2025 HCPCS code A4426
(Active) Effective Date: N/A Revision Date: N/A Medical Supplies - Ostomy Supplies Medical and Surgical Supplies Feed
Drainable ostomy pouch for use with a barrier and locking flange (2-piece system), each.
Medical necessity is established by the presence of a functioning ostomy requiring a collection system.The documentation should support the need for a drainable pouch and the use of a two-piece system with a locking flange based on the patient's individual needs and clinical condition.
Clinicians providing ostomy care are responsible for selecting and applying appropriate pouching systems for patients based on individual needs, including skin condition and type of ostomy.
- Medical and Surgical Supplies
- A4206-A8004: Ostomy Pouches and Supplies; A4361-A4438: Ostomy Accessories
In simple words: This code covers a type of drainable ostomy bag that is used with a special skin protector. The bag can be emptied without taking it off the skin.
This code represents a drainable ostomy pouch designed for use with a skin barrier that features a locking flange.This two-piece system allows for the pouch to be emptied or changed without removing the barrier from the skin.
Example 1: A patient with a newly created ileostomy requires a two-piece drainable pouch system with a locking flange to ensure secure attachment and ease of emptying., A patient with a colostomy experiences leakage and skin irritation with their current pouching system. They are switched to A4426 to improve the fit and reduce leakage, promoting skin health., A patient with a urostomy prefers a two-piece system that allows for changing the pouch without disturbing the skin barrier. A4426 provides this flexibility and promotes comfort.
Documentation should include the type of ostomy, the specific product used (A4426), and the medical necessity for the device.The patient's skin condition and any related complications should also be documented.
** Medicare guidelines determine the allowable quantity of ostomy supplies based on several factors including ostomy type, location, and the patient's skin condition around the stoma.
- Payment Status: Active