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

HCPCS code

Name of the Procedure:

  • Common Name: Ostomy pouch
  • Technical Term: Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each (A4390)


An ostomy pouch is a medical device used by individuals who have had surgery to create an opening (stoma) in the body to allow waste to exit. This specific pouch features a drainable opening, an extended wear barrier for prolonged use, and built-in convexity to provide a better fit and seal around the stoma.


The ostomy pouch is designed to collect waste directly from the body for individuals who cannot pass waste through their usual bodily routes. It aims to improve the quality of life for those with colostomies, ileostomies, or urostomies by providing a safe, sanitary, and comfortable method to manage bodily waste.


  • Patients with stomas due to conditions such as colorectal cancer, Crohn's disease, ulcerative colitis, or bladder cancer.
  • Patients requiring an extended wear barrier due to sensitive skin or high output.
  • Individuals needing a built-in convexity for better placement and fit over the stoma.


  • Ensure the area around the stoma is clean and dry.
  • Trim any excess hair around the stoma if necessary.
  • No specific fasting or medication adjustments required.
  • Routine stoma and skin assessments might be performed.

Procedure Description

  1. Gather all necessary supplies including the ostomy pouch, adhesive remover, stoma measuring guide, and cleaning supplies.
  2. Remove the old pouch carefully, using adhesive remover if needed to avoid skin irritation.
  3. Clean the stoma and surrounding skin thoroughly with water and gentle soap, then dry completely.
  4. Measure the stoma using a measuring guide and cut the opening in the new pouch barrier to fit the stoma size.
  5. Apply the new ostomy pouch by centering the opening over the stoma. Press firmly around the barrier to ensure a good seal.
  6. Secure any fastening mechanisms if present and check for leaks.


The procedure typically takes 15-30 minutes, depending on experience and patient condition.


The procedure is usually performed at home by the patient or caregiver, but initial training can occur in a hospital, outpatient clinic, or by a home health nurse.


  • Initial training by a stoma care nurse or healthcare provider.
  • Ongoing care managed by the patient, caregiver, or a home health nurse.

Risks and Complications

  • Skin irritation or infection around the stoma.
  • Leakage or poor fit leading to discomfort.
  • Allergic reactions to the adhesive material.
  • Rare complications include stoma blockage or retraction.


  • Improved waste management and sanitary conditions.
  • Enhanced comfort and confidence in daily activities.
  • Extended wear barrier reduces the frequency of pouch changes, minimizing skin irritation.


  • Minimal recovery required; procedure becomes a routine part of daily care.
  • Regular skin care and monitoring are essential to prevent complications.
  • Follow-up appointments with a healthcare provider may be necessary to address any issues.


  • Two-piece ostomy systems with separate skin barriers and pouches.
  • Different pouching systems using alternative materials or designs.
  • Surgical options to revise the stoma in some cases. ##### Pros of Alternatives:
  • Potential for a more customized fit and easier pouch changes. ##### Cons of Alternatives:
  • May require more frequent changes or adjustments.
  • Could be less comfortable or effective depending on individual needs.

Patient Experience

  • Initial discomfort and learning curve while adapting to the routine.
  • Minimal pain during the pouch change.
  • Over time, the procedure becomes quicker and second nature.
  • Use of barrier creams and powders can enhance comfort and skin protection.

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