Summary & Overview
HCPCS Level II A4369: Ostomy Skin Barrier, Liquid (per oz)
HCPCS Level II code A4369 denotes a liquid ostomy skin barrier (spray, brush, etc.), billed per ounce. This supply item is central to ostomy care, protecting peristomal skin from irritation and breakdown, and supporting pouch adhesion and wear time. Nationally, ostomy supplies are a consistent component of durable medical equipment and home health benefit management, affecting patients with fecal or urinary ostomies and payers that cover ostomy-related supplies.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical role and typical sites of service, plus what to expect when evaluating coverage and billing for liquid skin barrier products. The publication also outlines common billing considerations, typical utilization contexts, and related supply categories.
This summary prepares clinicians, billing staff, and policy analysts to understand where A4369 fits in ostomy supply catalogs, how it is used in outpatient and home settings, and which payers commonly manage coverage for these items. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A4369 describes an ostomy skin barrier, liquid (spray, brush, etc.), per oz. This code covers liquid-form skin barrier products used to protect peristomal skin from effluent and adhesives.
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Service type: Ostomy supply skin protection — liquid barrier application
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Typical site of service: Durable medical equipment and supply settings, outpatient clinics, home health care, and patient self-care at home
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a permanent or temporary ostomy (colostomy, ileostomy, or urostomy) who requires ostomy appliance care and peristomal skin protection. The clinician (wound, ostomy, and continence nurse or home health nurse) evaluates the peristomal skin during a dressing change or ostomy pouch change, identifies irritation or difficulty maintaining an adequate seal, and applies an ostomy skin barrier in a liquid formulation (A4369) to create a thin protective film over the skin or to improve adhesion of an ostomy wafer. The workflow: assessment of stoma and peristomal skin, cleansing and drying the skin, measurement of stoma, optional application of paste or barrier ring, then application of the liquid barrier spray/brush by the nurse or patient caregiver in a clinic, home health visit, or outpatient wound/ostomy clinic. Typical sites of service include outpatient wound/ostomy clinics, home health visits, long-term care facilities, and outpatient surgical clinics. Supplies are billed per ounce of product used and documented by product volume applied and clinical indication (e.g., peristomal dermatitis, frequent pouch leakage, fragile skin).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier information | Rarely used; default when no modifier applies |