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

HCPCS code

Name of the Procedure:

Ostomy Pouch, Drainable, with Extended Wear Barrier Attached, with Built-In Convexity, with Filter, (1 Piece), Each (HCPCS A5057)


An ostomy pouch is a medical device designed to collect waste from a surgically created stoma, which is an opening in the abdomen. This specific type includes an extended wear barrier for longer use, a built-in convexity to improve the fit around the stoma, and a filter to manage gas and odor.


The ostomy pouch is used for patients who have undergone ostomy surgery due to conditions like colorectal cancer, inflammatory bowel disease, or other gastrointestinal issues resulting in the need for waste diversion. The goal is to provide a convenient and hygienic method for waste collection, enhancing the patient's quality of life and reducing skin irritation around the stoma.


  • Patients with a surgically created stoma (ileostomy, colostomy, urostomy).
  • Conditions such as colorectal cancer, Crohn’s disease, ulcerative colitis, or bladder cancer.
  • Patients experiencing frequent skin irritation or leakage with standard ostomy pouches.


  • Ensure the skin around the stoma is clean and dry.
  • No specific fasting or medication adjustments are typically required.
  • It may be helpful to have the patient's stoma size measured by a healthcare professional for an optimal fit.

Procedure Description

  1. Preparation: The patient or caregiver will gather the ostomy pouch and any necessary cleaning supplies.
  2. Cleaning: Clean and dry the peristomal skin (skin around the stoma).
  3. Application: Remove the backing from the adhesive barrier of the pouch. Center the opening over the stoma and press firmly to ensure it sticks to the skin.
  4. Check Fit: Ensure the built-in convexity comfortably “cups” the stoma, and the filter is positioned to allow gas to escape without odor.
  5. Secure: Smooth out any wrinkles in the adhesive to prevent leaks.

Tools: Ostomy pouch (A5057), optional stoma measurement guide. Anesthesia: Not applicable.


Application of the ostomy pouch typically takes about 10-15 minutes.


This procedure is usually carried out at home or wherever the patient resides, but initial training and fitting may occur in a hospital, outpatient clinic, or specialized care center.


Primarily managed by the patient or a caregiver. Initial education and fitting may be assisted by a stoma care nurse or other healthcare provider.

Risks and Complications

  • Skin irritation or breakdown around the stoma.
  • Leakage if not properly sealed.
  • Allergic reactions to the adhesive materials.
  • Potential for developing a hernia around the stoma site (rare).


  • Effective waste management and convenience.
  • Extended wear time reduces the frequency of changes, lowering skin irritation and increasing comfort.
  • Built-in convexity provides a better fit, reducing the risk of leaks.
  • The filter manages gas, preventing ballooning and controlling odor.


  • Immediate use upon successful application.
  • Regular monitoring and changing of the pouch based on wear time and individual needs.
  • Follow-up with a healthcare provider if issues such as persistent skin irritation or leaking occur.


  • Two-piece ostomy systems where the barrier and pouch are separate.
  • Standard non-convex ostomy pouches.
  • Different manufacturers' products with varying features.
  • Surgical options to reverse the stoma, if appropriate and possible.

Patient Experience

Patients may initially feel discomfort or anxiety when learning to care for their stoma. Over time, they often become proficient and find the process manageable. Pain is generally not associated with the procedure itself, but proper stoma care is essential to avoid irritation and complications. Education and support from healthcare professionals and peer groups can significantly improve the patient experience.

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