A4375 Ostomy pouch, drainable, with faceplate attached, plastic, each...
A4375 - Drainable plastic pch w fcplNeed more information about A4375? Get access to fees, crosswalks, billing policies, similar codes and much more. Access to this feature is available in the following products:
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Additional Code Information includes:
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Save time with a Professional or Facility subscription! You will be able to see the most common modifiers billed to Medicare along with this code.
HCPCS Index Entries (Reverse Index Lookup)
reverse_index/reverse_index_content.php?set=HCPCS&c=A4375
View historical information about the code including when it was added, changed, deleted, etc. Access to this feature is available in the following products:
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Subscribers may add their own notes as well as "Admin Notes" visible to all subscribers in their account. Access to this feature is available in the following products:
Subscribers may add their own notes as well as "Admin Notes" visible to all subscribers in their account. |
Medicare - Special Coverage Instructions
Subscribers will see related documentation, coding and billing tips. Access to this feature is available in the following products:
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DMEPOS Products (Durable Medical Equipment, Prosthetics, Orthotics, Supplies)
dmepos/dmepos_content.php?set=HCPCS&c=A4375
* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $24.08 | $36.12 | $48.16 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
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Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $24.08 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare vs. My Fee Evaluation
| Modifier | Medicare Allowed | 150% | 200% | My Fee |
|---|---|---|---|---|
| (none) | $24.08 | $36.12 | $48.16 | (your fee) |
Access to calculated fee values is available. Access to this feature is available in the following products:
Note: Subscribers will see the calculated values below. |
Medicare Participating - Assignment Accepted (Mandatory)
| Modifier | Allowed | Medicare 80% | Patient Pays |
|---|---|---|---|
| (none) | $24.08 | $##.## | $##.## |
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier | Allowed | Medicare 80% | Patient Pays | Limiting Charge (Amount Billed) |
|---|---|---|---|---|
| (none) | $##.## | $##.## | $##.## | $##.## |
This section shows APC information including: Status Indicator, Relative Weight, Payment Rate, Crosswalks, and more. Access to this feature is available in the following products:
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View fees for this code from 4 different built-in fee schedules and from those you've added using the Compare-A-Fee™ tool. If you work with several fee schedules or would like to create custom fee comparison reports, you need our exclusive Compare-A-Fee™ tool.
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View a table of UCR, Worker's Comp, and Medicare Fees here, as well as see UCR Fees in the charts below. Access to this feature is available in the following products:
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View a chart showing the last 8+ years of Medicare denial rates, Medicare Allowed amounts, and Medicare billed amounts. Access to this feature is available in the following products:
Note: Subscribers will see the fee graphs below. |
Cross-A-Code™ (ICD-9/10, CPT, Modifiers, NCCI, NDC, ASA CROSSWALK®)
crosswalks/crosswalk_content.php?set=HCPCS&c=A4375
View relationships (or crosswalks) between code sets. Access to this feature is available in the following products:
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Medicare Policies & Guidelines (Articles, LCDs, NCDs)
coverage/coverage_content.php?set=HCPCS&c=A4375
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