Summary & Overview
HCPCS A4383: Urinary Ostomy Pouch for Faceplate, Rubber
HCPCS Level II code A4383 denotes a rubber urinary ostomy pouch designed for attachment to a faceplate and billed per pouch. These ostomy appliances are a routine durable medical supply for patients with urostomies and are important for continence management, infection prevention, and quality of life. National reimbursement and coverage for ostomy supplies affect access and out-of-pocket costs for a growing population of patients living with urinary diversions.
Key payers considered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the code, typical service setting, and expected use. The publication provides benchmarking context where available, summarizes coverage considerations across major payers, and outlines clinical context relevant to billing and supply provision. Policy updates that influence durable medical equipment coverage and documentation expectations are discussed in general terms.
This resource is intended for billing managers, clinicians who coordinate ostomy care, and policy analysts seeking a clear reference for HCPCS Level II code A4383 and its role in outpatient and home-based ostomy supply provision. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A4383 describes an ostomy pouch, urinary, for use on faceplate, rubber, each. This item is a single-use urinary ostomy pouch designed to attach to a faceplate and is typically supplied as durable medical equipment for patients with a urostomy.
Service type: Durable medical supply / ostomy appliance
Typical site of service: Home use or outpatient setting where ostomy supplies are provided, including home health supply delivery and outpatient durable medical equipment distribution.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a permanent urinary stoma (urostomy) following cystectomy or other urinary diversion. The patient presents to an outpatient wound/ostomy clinic or home health nurse visit for routine supply resupply and inspection of the stoma and peristomal skin. The clinician selects a A4383 ostomy pouch — a rubber urinary pouch designed to attach to a faceplate — to replace a soiled or leaking appliance. Workflow: triage by nursing, removal and inspection of the existing pouch and faceplate, cleansing of the stoma and peristomal skin, measurement and adjustment of the faceplate opening, application of the new A4383 pouch, and patient education on appliance care and leakage prevention. Typical settings include outpatient ostomy/wound clinics, home health visits, and durable medical equipment dispensing sites.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies for suppliers reporting HCPCS Level II. |
11 |