HCPCS Level II A4423: Closed Ostomy Pouch for Locking Flange with Filter

HCPCS Level II code A4423 describes a closed ostomy pouch designed for use with a barrier that has a locking flange and includes a filter; the item is billed per piece and is used as a two-piece ostomy appliance component. Service type: durable medical supply / ostomy appliance. Typical site of service: outpatient, home health, or retail medical supply settings where ostomy supplies are dispensed or used.

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HCPCS Level II A4423: Closed Ostomy Pouch for Locking Flange with Filter

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Get alerted when payer policies referencing A4423 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with a long-standing colostomy presents to outpatient durable medical equipment (DME) services for routine supplies. The patient uses a two-piece ostomy system with a locking flange and requires closed ostomy pouches with integrated filters to manage effluent and control odors. The typical clinical workflow begins with an order from the treating provider (often a colorectal surgeon, general surgeon, or wound/ostomy nurse practitioner) specifying supply type and frequency. The DME supplier verifies the prescription, confirms payer coverage and medical necessity, selects appropriate pouch size and filter type, and dispenses individual A4423 units (closed pouch, two-piece, with filter). Education on application, seal care, and disposal is provided by the wound and ostomy nurse, and follow-up orders are issued at routine postoperative or stoma-care visits. Typical site of service is outpatient DME supplier or home delivery; supplies are worn in the community and changed by the patient or caregiver at home.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44320`	Closure or repair of enteric stoma (e.g., colostomy, ileostomy) — not commonly performed with supply dispensing	Surgical procedures related to ostomy creation or reversal; may precede long-term supply needs
`44310`	Revision of stoma	Performed when stoma complications require revision; impacts ongoing pouch selection and frequency
`93990`	Noninvasive vascular diagnostic study, not otherwise specified — placeholder for ostomy-related perfusion studies	Occasionally used in perioperative assessment of abdominal wall or stoma perfusion; not directly tied to pouch billing

Related Modifiers

5 rows

Modifier	Description	When to Use
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208100000X	Physical Medicine & Rehabilitation Physician	Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and…
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
363LA2200X	Adult Health Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
364SL0600X	Long-Term Care Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
207VE0102X	Reproductive Endocrinology Physician	An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.
207LP3000X	Pediatric Anesthesiology Physician	An anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs…
2080P1004X	Physician Nutrition Specialist (Pediatrics)	A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…

Related Codes

HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

HCPCS Level II A4210: Needle-free Injection Device, Each

HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

HCPCS Level II A4211: Supplies for Self-Administered Injections

HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

HCPCS Level II A4215: Needle, Sterile, Any Size

HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

Showing 1–10 of 633

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44320`	Closure or repair of enteric stoma (e.g., colostomy, ileostomy) — not commonly performed with supply dispensing	Surgical procedures related to ostomy creation or reversal; may precede long-term supply needs
`44310`	Revision of stoma	Performed when stoma complications require revision; impacts ongoing pouch selection and frequency
`93990`	Noninvasive vascular diagnostic study, not otherwise specified — placeholder for ostomy-related perfusion studies	Occasionally used in perioperative assessment of abdominal wall or stoma perfusion; not directly tied to pouch billing

Related Modifiers

5 rows

Modifier	Description	When to Use
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208100000X	Physical Medicine & Rehabilitation Physician	Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and…
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
363LA2200X	Adult Health Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
364SL0600X	Long-Term Care Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
207VE0102X	Reproductive Endocrinology Physician	An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.
207LP3000X	Pediatric Anesthesiology Physician	An anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs…
2080P1004X	Physician Nutrition Specialist (Pediatrics)	A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…

Related Codes

HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

HCPCS Level II A4210: Needle-free Injection Device, Each

HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

HCPCS Level II A4211: Supplies for Self-Administered Injections

HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

HCPCS Level II A4215: Needle, Sterile, Any Size

HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

Showing 1–10 of 633

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

HCPCS Level II A4423: Closed Ostomy Pouch for Locking Flange with Filter

Sign up for hcpcs A4423 policy alerts

HCPCS Level II A4423: Closed Ostomy Pouch for Locking Flange with Filter

Sign up for hcpcs A4423 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What exactly does HCPCS code A4423 represent?

Who orders and dispenses items coded A4423, and what is the usual workflow?

Where are A4423 ostomy pouches typically used and provided?

Which clinical specialties and provider types are associated with A4423?

Do payers cover A4423 and where can I find coverage criteria or reimbursement rates?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What exactly does HCPCS code A4423 represent?

Who orders and dispenses items coded A4423, and what is the usual workflow?

Where are A4423 ostomy pouches typically used and provided?

Which clinical specialties and provider types are associated with A4423?

Do payers cover A4423 and where can I find coverage criteria or reimbursement rates?

References