Question 1

What is HCPCS code A5057?

Accepted Answer

HCPCS code A5057 is "1 pc ost pou w built-in conv". Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each

Question 2

What category is A5057 in?

Accepted Answer

A5057 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A5057?

Accepted Answer

Use A5057 when billing for 1 pc ost pou w built-in conv. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is A5057 covered by Medicare?

Accepted Answer

Coverage for A5057 (1 pc ost pou w built-in conv) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for A5057?

Accepted Answer

Documentation for A5057 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).