Ostomy Supplies - Policy Article

Ostomy supplies are a covered prosthetic device for beneficiaries with a permanent, surgically created stoma (colostomy, ileostomy, or urinary ostomy) when reasonable and necessary. Coverage requires initial medical justification and, for specified HCPCS codes subject to Final Rule 1713, a prior face-to-face encounter and Written Order Prior to Delivery (WOPD); certain items (e.g., pouch cover A9270) are noncovered and supplies are not separately payable during a covered home health episode.

"Ostomy supplies are covered under the Prosthetic Device benefit for beneficiaries with a permanent impairment requiring an ostomy; permanence means a condition of long and indefinite duration as do..."

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