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Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each

HCPCS code

Name of the Procedure:

  • Common names: Ostomy skin barrier with flange
  • Medical term: Ostomy skin barrier (solid, flexible, or accordion) larger than 4 x 4 inches, without built-in convexity (HCPCS A4415)


An ostomy skin barrier with a flange is a medical device used to protect the skin around a stoma and secure a collection pouch. It is larger than 4 x 4 inches and does not include built-in convexity, which means it lies flat against the skin.


  • Medical conditions/problems it addresses: Used for patients with a stoma to manage waste securely.
  • Goals/expected outcomes: To prevent skin irritation and ensure the ostomy pouch stays in place, reducing discomfort and infection risk.


  • Specific symptoms/conditions: Patients with any type of ostomy (e.g., colostomy, ileostomy, urostomy).
  • Patient criteria: Those requiring a larger skin barrier without convexity.


  • Pre-procedure instructions: Ensure the peristomal skin (around the stoma) is clean and dry before the application.
  • Diagnostic tests: Generally, no specific pre-procedure tests required, but routine stoma care evaluation may be recommended.

Procedure Description

  1. Skin Preparation: Clean the peristomal area with mild soap and water, then dry thoroughly.
  2. Sizing the Stoma: Measure the stoma to ensure the correct size of the skin barrier opening.
  3. Cutting the Barrier: Using scissors, cut the barrier opening to match the stoma size.
  4. Applying the Barrier: Remove the protective backing from the barrier and gently press it around the stoma.
  5. Securing the Pouch: Attach the ostomy pouch to the flange on the skin barrier.
  • Tools/Equipment:

    • Ostomy skin barrier with flange
    • Stoma measuring guide
    • Scissors
    • Ostomy pouch
  • Anesthesia or sedation: Not required.


Applying the ostomy skin barrier usually takes about 10-15 minutes.


Typically performed in the patient's home or outpatient clinic. Nurses or caregivers may assist initially.


  • Healthcare professionals involved: Nurses, particularly ostomy care nurses, may assist the patient in learning the procedure.

Risks and Complications

  • Common risks: Skin irritation, leakage, adhesive allergies.
  • Rare risks: Severe skin breakdown, infection.
  • Management: Proper hygiene, regular monitoring, and adjustments by healthcare providers.


  • Expected benefits: Enhanced skin protection, secure fitting, reduced leakage, improved comfort.
  • Realization of benefits: Typically immediate, as the barrier provides an instant fit and protection.


  • Post-procedure care: Regular cleaning and monitoring of the peristomal skin.
  • Recovery time: Not applicable; patients continue with regular ostomy care.
  • Restrictions/Follow-up: Regular follow-up with healthcare providers to review stoma and skin health.


  • Other options: Pre-cut skin barriers, barriers with built-in convexity, different sizes and types of barriers.
  • Pros and cons: Customization with the described barrier vs. ease of use with pre-cut or convex barriers.

Patient Experience

  • During the procedure: Minimal discomfort during application.
  • After the procedure: Generally little to no pain; some initial adjustments may be required for comfort. Use of skin barrier powders and adhesive removers can further enhance comfort.

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