HCPCS Level II A4427: Drainable Ostomy Pouch with Locking Flange, Filter

HCPCS Level II code A4427 describes a drainable ostomy pouch designed for use with a barrier that has a locking flange, and includes a filter as part of a two-piece ostomy system; the service is a durable medical equipment supply for ostomy management, typically provided for outpatient or home use to collect stoma output and allow periodic emptying while maintaining a secure flange connection.

For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing, Bone Turnover Markers Testing.

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HCPCS Level II A4427: Drainable Ostomy Pouch with Locking Flange, Filter

For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing, Bone Turnover Markers Testing.

Customize your policy alerts

Sign up for hcpcs A4427 policy alerts

Get alerted when payer policies referencing A4427 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a surgically created stoma (ileostomy or colostomy) who requires a two‑piece, drainable ostomy pouch with a locking flange and integrated filter for routine wear and pouch changes. The patient presents to an outpatient wound, ostomy, and continence (WOC) clinic or durable medical equipment (DME) supplier for a supply refill and device fitting. The clinical workflow includes verification of the stoma type and peristomal skin status, measurement of stoma diameter, assessment of pouching system compatibility with the existing barrier/skin barrier with locking flange, education on pouch emptying and filter function, and documentation of medical necessity (e.g., chronic ostomy following colorectal surgery, tumor resection, or inflammatory bowel disease). The supplier or WOC nurse ensures the pouch A4427 (ostomy pouch, drainable; for use on barrier with locking flange, with filter, two‑piece system) matches the barrier flange size and locking mechanism, obtains any required prior authorization from payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, or Medicare, and dispenses the item with appropriate frequency and ICD‑10 linkage for billing and durable medical equipment records.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99406`	Smoking and tobacco use cessation counseling, intermediate, 3–10 minutes	May be provided in ostomy clinics as brief counseling during supply visits when relevant to wound healing
`99407`	Smoking and tobacco use cessation counseling, intensive, greater than 10 minutes	Used when extended counseling is provided during a visit that includes supply fitting and education
`99401`	Preventive medicine counseling, individual, approximately 15 minutes	Used for patient education and self‑care training related to ostomy management
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	May be used when non‑DME items or additional supplies are provided in the clinic alongside `A4427`
`G0452`	Face‑to‑face visit for evaluation and management and risk assessment for coverage determinations for home health or DME	Applies when a visit is required to document medical necessity before dispensing durable medical equipment such as `A4427`

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
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…
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…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
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…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
364S00000X	Clinical Nurse Specialist	A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
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…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
176P00000X	Funeral Director	A person, usually an embalmer, whose business is to arrange for the burial or cremation of the dead and to assist at the funeral rites.
246W00000X	Cardiology Technician	An individual who has knowledge of specific techniques, instruments, and equipment required in performing specific cardiovascular/peripheral vascular …
2084N0600X	Clinical Neurophysiology Physician	Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autono…
2085R0203X	Therapeutic Radiology Physician	Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.

Related ICD-10-CM Codes

27 rows

ICD-10-CM Code	Description
A41.9	Sepsis, unspecified organism
C18.9	Malignant neoplasm of colon, unspecified
C19	Malignant neoplasm of rectosigmoid junction
C20	Malignant neoplasm of rectum
D12.6	Benign neoplasm of colon, unspecified
E86.0	Dehydration
K56.1	Intussusception
K57.20	Diverticulitis of large intestine with perforation and abscess without bleeding
K57.30	Diverticulosis of large intestine without perforation or abscess without bleeding
K57.50	Diverticulosis of both small and large intestine without perforation or abscess without bleeding

Showing 1–10 of 27

Related Payer Policy Updates

Specialty: Endocrinology1 / 3

10 rows

Policy	Payer	Effective Date
Salivary Hormone Testing	Oscar Health	2026-10-01
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing	Oscar Health	2026-10-01
Bone Turnover Markers Testing	Oscar Health	2026-10-01
Testosterone — Coverage Criteria for Measurement and Monitoring	Oscar Health	2026-10-01
Thyroid Disease Testing	Oscar Health	2026-10-01
Diabetes Mellitus Testing — Coverage Criteria	Oscar Health	2026-10-01
Thyroid Disease Testing	blue cross blue shield - louisiana	2026-09-15
Thyroid Disease Testing	Blue Cross Blue Shield - New Mexico	2026-09-04
Parathyroid Hormone, Phosphorous, Calcium and Magnesium Testing	Blue Cross Blue Shield - New Mexico	2026-09-04
Testosterone laboratory testing and measurement (coverage criteria)	Premera Bluecross	2026-09-04

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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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99406`	Smoking and tobacco use cessation counseling, intermediate, 3–10 minutes	May be provided in ostomy clinics as brief counseling during supply visits when relevant to wound healing
`99407`	Smoking and tobacco use cessation counseling, intensive, greater than 10 minutes	Used when extended counseling is provided during a visit that includes supply fitting and education
`99401`	Preventive medicine counseling, individual, approximately 15 minutes	Used for patient education and self‑care training related to ostomy management
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	May be used when non‑DME items or additional supplies are provided in the clinic alongside `A4427`
`G0452`	Face‑to‑face visit for evaluation and management and risk assessment for coverage determinations for home health or DME	Applies when a visit is required to document medical necessity before dispensing durable medical equipment such as `A4427`

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
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…
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…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
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…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
364S00000X	Clinical Nurse Specialist	A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
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…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
176P00000X	Funeral Director	A person, usually an embalmer, whose business is to arrange for the burial or cremation of the dead and to assist at the funeral rites.
246W00000X	Cardiology Technician	An individual who has knowledge of specific techniques, instruments, and equipment required in performing specific cardiovascular/peripheral vascular …
2084N0600X	Clinical Neurophysiology Physician	Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autono…
2085R0203X	Therapeutic Radiology Physician	Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.

Related ICD-10-CM Codes

27 rows

ICD-10-CM Code	Description
A41.9	Sepsis, unspecified organism
C18.9	Malignant neoplasm of colon, unspecified
C19	Malignant neoplasm of rectosigmoid junction
C20	Malignant neoplasm of rectum
D12.6	Benign neoplasm of colon, unspecified
E86.0	Dehydration
K56.1	Intussusception
K57.20	Diverticulitis of large intestine with perforation and abscess without bleeding
K57.30	Diverticulosis of large intestine without perforation or abscess without bleeding
K57.50	Diverticulosis of both small and large intestine without perforation or abscess without bleeding

Showing 1–10 of 27

Related Payer Policy Updates

Specialty: Endocrinology1 / 3

10 rows

Policy	Payer	Effective Date
Salivary Hormone Testing	Oscar Health	2026-10-01
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing	Oscar Health	2026-10-01
Bone Turnover Markers Testing	Oscar Health	2026-10-01
Testosterone — Coverage Criteria for Measurement and Monitoring	Oscar Health	2026-10-01
Thyroid Disease Testing	Oscar Health	2026-10-01
Diabetes Mellitus Testing — Coverage Criteria	Oscar Health	2026-10-01
Thyroid Disease Testing	blue cross blue shield - louisiana	2026-09-15
Thyroid Disease Testing	Blue Cross Blue Shield - New Mexico	2026-09-04
Parathyroid Hormone, Phosphorous, Calcium and Magnesium Testing	Blue Cross Blue Shield - New Mexico	2026-09-04
Testosterone laboratory testing and measurement (coverage criteria)	Premera Bluecross	2026-09-04

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 A4427: Drainable Ostomy Pouch with Locking Flange, Filter

Sign up for hcpcs A4427 policy alerts

HCPCS Level II A4427: Drainable Ostomy Pouch with Locking Flange, Filter

Sign up for hcpcs A4427 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What exactly does HCPCS code A4427 describe?

Where is A4427 usually provided and what clinical steps are involved?

Which payers commonly cover A4427 and is prior authorization mentioned?

Which specialties or taxonomy codes are involved in supplying or managing A4427?

Which HCPCS/CPT modifiers are applicable when billing A4427 and when should they be used?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What exactly does HCPCS code A4427 describe?

Where is A4427 usually provided and what clinical steps are involved?

Which payers commonly cover A4427 and is prior authorization mentioned?

Which specialties or taxonomy codes are involved in supplying or managing A4427?

Which HCPCS/CPT modifiers are applicable when billing A4427 and when should they be used?

References