A4421 — Ostomy supply; miscellaneous
A4421 is a HCPCS Level II code for ostomy supply; miscellaneous. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for A4421
- Long descriptor
- Ostomy supply; miscellaneous
- Short descriptor
- Ostomy supply misc
- Added
- January 1, 1985
- BETOS
- D1F
- Pricing indicator
- 46 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Carrier priced — not otherwise classified, individual determination, carrier discretion, or gap-filled amounts.
Codes adjacent to A4421
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4421 is not quite right, the correct code is very often within a few positions of it.
- A4413Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each
- A4414Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each
- A4415Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each
- A4416Ostomy pouch, closed, with barrier attached, with filter (1 piece), each
- A4417Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each
- A4418Ostomy pouch, closed; without barrier attached, with filter (1 piece), each
- A4419Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each
- A4420Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each
- A4422Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each
- A4423Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each
- A4424Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each
- A4425Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each
- A4426Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each
- A4427Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each
- A4428Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each
- A4429Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
Questions about A4421
What is HCPCS code A4421?
A4421 is a HCPCS Level II code for ostomy supply; miscellaneous. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4421?
The CMS HCPCS file marks A4421 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A4421 paid under the physician fee schedule?
A4421 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.