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    v1.0.28
    OpenPayerBilling CodesMedical And Surgical SuppliesHCPCS hcpcs-a5131-appliance-cleaner-incontinence-ostomy
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    HCPCS Level II A5131: Appliance Cleaner for Incontinence and Ostomy Appliances

    HCPCS Level II code A5131 describes a 16-ounce appliance cleaner for use with incontinence and ostomy appliances, categorized as a disposable medical supply; the service type is supply/ancillary product distribution and the typical site of service is outpatient clinics, home health settings, or durable medical equipment suppliers where patients obtain wound, ostomy, and continence care supplies.

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

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult or pediatric individual with fecal or urinary incontinence or an ostomy (colostomy, ileostomy, or urostomy) who requires routine supplies for appliance maintenance. The patient obtains a 16-ounce bottle of appliance cleaner (A5131) from a durable medical equipment provider or a home medical supply company. Clinical workflow: a clinician (wound/ostomy nurse, primary care clinician, or home health nurse) assesses the stoma or peristomal skin during an office, clinic, or home visit; documents the need for safe, skin-friendly cleaning products to maintain seal integrity and reduce skin irritation; orders or supports DME supply provision; the supplier dispenses A5131 with appropriate documentation of medical necessity and a prescription or order when payer policy requires it. The typical site of service is outpatient clinics, home health visits, long-term care facilities, and durable medical equipment supplier locations.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99401Preventive medicine counseling visit, individual, approximately 15 minutesCounseling on ostomy care, skin protection, and appliance maintenance may accompany supply dispensing
    99402Preventive medicine counseling visit, individual, approximately 30 minutesExtended education on ostomy management and demonstration of cleaner use
    99501Home visit for routine home care, new patientHome health visits that include assessment and ordering of supplies like A5131
    97597Debridement, open wound, selective debridement, without anesthesia (cleansing may be necessary)Peristomal skin cleansing and wound care may be performed in conjunction with ordering appliance cleaner
    99070Supplies and materials (except spectacles), provided by the physician or other qualified health care professionalMay be used when billing for sundry supplies provided in-office in addition to DME billing

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    22Modifier –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…
    52Modifier ‑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…
    53Modifier 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…
    62Modifier 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…
    78CPT 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…
    80CPT® 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 CodeSpecialtyNotes
    251B00000XCase Management AgencyAn organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
    207Q00000XFamily Medicine PhysicianFamily 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…
    364S00000XClinical Nurse SpecialistA registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    251S00000XCommunity/Behavioral Health AgencyA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intell…
    2471C1101XCardiovascular-Interventional Technology Radiologic TechnologistA radiologic technologist who specializes in cardiovascular interventional technology.
    261QM1000XMigrant Health Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    103TR0400XRehabilitation PsychologistA psychologist who specializes in the study and application of psychological principles on behalf of persons who have disability due to injury or illn…

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    E10.21Type 1 diabetes mellitus with diabetic nephropathy
    E11.21Type 2 diabetes mellitus with diabetic nephropathy
    E86.0Dehydration
    E86.1Hypovolemia
    G04.90Encephalitis and encephalomyelitis, unspecified
    G81.90Hemiplegia, unspecified affecting unspecified side
    G82.20Paraplegia, unspecified
    G83.4Cauda equina syndrome
    K51.90Ulcerative colitis, unspecified, without complications
    K51.914Ulcerative colitis, unspecified with abscess

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    5 rows

    PolicyPayerEffective Date
    Salivary Hormone TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01
    Parathyroid Hormone, Phosphorus, Calcium, and Magnesium TestingOscar Health2026-10-01
    Testosterone — Coverage Criteria for Measurement and MonitoringOscar Health2026-10-01
    Thyroid Disease TestingOscar Health2026-10-01

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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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