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Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each

HCPCS code

Name of the Procedure:

Ostomy Pouch Application
Common name(s): Urinary Ostomy Pouch
Technical term: Urinary Ostomy Pouch with Extended Wear Barrier and Faucet-type Tap with Valve (HCPCS Code A4428)


An ostomy pouch is a medical device used by individuals who have had urinary bladder diversions. The pouch is attached to the body through a barrier and collects urine from a surgically created opening in the abdomen. This specific type of pouch features an extended wear barrier and a faucet-type tap with a valve for easy urine drainage.


This device addresses the needs of patients who have undergone a urostomy, a type of surgery that creates an opening for urine to leave the body. The goals are to collect urine efficiently, minimize leakages, and provide comfort and convenience for the patient.


  • Patients with conditions such as bladder cancer, neurogenic bladder, chronic bladder infection, or severe trauma to the bladder.
  • Individuals who have undergone urostomy surgery and require a reliable method to manage urinary output.


  • Patients may need to clean the abdominal area thoroughly.
  • No specific fasting or medication adjustments are typically required.
  • A proper fitting and skin assessment by a healthcare provider are essential before device application.

Procedure Description

  1. Preparation: Ensure the abdominal skin where the pouch will adhere is clean and dry.
  2. Sizing: Determine the appropriate size of the barrier opening to fit the stoma.
  3. Barrier Application: Remove the protective backing and apply the extended wear barrier around the stoma.
  4. Pouch Attachment: Secure the pouch to the barrier. Ensure the faucet-type tap with a valve is accessible for easy drainage.
  5. Checking Fit: Smooth out wrinkles and check for any gaps to prevent leaks.


The initial fitting and application typically take about 15-30 minutes. Daily maintenance involves regular emptying and occasional changing of the pouch, usually every 3-5 days.


This procedure can be performed in a variety of settings, including hospitals, outpatient clinics, and at home.


Typically performed or supervised by a:

  • Ostomy nurse
  • Urologist
  • Specialized healthcare provider

Risks and Complications

  • Skin irritation or infection at the stoma site.
  • Leakage from an improperly fitted pouch.
  • Mechanical failure of the faucet-type tap.


  • Effective management of urinary output.
  • Increased comfort and convenience due to the faucet-type tap.
  • Extended wear barrier reduces the frequency of changes.


  • Post-application care involves regular monitoring of the stoma and surrounding skin.
  • Patients should follow instructions for emptying and changing the pouch.
  • Follow-up appointments may be scheduled to ensure proper fit and function.


  • Two-piece systems (separate barrier and pouch).
  • Non-valved pouches.
  • Continence devices or catheters.

Pros of HCPCS A4428:

  • All-in-one system simplifies management.
  • Extended wear barrier offers added durability.
  • Faucet-type tap provides easier urine drainage.


  • Initial learning curve for proper application.
  • May require specific healthcare consultations.

Patient Experience

  • Initial discomfort or apprehension that typically improves with familiarity.
  • Regular emptying of the pouch is required to avoid overfilling.
  • Pain management is generally unnecessary, but skin care is crucial for comfort.

Comfort measures include ensuring a snug fit, using skin protectant barriers, and maintaining good hygiene practices to prevent infection.

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