This section covers a wide variety of medical and surgical supplies, as well as some DME-related supplies and accessories. Medicare generally covers DME-related supplies, accessories, maintenance, and repair under the prosthetic devices provision.


  • A4424

    Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each
  • A4425

    Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each
  • A4426

    Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each
  • A4427

    Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each
  • A4428

    Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each
  • A4429

    Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
  • A4430

    Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
  • A4431

    Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each
  • A4432

    Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each
  • A4433

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


  • Continued
  • A4434

    Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each
  • A4435

    Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each
  • A4436

    Irrigation supply; sleeve, reusable, per month
  • A4437

    Irrigation supply; sleeve, disposable, per month
  • A4438

    Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
  • A4450

    Tape, non-waterproof, per 18 square inches
  • A4452

    Tape, waterproof, per 18 square inches
  • A4453

    Rectal catheter with or without balloon, for use with any type transanal irrigation system, each
  • A4455

    Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
  • A4456

    Adhesive remover, wipes, any type, each
  • A4457

    Enema tube, with or without adapter, any type, replacement only, each
  • A4458

    Enema bag with tubing, reusable
  • A4459

    Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type
  • A4461

    Surgical dressing holder, non-reusable, each
  • A4463

    Surgical dressing holder, reusable, each
  • A4465

    Non-elastic binder for extremity
  • A4466

    Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each
  • A4467

    Belt, strap, sleeve, garment, or covering, any type
  • A4468

    Exsufflation belt, includes all supplies and accessories
  • A4470

    Gravlee jet washer


  • Continued
  • A4479

    Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type   New
  • A4480

    Vabra aspirator
  • A4481

    Tracheostoma filter, any type, any size, each
  • A4483

    Moisture exchanger, disposable, for use with invasive mechanical ventilation
  • A4490

    Surgical stockings above knee length, each
  • A4495

    Surgical stockings thigh length, each
  • A4500

    Surgical stockings below knee length, each
  • A4510

    Surgical stockings full length, each
  • A4520

    Incontinence garment, any type, (e.g., brief, diaper), each
  • A4540

    Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
  • A4541

    Monthly supplies for use of device coded at e0733
  • A4542

    Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
  • A4543

    Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month
  • A4544

    Electrode for external lower extremity nerve stimulator for restless legs syndrome
  • A4545

    Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month
  • A4550

    Surgical trays
  • A4553

    Non-disposable underpads, all sizes
  • A4554

    Disposable underpads, all sizes
  • A4555

    Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only
  • A4556

    Electrodes, (e.g., apnea monitor), per pair