2024 HCPCS Code A5054

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

Short Description	Clsd ostomy pouch w/flange
HCPCS Coverage Code	D - Special coverage instructions apply
HCPCS Action Code	N - No maintenance for this code
HCPCS Action Effective Date	January 01, 2003
HCPCS Code Added Date	January 01, 1990
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 Coverage Issues Manual Reference Section Number
HCPCS Type Of Service Code	P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Anesthesia Base Unit Quantity	0