A5131: Appliance cleaner, incontinence and ostomy appliances, per 16 oz.
A5131 is a HCPCS Level II code for appliance cleaner, incontinence and ostomy appliances, per 16 oz.. 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 2026Q4-Oct. 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 A5131 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: CMS Workgroup
- DME supplier
- 3 units MAI 3: Date of Service Edit: Clinical · Published Contractor Policy
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 2026Q4.
The CMS record for A5131
- Long descriptor
- Appliance cleaner, incontinence and ostomy appliances, per 16 oz.
- Short descriptor
- Appliance cleaner
- 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 A5131
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If A5131 is not quite right, the correct code is very often within a few positions of it.
- A5105Urinary suspensory with leg bag, with or without tube, each
- A5112Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each
- A5113Leg strap; latex, replacement only, per set
- A5114Leg strap; foam or fabric, replacement only, per set
- A5120Skin barrier, wipes or swabs, each
- A5121Skin barrier; solid, 6 x 6 or equivalent, each
- A5122Skin barrier; solid, 8 x 8 or equivalent, each
- A5126Adhesive or non-adhesive; disk or foam pad
- A5200Percutaneous catheter/tube anchoring device, adhesive skin attachment
- A5500For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe
- A5501For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe
- A5503For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe
- A5504For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe
- A5505For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe
- A5506For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe
- A5507For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe