A5051 — Ostomy pouch, closed; with barrier attached (1 piece), each
A5051 is a HCPCS Level II code for ostomy pouch, closed; with barrier attached (1 piece), each. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
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 statusP
Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A5051 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A5051
- Long descriptor
- Ostomy pouch, closed; with barrier attached (1 piece), each
- Short descriptor
- Pouch clsd w barr attached
- Added
- January 1, 1990
- BETOS
- D1F
- Pricing indicator
- 37 — 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.
Ostomy, tracheostomy and urological supplies. Price subject to floors and ceilings.
Codes adjacent to A5051
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A5051 is not quite right, the correct code is very often within a few positions of it.
- A4913Miscellaneous dialysis supplies, not otherwise specified
- A4918Venous pressure clamp, for hemodialysis, each
- A4927Gloves, non-sterile, per 100
- A4928Surgical mask, per 20
- A4929Tourniquet for dialysis, each
- A4930Gloves, sterile, per pair
- A4931Oral thermometer, reusable, any type, each
- A4932Rectal thermometer, reusable, any type, each
- A5052Ostomy pouch, closed; without barrier attached (1 piece), each
- A5053Ostomy pouch, closed; for use on faceplate, each
- A5054Ostomy pouch, closed; for use on barrier with flange (2 piece), each
- A5055Stoma cap
- A5056Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each
- A5057Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
- A5061Ostomy pouch, drainable; with barrier attached, (1 piece), each
- A5062Ostomy pouch, drainable; without barrier attached (1 piece), each
Questions about A5051
What is HCPCS code A5051?
A5051 is a HCPCS Level II code for ostomy pouch, closed; with barrier attached (1 piece), each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A5051?
The CMS HCPCS file marks A5051 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is A5051 paid under the physician fee schedule?
A5051 carries PFS status code P. Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.