2021/2022 HCPCS Code A4428

Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each
Short Description Urine ost pouch w faucet/tap
HCPCS Coverage Code C = Carrier judgment
HCPCS Action Code N = No maintenance for this code
HCPCS Action Effective Date January 01, 2004
HCPCS Code Added Date January 01, 2004
HCPCS Pricing Indicator Code 37 = Ostomy, tracheostomy and urological supplies (price subject to floors and ceilings)
HCPCS Multiple Pricing Indicator Code A = Not applicable as HCPCS priced under one methodology
HCPCS Type Of Service Code P = Lump sum purchase of DME, prosthetics, orthotics
HCPCS Anesthesia Base Unit Quantity 0