A5126 – Adhesive or non-adhesive; disk or foam pad
HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
HCPCS codeA5126
- Long description
- Adhesive or non-adhesive; disk or foam pad
- Short description
- Disk/foam pad +or- adhesive
- Pricing indicator
37Ostomy, tracheostomy and urological supplies- Medicare coverage
DSpecial coverage instructions apply- BETOS category
D1FProsthetic/Orthotic devices- Added
- January 1, 1990
- Last change
- January 1, 2000 – No change
Frequently asked questions
What is HCPCS code A5126?
A5126 is a HCPCS Level II code for adhesive or non-adhesive; disk or foam pad.
Does Medicare cover A5126?
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
- A5102 – Bedside drainage bottle with or without tubing, rigid or expandable, each
- A5105 – Urinary suspensory with leg bag, with or without tube, each
- A5112 – Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each
- A5113 – Leg strap; latex, replacement only, per set
- A5114 – Leg strap; foam or fabric, replacement only, per set
- A5120 – Skin barrier, wipes or swabs, each
- A5121 – Skin barrier; solid, 6 x 6 or equivalent, each
- A5122 – Skin barrier; solid, 8 x 8 or equivalent, each
- A5131 – Appliance cleaner, incontinence and ostomy appliances, per 16 oz.
- A5200 – Percutaneous catheter/tube anchoring device, adhesive skin attachment
- A5500 – For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe
- A5501 – For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe
- A5503 – For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe
- A5504 – For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe
- A5505 – For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe
- A5506 – For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.