Summary & Overview
HCPCS Level II A4407: Ostomy Skin Barrier with Flange, Extended Wear
HCPCS Level II code A4407 designates an ostomy skin barrier with flange, extended wear, and built-in convexity sized 4 x 4 inches or smaller. This supply is a component of ostomy management, supporting peristomal skin protection and appliance adhesion for patients requiring stoma care. Nationally, ostomy supplies like this are significant for postoperative and chronic ostomy management, impacting durable medical equipment coverage, patient access to supplies, and clinical outcomes related to skin integrity.
Major commercial payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find a concise explanation of what the code represents, the clinical context for its use, and how it fits within durable medical equipment billing for ostomy supplies. The publication outlines typical sites of service and payer relevance, and provides guidance on common documentation and billing considerations where available. When input data is not provided, the text notes that "Data not available in the input." This piece does not provide provider recommendations but focuses on clarifying the code purpose, service classification, and the aspects of coverage and billing practices that national stakeholders track for ostomy supply reimbursement and policy alignment.
Billing Code Overview
HCPCS Level II code A4407 describes an ostomy skin barrier with flange (solid, flexible, or accordion), extended wear, with built-in convexity, sized 4 x 4 inches or smaller, each. This item is classified under Durable Medical Equipment / Ostomy Supplies and is intended to protect peristomal skin and secure ostomy appliances for patients with stomas.
Typical site of service: Office (POS 11).
Clinical & Coding Specifications
Clinical Context
A patient with an ostomy (colostomy, ileostomy, or urostomy) presents to an outpatient clinic (Office POS 11) for replacement of an ostomy skin barrier. The barrier required is a small flange-style, extended-wear skin barrier with built-in convexity measuring 4 x 4 inches or smaller. The clinical workflow typically includes: a focused assessment of the peristomal skin and stoma output; selection and fitting of the appropriate ostomy skin barrier product; education on application and wear time; and documentation of the medical necessity for an extended-wear, built-in-convexity barrier (e.g., peristomal skin irritation, retracted stoma, or frequent leakage). The product is supplied as Durable Medical Equipment / ostomy supplies and billed using HCPCS Level II code A4407 with appropriate modifier(s) based on acquisition status (e.g., new equipment or rental) and medical policy requirement flags.
Coding Specifications
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Modifiers
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NU- New EquipmentUse when the ostomy skin barrier is being provided as new, first-time equipment to the beneficiary.
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RR- RentalUse when the supplier is billing for the item as a rental per payer rental policies.
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KX- Requirements specified in the medical policy have been metUse when documentation exists that the payer-specific medical policy conditions for coverage are satisfied.