A4391 – Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each
HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
HCPCS codeA4391
- Long description
- Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each
- Short description
- Urinary pouch w ex wear barr
- Pricing indicator
37Ostomy, tracheostomy and urological supplies- Medicare coverage
DSpecial coverage instructions apply- BETOS category
D1FProsthetic/Orthotic devices- Added
- January 1, 2000
- Last change
- January 1, 2003 – No change
Frequently asked questions
What is HCPCS code A4391?
A4391 is a HCPCS Level II code for ostomy pouch, urinary, with extended wear barrier attached (1 piece), each.
Does Medicare cover A4391?
The HCPCS file lists coverage code D: Special coverage instructions apply. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby A codes
- A4382 – Ostomy pouch, urinary, for use on faceplate, heavy plastic, each
- A4383 – Ostomy pouch, urinary, for use on faceplate, rubber, each
- A4384 – Ostomy faceplate equivalent, silicone ring, each
- A4385 – Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each
- A4387 – Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each
- A4388 – Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each
- A4389 – Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each
- A4390 – Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each
- A4392 – Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each
- A4393 – Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each
- A4394 – Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce
- A4395 – Ostomy deodorant for use in ostomy pouch, solid, per tablet
- A4396 – Ostomy belt with peristomal hernia support
- A4397 – Irrigation supply; sleeve, each
- A4398 – Ostomy irrigation supply; bag, each
- A4399 – Ostomy irrigation supply; cone/catheter, with or without brush
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.