Altered Ostomy HCPCS Codes
I've just become aware of a change which affects many ostomates in the United States, although I haven't seen it publicized. On Jan 1, 2000 (roughly a year ago), new HCPCS codes were assigned for a number of commonly used ostomy supplies.
"HCPCS" (sometimes pronounced "hick-picks") stands for "HCFA Common Procedure Coding System" and refers to codes which the providers of ostomy supplies must specify when filing for reimbursement by Medicare or any other Insurance carrier.
I've noticed that insurance reimbursements for some of my ostomy supply purchases during 2nd half of 2000 weren't quite right. I also discovered that my ostomy supply provider was still using old HCPCS codes when filing insurance paperwork. Possibly, the incorrect reimbursements resulted from use of the old codes.
The table below displays old and new codes for a number of ostomy product categories, according to information downloaded from HCFA at www.hcfa.gov. The "K" codes for many ostomy supplies have been replaced with "A" codes. If you use any products in this table, and if your ostomy supply purchases are covered by any sort of insurance, make sure your supplier has the up-to-date HCPCS codes.
|K0137||A4369||Skin barrier, liquid.|
|K0138||A4370||Skin barrier, paste.|
|K0139||A4371||Skin barrier, powder.|
|K0278||A4373||2-piece flange with standard-wear barrier, built-in convexity.|
|K0279||A4374||2-piece flange with extended-wear barrier, built-in convexity.|
|K0430||A4386||2-piece flange with extended-wear barrier, no convexity.|
|K0431||A4387||1-piece closed pouch, standard-wear barrier, built-in convexity.|
|K0432||A4388||1-piece drainable pouch, extended-wear barrier, no convexity.|
|K0433||A4389||1-piece drainable pouch, standard-wear barrier, built-in convexity.|
|K0434||A4390||1-piece drainable pouch, extended-wear barrier, built-in convexity.|
|K0435||A4391||1-piece urinary pouch, extended-wear barrier, no convexity.|
|K0436||A4392||1-piece urinary pouch, standard-wear barrier, built-in convexity.|
|K0437||A4393||1-piece urinary pouch, extended-wear barrier, built-in convexity.|
|K0438||A4394||Deodorant for ostomy pouch, liquid.|
|K0439||A4395||Deodorant for ostomy pouch, solid.|
Note: "Extended-wear" barriers refer primarily to Hollister Flextend and ConvaTec Durahesive materials. So far as I know, all other ostomy skin barriers are considered "standard-wear."
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Content last revised 2001-01-01