A5054 – Ostomy pouch, closed; for use on barrier with flange (2 piece), each

Long description

Ostomy pouch, closed; for use on barrier with flange (2 piece), each

Short description

Clsd ostomy pouch w/flange

Pricing indicator

37 Ostomy, tracheostomy and urological supplies

Medicare coverage

D Special coverage instructions apply

BETOS category

D1F Prosthetic/Orthotic devices

Added

January 1, 1990

Last change

January 1, 2003 – No change

Nearby A codes

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• A5051 – Ostomy pouch, closed; with barrier attached (1 piece), each
• A5052 – Ostomy pouch, closed; without barrier attached (1 piece), each
• A5053 – Ostomy pouch, closed; for use on faceplate, each
• A5055 – Stoma cap
• A5056 – Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each
• A5057 – Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
• A5061 – Ostomy pouch, drainable; with barrier attached, (1 piece), each
• A5062 – Ostomy pouch, drainable; without barrier attached (1 piece), each
• A5063 – Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each
• A5071 – Ostomy pouch, urinary; with barrier attached (1 piece), each
• A5072 – Ostomy pouch, urinary; without barrier attached (1 piece), each