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Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each

HCPCS code

Name of the Procedure:

Ostomy Pouch, Drainable, with Barrier Attached, with Built-in Convexity (1 piece)
Common Name: Ostomy Pouch with Convex Barrier
Medical Term: A4389


An ostomy pouch with a built-in convex barrier is a medical device used for individuals who have undergone ostomy surgery, such as a colostomy or ileostomy. The pouch collects waste from the stoma, and the convex barrier helps to ensure a secure fit against the skin, providing additional support and preventing leaks.


This procedure is primarily designed for patients who have difficulty getting a good seal with flat ostomy barriers due to irregular stoma shapes or skin contours. The goal is to provide an effective, leak-proof solution that enhances the patient's quality of life by making the ostomy care process simpler and more reliable.


  • Individuals with a colostomy, ileostomy, or urostomy
  • Stomas that are flush, retracted, or located in folds of skin
  • Skin irritation or leakage problems with standard flat barriers


  • Clean the stoma and surrounding skin with water and mild soap.
  • Pat the area dry thoroughly.
  • Measure the stoma to ensure correct pouch size.
  • No fasting or medication adjustments are usually needed specifically for applying the pouch, but follow general advice from your healthcare provider.

Procedure Description

  1. Clean the stoma and surrounding area.
  2. Cut the opening in the barrier to fit the stoma size if not pre-sized.
  3. Remove the adhesive backing from the built-in convex barrier.
  4. Position the pouch over the stoma, ensuring the convex part is properly placed around the stoma to create a good seal.
  5. Press down firmly to make sure the adhesive attaches securely.
  6. Ensure that the bottom of the pouch is closed and sealed.


Applying the ostomy pouch typically takes about 10-15 minutes.


This procedure can be performed at home or in a healthcare setting such as a hospital or outpatient clinic.


While patients or caregivers typically perform this procedure, guidance and initial training may be provided by:

  • Ostomy Care Nurses
  • General Nurses
  • Primary Care Physicians

Risks and Complications

  • Skin irritation or allergic reaction to the adhesive
  • Leakage if the pouch is not applied correctly
  • Discomfort from the convex barrier


  • Secure and leak-proof collection of waste
  • Reduced skin irritation compared to flat barriers
  • Improved confidence and quality of life for ostomy patients The benefits are often realized immediately upon proper application.


  • There is no recovery time needed as this is not a surgical procedure.
  • Follow-up appointments may be necessary to monitor skin health and ensure proper pouch usage.


  • Flat ostomy pouches
  • Two-piece ostomy systems
  • Custom-fitted ostomy barriers Pros: More personalized fit; may be easier to use for some patients. Cons: May require more frequent changes; higher risk of leakage for irregular stoma shapes.

Patient Experience

Patients will likely feel more confident and secure with the convex barrier compared to flat barriers. Initial application might involve some trial and error to get the perfect fit. Proper fitting minimizes discomfort and reduces the likelihood of leaks, leading to a more comfortable day-to-day experience. Pain management is usually not needed, but if skin irritation occurs, consult a healthcare provider for appropriate treatment.

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