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A4391 - Urinary pouch w ex wear barr

Navigation: HCPCS Codes > Codes with Prefix: A4
Field Value
HCPCS Code: A4391
Long Description: Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each
Short Description: Urinary pouch w ex wear barr
Pricing Indicator 1: 37 (Ostomy, tracheostomy and urological supplies (price subject to floors and ceilings))
Multiple Pricing Code: A (Not applicable as HCPCS priced under one methodology)
MCM Reference Section Number 1: 2130
Statute Number:
Coverage Code: D (Special coverage instructions apply)
ASC Payment Group Code:
Processing Note Number:
Berenson-Eggers Type of Service (BETOS) Code: D1F (Orthotic devices)
Type of Service Code 1: P (Lump sum purchase of DME, prosthetics, orthotics)
Anesthesia Base Unit Quality: 0
Code Added: 01-01-2000
Action Effective Date: 01-01-2003
Action Code: N (No maintenance for this code)