Question 1

What is HCPCS code A4412?

Accepted Answer

HCPCS code A4412 is "Ost pouch drain high output". Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each

Question 2

What category is A4412 in?

Accepted Answer

A4412 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A4412?

Accepted Answer

Use A4412 when billing for ost pouch drain high output. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is A4412 covered by Medicare?

Accepted Answer

Coverage for A4412 (Ost pouch drain high output) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for A4412?

Accepted Answer

Documentation for A4412 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).