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Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each

HCPCS code

Name of the Procedure:

Ostomy Pouch Application Technical Term: Application of Ostomy Pouch, Closed; for use on barrier with non-locking flange, with filter (2 piece), each (HCPCS A4419)


An ostomy pouch is a medical device used to collect waste from a surgically diverted biological system (ostomy). The closed ostomy pouch with a filter is designed for use with a non-locking flange. This specific setup helps patients manage their stoma output more efficiently and comfortably.


The primary goal of using an ostomy pouch is to provide a sanitary and manageable way for patients with stomas (e.g., due to colostomy, ileostomy, or urostomy) to collect their body waste. This promotes quality of life by enabling them to continue daily activities with confidence and reduced risk of leakage or odor.


  • Patients with a colostomy, ileostomy, or urostomy.
  • Those who need a reliable, easy-to-use waste collection system.
  • Patients who require an ostomy pouch that integrates with a non-locking flange barrier for secure attachment.


  • No specific fasting or medication adjustments are typically necessary.
  • Patients may be advised to check the integrity of their stoma and the surrounding skin.
  • Ensure the skin barrier and flange area are clean and dry before application.

Procedure Description

  1. Tool Preparation: Gather the closed ostomy pouch with filter, skin barrier, and non-locking flange.
  2. Cleaning: Gently clean the stoma and surrounding skin with water. Pat dry thoroughly.
  3. Barrier Application: Apply the skin barrier to the area around the stoma, ensuring it's secure and free of wrinkles.
  4. Flange Attachment: Attach the non-locking flange to the skin barrier snugly.
  5. Pouch Connection: Connect the closed ostomy pouch to the flange, ensuring a tight fit without gaps.
  6. Inspection: Check for secure attachment, comfort, and any potential signs of leakage.


Approximately 10-15 minutes.


This procedure can be performed at home, in an outpatient clinic, or at a specialized ostomy care center.


  • Ostomy care nurses or trained healthcare providers for initial education.
  • Patients or caregivers for routine application and maintenance.

Risks and Complications

  • Skin irritation or breakdown around the stoma.
  • Leakage due to improper application.
  • Infection if the stoma area is not kept clean.
  • Discomfort or skin reactions to the adhesive materials.


  • Easier and more hygienic management of stoma output.
  • Enhanced comfort due to the closed design with a filter for odor control.
  • Improved confidence and quality of life with fewer concerns about leakage or odors.
  • Immediate benefits can be realized upon correct application.


  • No specific recovery time needed as this is a routine management task.
  • Regular inspection of the stoma and surrounding area.
  • Follow-up appointments with healthcare providers as needed to address any issues.


  • One-piece ostomy systems.
  • Different types of pouches (e.g., drainable vs. closed).
  • Other methods of stoma management such as irrigation for colostomies.

Patient Experience

  • Patients may experience a sensation of security and reduced anxiety about leaks and odors.
  • Initial discomfort or skin sensitivity may occur but typically resolves with proper technique and products.
  • Pain management is usually not necessary, but skin care measures may be recommended to maintain comfort.

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