HCPCS Code Details - A4390

HCPCS Level II Code
Transportation Services Including Ambulance, Medical & Surgical Supplies
HCPCS Code A4390
Description

Long description:
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each

Short description:
Drainable pch ex wear convex

HCPCS Modifier1
HCPCS Pricing indicator 37 - Ostomy, tracheostomy and urological supplies (price subject to floors and ceilings)
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code D - Special coverage instructions apply
BETOS2 code D1F - Prosthetic/Orthotic devices
HCPCS Action code N - No maintenance for this code
Type of service P - Lump sum purchase of DME, prosthetics, orthotics
Effective date Effective Jan 01, 2003
Date added Added Jan 01, 2000
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

See also

  • HCPCS A4375 · Ostomy pouch, drainable, with faceplate attached, plastic, each

  • HCPCS A4376 · Ostomy pouch, drainable, with faceplate attached, rubber, each

  • HCPCS A4377 · Ostomy pouch, drainable, for use on faceplate, plastic, each

  • HCPCS A4378 · Ostomy pouch, drainable, for use on faceplate, rubber, each

  • HCPCS A4388 · Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each

  • HCPCS A4389 · Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each

  • HCPCS A4412 · Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each

  • HCPCS A4413 · Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each

  • HCPCS A4424 · Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each

  • HCPCS A4435 · Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each

  • HCPCS A5056 · Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each

  • HCPCS A5057 · Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each

  • HCPCS A4391 · Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”