Ostomy Supplies - DME.SW.111.A

Ostomy supplies (e.g., pouches, skin barriers, belts, stoma caps/plugs/absorptive covers, bedside drainage bags or bottles for urinary ostomies) are medically necessary for individuals with colostomy/ileostomy/urostomy, but concurrent use of liquid ostomy skin barrier (A4369) and wipes/swabs (A5120) is not considered medically necessary. Usual monthly HCPCS-specific quantity limits apply and any request for quantities above those limits must include clear documentation of medical necessity (including ostomy type, location, construction and peristomal skin condition) in the medical record.

"Ostomy supplies are considered medically necessary for an individual with an ostomy (e."

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