Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each
Basic Information
| Added: | 1/1/2004 |
| HCPCS Action Effective Date | 1/1/2004 |
| HCPCS Action Code/Description | N / No maintenance for this code |
| Short Description: | Ost pch w bar/bltinconv/fltr |
| Long Description: | Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each |
| Anesthesia Base Unit Quantity | 0 |
Service Code Information
| HCPCS Berenson-Eggers Type Of Service Code/Description: | D1F / Prosthetic/Orthotic devices |
Pricing/Coverage Information
| Coverage Code | C |
| Description | Carrier judgment |
| Pricing Indicator Code #1 | 37 |
| Pricing Indicator Code #1 Description | Ostomy, tracheostomy and urological supplies (price subject to floors and ceilings) |
| Pricing Indicator Code #1 Type | Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings |
| Multi-Pricing Indicator Code | A |
| Description | Not applicable as HCPCS priced under one methodology |
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