIPAA compliance checklist for your practice type alongside the applicable LCD to ensure documentation standards align with both regulatory layers.

VA and payer reimbursement rates for A4927

The VA Community Care Outpatient fee schedule (v3-25, Table K) sets the reimbursement rate for HCPCS Code A4927 at $15.57 per 100 non-sterile gloves. This is a verified current figure for VA Community Care claims. For comparison, the same schedule lists A4930 (sterile gloves, per pair) at $2.66 and A4928 (surgical mask, per 20) at $1.19.

Medicare reimbursement rates through the Physician Fee Schedule or DME fee schedule are jurisdiction-dependent and subject to annual CMS updates. Check the current DME fee schedule directly on cms.gov for A4927 rates by year and locality, rather than third-party lookup tools, since those can lag official updates.

Always use the current year’s published CMS fee schedule, not historical rates, when submitting claims.

Commercial payers set their own contracted rates separately from Medicare. If your facility is contracted with a commercial insurer, the allowable for A4927 will appear in your provider agreement or through the payer’s online fee schedule portal. Rate verification before billing prevents write-offs from under-estimation and prevents audit flags from over-billing.

Modifiers and billing requirements

HCPCS Level II supply codes like A4927 use modifiers less frequently than procedure codes, but several modifier scenarios apply in specific circumstances.

• Modifier NU (new equipment): Distinguishes a new purchase from a rental for durable equipment codes. A4927 is a consumable supply with no rental-vs-purchase distinction, so NU — like RR — generally does not apply; confirm modifier requirements against the applicable DME MAC LCD rather than defaulting to NU.
• Modifier KX: Used when the supplier attests that requirements specified in the applicable LCD have been met. If your DME MAC LCD for dialysis supplies requires KX to confirm medical necessity documentation is on file, omitting it will result in automatic denial.
• Modifier GY: Applied when billing for a non-covered item or service that the patient has agreed to pay out of pocket. If Medicare has determined A4927 is not covered in a specific clinical context, GY triggers the payer’s notice-of-exclusion process.
• Modifier GZ: Signals that the item is expected to be denied as not medically necessary. Use this modifier when submitting a claim you expect to be denied, to preserve appeal rights.
• Modifier RR (rental): Not applicable for single-use supply codes like A4927. Non-sterile gloves are consumable supplies, not rental items.

For the most current modifier guidance specific to HCPCS Level II supply codes, consult the AAPC HCPCS code reference or your DME MAC’s billing manual. Modifier policies are updated annually, and an incorrect modifier can be harder to correct post-submission than a missing one.

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A4927 vs A4930 and related HCPCS codes

The most common coding confusion in glove billing is between A4927 and A4930. They describe different products and use different quantity units, which means mixing them up creates claim errors that are detectable on audit.

The unit distinction between A4927 and A4930 is the billing-critical difference. A4927 bills per 100 gloves, so the number of units on a claim represents boxes of 100.

A4930 bills per pair, meaning each unit on the claim represents two gloves. Billing A4930 quantities using A4927’s per-100 logic, or vice versa, produces a quantity mismatch that payers flag for medical review or automatic denial.

When to use each: non-sterile gloves in a dialysis or general examination setting belong under A4927. When a procedure requires a sterile field, such as wound care or minor surgical intervention, A4930 is the correct code. The clinical record must support the glove type billed.

Tracking these supply code distinctions across a multi-location practice is where automated billing workflows reduce exposure. Each code type, quantity unit, and applicable modifier can be mapped to the correct supply at the point of clinical documentation, reducing the manual lookup burden on billing staff.

For providers also managing wearable defibrillator and durable medical equipment codes alongside HCPCS supply codes, keeping supply and procedure billing separated prevents cross-code contamination on claims.

Documentation requirements and ICD-10 pairing for A4927

Documentation for supply codes requires proof that the supply was medically necessary and actually provided. For HCPCS Code A4927, the clinical record should capture three things: the patient’s diagnosis or condition requiring the use of non-sterile gloves, the quantity of gloves provided or used during the covered service period, and the care setting (dialysis, ESRD facility, or other qualifying setting).

ICD-10 codes commonly paired with A4927

A4927 does not have a fixed ICD-10 code assignment. Instead, the diagnosis code on the claim reflects the patient’s underlying condition that necessitates the service setting where gloves are used. Common pairings include:

• N18.6 (End-stage renal disease): The most common pairing for A4927 in dialysis facilities. The ESRD diagnosis justifies the dialysis supply category under which A4927 is classified.
• N18.5 (Chronic kidney disease, stage 5): Used when the patient is CKD stage 5 but not yet classified as ESRD. Facilities treating stage 5 CKD patients on dialysis frequently use this pairing.
• Z49.01 (Encounter for fitting and adjustment of extracorporeal dialysis catheter): Applicable when the encounter specifically involves dialysis access management, with gloves as a supply item.
• Z99.2 (Dependence on renal dialysis): Captures ongoing dialysis dependence as a chronic condition, suitable for recurring supply billing.

The ICD-10 code on the claim must be the most specific code that reflects the documented clinical condition. Unspecified codes are frequently challenged by DME MACs on audit. If the patient’s record documents ESRD (N18.6), billing with the less specific N18.9 (chronic kidney disease, unspecified) delays payment and invites review.

Good clinical documentation starts with structured clinical forms that capture the diagnosis, care setting, and supply quantities at the point of service. When this information flows directly from the clinical encounter into the billing record, the pairing accuracy between diagnosis codes and supply codes improves.

For dialysis facilities managing HIPAA compliance for medical offices alongside CMS supply billing rules, consistent documentation across both frameworks is not optional.

Claim submission workflow for A4927

Billing A4927 on a CMS-1500 or electronic 837P claim follows the same structure as other HCPCS Level II supply codes. The steps below cover the critical fields that affect payment.

1. Verify LCD coverage: Confirm the applicable DME MAC LCD covers A4927 for your facility type and patient’s diagnosis. Document the LCD number in the billing record.
2. Confirm bundling status: For ESRD facilities, check whether the current payment cycle includes gloves in the bundled rate. If bundled, do not bill A4927 separately.
3. Enter the correct quantity: A4927 bills per 100 gloves. One unit = 100 gloves. Three boxes of 100 gloves = 3 units. Never bill in individual gloves or pairs.
4. Apply the correct modifier: A4927 is a consumable supply code, so NU (like RR) generally does not apply. Check the applicable DME MAC LCD for modifier requirements: KX if it requires attestation of medical necessity on file, or GY/GZ for non-covered scenarios.
5. Assign the ICD-10 code: Use the most specific diagnosis code documented in the clinical record (typically N18.6 for ESRD settings).
6. Submit and track: Log the claim date, payer, and expected response window. Set a follow-up task at the denial threshold date to catch rejections before they age past the appeal window.

Using practice management software that captures supply code billing at the point of clinical documentation shortens the path from patient encounter to clean claim submission. For facilities regularly billing dialysis supplies alongside other procedure codes, a shared platform for digital intake forms and billing workflows reduces the manual data entry that introduces quantity and code errors.

Related supply codes such as the nebulizer with compressor (E0570) and raised toilet seat (E0244) follow similar per-unit billing logic and can be managed alongside A4927 in integrated billing systems.

Common A4927 billing errors and how to avoid them

The most frequent A4927 claim denials follow predictable patterns. Knowing them in advance is faster than learning them through remittance advice.

Each of these errors shares a common root cause: supply type, quantity, and clinical context are captured separately from the billing workflow. When supply requisition data feeds directly into claim submission through an integrated system, quantity and code mismatches are caught before submission.

For facilities also managing paperless clinical documentation, an integrated approach also prevents a paper supply log from contradicting the electronic claim. Providers billing HCPCS drug or injection codes alongside supplies — such as abobotulinumtoxinA (J0586) or durvalumab (J9173) — benefit from a unified workflow that tracks both supply and drug claim lines in a single system.

Facilities using digital patient assessment tools as part of intake can further integrate clinical data capture with billing, reducing transcription errors.

For additional reference on HCPCS Level II coding structure and annual updates, the Medicare Informatics HCPCS tables provide current code status information sourced from CMS data files. Cross-reference any code before billing to confirm it remains active and unretired.

Summary

HCPCS Code A4927 requires per-100 quantity discipline, LCD verification before each billing cycle, and precise ICD-10 pairing — particularly for dialysis facilities where the ESRD prospective payment system can bundle supply costs into the facility rate.

Pabau’s claims management software helps healthcare facilities map supply codes to clinical encounters, apply the correct modifiers, and track claim outcomes, reducing the manual errors that generate A4927 denials.

Providers seeking additional HCPCS Level II orthotic and DME billing references may also find the knee orthosis (L1845) billing guide and the bath tub wall rail (E0241) guide useful companion references for DME supply coding. To see how Pabau handles supply billing across dialysis and clinical settings, book a demo.

Continue your research

Managing multiple HCPCS supply codes across locations? Multi-location management tools keep billing consistent across sites.

Need structured clinical documentation to support supply billing? Clinical documentation software explains how structured data capture improves billing accuracy.

Billing other HCPCS procedure codes alongside supply codes? Coaching CPT codes is a reference example for navigating HCPCS Level II and CPT code distinctions in multi-code billing environments.

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