A4412 – Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each

HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental

Active code Special coverage instructions apply

HCPCS codeA4412
Long description
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each
Short description
Ost pouch drain high output
Pricing indicator
37 Ostomy, tracheostomy and urological supplies
Medicare coverage
D Special coverage instructions apply
BETOS category
D1F Prosthetic/Orthotic devices
Added
January 1, 2006
Last change
January 1, 2006 – No change

Frequently asked questions

What is HCPCS code A4412?

A4412 is a HCPCS Level II code for ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each.

Does Medicare cover A4412?

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

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.