Ostomy Supplies

Ostomy supplies are covered when they are Medicare benefit-eligible, reasonable and necessary for diagnosis/treatment or to improve function, and meet Medicare statutory and regulatory requirements; quantities are individualized based on ostomy type, location, construction, and peristomal skin condition. The LCD lists usual maximum monthly and 6-month quantities by HCPCS code (excess requires clear medical record justification), requires a Standard Written Order (and WOPD when applicable) and proof of delivery, and mandates documented beneficiary confirmation prior to refills with specific timing and supply-duration limits (1 month nursing facility, 3 months home).

"An ostomy supply is covered when it is an eligible Medicare benefit category item, is reasonable and necessary for diagnosis or treatment of illness or injury or to improve the functioning of a mal..."