Ostomy Care Ostomy Care
General Information HCPCS Codes Disclaimer The reimbursement information provided herein is intended to provide general information concerning coding of Hollister products only. Hollister does not guarantee coverage or payment for any products. The ultimate responsibility for proper coding, satisfying reimbursement requirements, and obtaining reimbursement remains with the provider.
Latex Statement The specifications for the Hollister Continence Care products listed below include natural rubber latex as a component; our suppliers add natural rubber latex as part of the production process. If a Hollister product(s) found in this catalog is not listed below, the specification for that product(s) and packaging does not include natural rubber latex as a component, and our component suppliers do not add natural rubber as part of their production process.
Table of Contents • Ostomy Care Contents Quick Reference for Product Selection..........................................11–16 New Image Two-Piece Pouching System Skin Barriers.....................11 New Image Two-Piece Pouching System Pouches...........................12 New Image Two-Piece Pouching System Single-Use Kits.................13 Premier One-Piece Pouching System.........................................14–16 Premier One-Piece Pouching System Single-Use Kits.......................
Pouchkins Pediatric Pouching System...............................................59 Premie Pouch...................................................................................59 Newborn Pouch................................................................................59 One-Piece Pouches....................................................................59–60 Two-Piece Skin Barrier.....................................................................60 Two-Piece Pouches...............................
Quick Reference for Product Selection New Image Two-Piece Flat Skin Barriers with Integrated Floating Flanges (see pages 25 – 27) New Image Flat Barriers Cut-to-Fit Flextend A4409 Pre-Sized Cut-to-Fit FlexWear A4414 Pre-Sized FormaFlex A4409 Shapeto-Fit With Tape Without Tape 1-3/4" (44 mm) 14602 With Tape 14604 up to 1-3/4" (44 mm) 15602 up to 2-1/4" (57 mm) 15603 up to 1-1/4" (32 mm) up to 1-3/4" (44 mm) 1470x 14707 14708 16107 16108 14202 — — — — — 14709 14203 14204 up to 1-3
Quick Reference for Product Selection New Image Two-Piece Drainable Pouches (see pages 30 – 32) New Image Drainable Pouches Filter A4425 Lock ’n Roll No Filter A5063 Filter A4425 Pouch Clamp No Filter A5063 High Output With Soft Tap No Filter A4412 1-3/4" (44 mm) 2-1/4" (57 mm) 2-3/4" (70 mm) 4" (102 mm) Transparent 18192 18292 18193 18293 18194 18294 — Beige 18182 18282 18183 18283 18184 18284 — Transparent 18132 18133 18134 — Ultra-Clear 18002 18003 18004 18006 Beig
Quick Reference for Product Selection New Image Two-Piece Urostomy Pouches and Single Use Kits (see pages 33 – 35) New Image Urostomy Pouches 9" (23 cm) A4432 1-3/4" (44 mm) Drainable, No Filter, FlexWear, With Tape A5063 + A4414 Urostomy, Flextend, With Tape A4432 + A4409 Pouch lamp C 2-3/4" (70 mm) Transparent 18402 18403 18404 Ultra-Clear 18422 18423 18424 Beige 18412 18413 18414 New Image Single-Use Kits Lock ’n Roll 2-1/4" (57 mm) 1-3/4" (44 mm) 2-1/4" (57 mm) 2-3/4" (70 mm)
Quick Reference for Product Selection Premier One-Piece Drainable Pouches with Flat Barriers (see pages 41– 46) Premier Pouches Drainable with Flat Barriers Flextend, Filter, With Tape A5056 Lock ’n Roll Lock ’n Roll Flextend, No Filter, With Tape A4388 12" (30 cm) 12" (30 cm) 9" (23 cm) Pouch Clamp 12" (30 cm) FlexWear, Filter, With Tape A4424 FlexWear, No Filter, With Tape A5061 Cut-to-Fit Pre-Sized up to 2-1/2" (64 mm) 3/4" 1" 1-3/16" 1-1/4" 1-3/8" 1-1/2" 1-9/16" 1-3/4" 2" 2-1/2" (19 mm) (2
Quick Reference for Product Selection Premier One-Piece Drainable Pouches with Convex Barriers (see pages 46 – 47) Premier Pouches Drainable with Convex Barriers Lock Flextend, ’n Roll No Filter, With Tape A4390 Pouch Clamp 12" (30 cm) Flextend, With Filter, Lock With Tape ’n Roll A5057 convex product Cut-to-Fit Pre-Sized up to 1" up to 1-1/2" up to 2" 3/4" 7/8" 1" 1-1/8" 1-1/4" 1-3/8" 1-1/2" 1-5/8" 1-3/4" 2" (25 mm) (38 mm) (51 mm) (19 mm) (22 mm) (25 mm) (29 mm) (32 mm) (35 mm) (38 mm) (41 mm
Quick Reference for Product Selection Premier One-Piece Urostomy Pouches (see pages 51– 52) FlatA4428 A4428 Flat Premier Urostomy Pouches Convex A4430 Convex Flextend Cut-to-Fit Pre-Sized up to 1" up to 1-1/2" up to 2" up to 2-1/2" 1/2" 5/8" 3/4" 7/8" 1" 1-1/8" 1-1/4" 1-3/8" 1-1/2" 1-3/4" 2" (25 mm) (38 mm) (51 mm) (64 mm) (13 mm) (15 mm) (19 mm) (22 mm) (25 mm) (29 mm) (32 mm) (35 mm) (38 mm) (44 mm) (51 mm) Transparent — — — 8460 — — 8467 — 8462 — 8468 — Ultra-Clear — — — 8450
Medicare Utilization Chart Medicare’s Usual Maximum Quantity for Ostomy Supplies The quantity of ostomy supplies needed by a patient is determined primarily by the type of ostomy, its location, its construction, and the condition of the skin surface surrounding the stoma. There will be variation according to individual patient need and their needs may vary over time. The table below lists the maximum number of items/units of service that are usually medically necessary.
Medicare Utilization Chart HCPCS Long Description Quantity A4390 Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each A4391 Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each A4392 Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each A4393 Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each A4394 Ostomy deodorant, with or without lubricant,
HCPCS Long Description Quantity A4423 Ostomy pouch, closed, for use on barrier with locking 60 ea/mo flange, with filter (2 piece), each A4424 Ostomy pouch, drainable, with barrier attached, with filter 20 ea/mo (1 piece), each A4425 Ostomy pouch, drainable, for use on barrier with 20 ea/mo non-locking flange, with filter (2 piece system), each A4426 Ostomy pouch, drainable, for use on barrier with 20 ea/mo locking flange (2 piece system), each A4427 Ostomy pouch, drainable, for use on barrier with 20 ea/
Medicare Utilization Chart HCPCS Long Description A5081 A5082 A5083 A5093 A5102 A5120 A5121 A5122 A5126 A5131 A6216 A9270 ✳ No Quantity Continent device, plug for continent stoma 31 ea/mo Continent device, catheter for continent stoma 1 ea/mo Continent device, stoma absorptive cover for continent stoma 150 ea/mo Ostomy accessory, convex insert 10 ea/mo Bedside drainage bottle with or without tubing, rigid or 2 ea/6 mo expandable, each Skin barrier, wipes or swabs, each 150 ea/6 mo Skin barrier, solid, 6 x
New Image Two-Piece Pouching System New Image Two-Piece Pouching System
New Image Two-Piece Pouching System Hollister Ostomy. Details Matter. www.hollister.
New New Image Two-Piece Pouching System Color Matching System To help you select compatible New Image components, every box label is color-coded. First, select the proper skin barrier; then select a matching color-coded pouch (“red” skin barrier box label is compatible to “red” pouch box label).
New Image Two-Piece Pouching System Flat Skin Barriers with Integrated Floating Flanges (continued) 1470x (PRE-SIZED) Flextend (extended wear) Skin Barrier With Tape Border Box of 5 � � HCPCS: A4409 Stock No 14701 14702 14703 14704 14705 14706 14707 14708 14709 Flange Size Barrier Opening (44 mm) c 1-3/4" (44 mm) c 1-3/4" (44 mm) c 1-3/4" 1-3/4" mm) c 1-3/4" (44 mm) c 1-3/4" (44 mm) c 2-1/4" (44 mm) c 2-1/4" (57 (57 c 2-1/4" (57 mm) mm) c 5/8" (16 mm) 3/4" (19 mm) 7/8" (22 mm) 1" (25 mm) 1-1/8" (29 m
Flat Skin Barriers with Integrated Floating Flanges (continued) 1410x (shape-to-fit) FormaFlex (extended wear) Skin Barrier With Tape Border Box of 5 � � HCPCS: A4409 Stock No 14102 14103 14104 Flange Size (44 mm) c 1-3/4” 2-1/4” (57 mm) c 2-3/4” (70 mm) c Barrier Opening Up to 1-1/4” (32 mm) Up to 1-11/16” (43 mm) Up to 2-1/4” (57 mm) FormaFlex Shape-to-Fit Skin Barrier (Part of the New Image product line) This convenient, versatile skin barrier is simple to shape and reshape by hand for a customized
New Image Two-Piece Pouching System Convex Skin Barriers with Integrated Floating Flanges 1480x (CUT-TO-FIT) Flextend (extended wear) Skin Barrier With Tape Border Box of 5 � � HCPCS: A4407 Stock No Flange Size (44 mm) c 1-3/4" (57 mm) c 2-1/4" c 2-3/4" (70 mm) 14802 14803 14804 Barrier Opening up to 1" (25 mm) up to 1-1/2" (38 mm) up to 2" (51 mm) 1580x (CUT-TO-FIT) Flextend (extended wear) Skin Barrier Without Tape Border Box of 5 � � HCPCS for 15802 & 15803: A4407 HCPCS for 15804: A4408 Stock N
Convex Skin Barriers with Integrated Floating Flanges (continued) 149xx (PRE-SIZED) Flextend (extended wear) Skin Barrier With Tape Border Box of 5 � � HCPCS: A4407 Stock No 14901 14902 14903 14904 14905 14906 14907 14908 14909 14910 14911 Flange Size Barrier Opening (44 mm) c 1-3/4" (44 mm) c 1-3/4" (44 mm) c 1-3/4" 1-3/4" mm) c 2-1/4" (44 mm) c 2-1/4" (57 mm) c 2-1/4" (57 mm) c 2-1/4" (57 (57 c 2-3/4" (70 mm) c 2-3/4" (70 mm) c 2-3/4" (70 mm) mm) c 5/8" (16 mm) 3/4" (19 mm) 7/8" (22 mm) 1" (25 mm)
New Image Two-Piece Pouching System Drainable Pouches 1818x/1819x Drainable Pouch With Integrated AF300 Filter Lock ’n Roll Microseal Closure Odor-Barrier Rustle-Free Film With Belt Tabs With ComfortWear Panels - Transparent — Body Side Only - Beige — Both Sides Box of 10 � � � � � � HCPCS: A4425 Transparent Stock No Beige Stock No 18192 18193 18194 18182 18183 18184 Flange Size Pouch Length (44 mm) c 1-3/4" (57 mm) c 2-1/4" c 2-3/4" (70 mm) 12" (30 cm) 12" (30 cm) 12" (30 cm) 1828x/1829x
Drainable Pouches (continued) 1814x/1816x Drainable Pouch With Integrated AF300 Filter Clamp Closure Odor-Barrier Rustle-Free Film With Belt Tabs With ComfortWear Panels - Transparent — Body Side Only - Beige — Both Sides Box of 10 � � � � � � HCPCS: A4425 Transparent Stock No Beige Stock No 18162 18163 18164 18142 18143 18144 Flange Size (44 mm) c 1-3/4" 2-1/4" (57 mm) c 2-3/4" (70 mm) c Pouch Length 12" (30 cm) 12" (30 cm) 12" (30 cm) 1810x/1812x/1817x Box of 10 Drainable Pouch Without Inte
New Image Two-Piece Pouching System High Output Drainable Pouches 1801x Box of 10 Drainable Pouch Without Integrated Filter Soft Tap Odor-Barrier Film With Belt Tabs With ComfortWear Panel — Body Side Only � � � � � � HCPCS: A4412 Ultra-Clear Stock No Flange Size Pouch Length 1-3/4" (44 mm) c 2-1/4" mm) c 2-3/4" (57 (70 mm) c 4" (102 mm) c 12" (30 cm) 12" (30 cm) 12" (30 cm) 12" (30 cm) 1836x/1837x Closed Pouch With Integrated AF300 Filter Odor-Barrier Rustle-Free Film With Belt Tabs With ComfortWear
Closed Pouches (continued) 1833x 1873x Closed Pouch Without Integrated Filter With Belt Tabs With QuietWear Pouch Material HCPCS: A5054 Box of 30 Box of 60 � � � � Stock No Box of 30 Stock No Box of 60 18332 18333 18334 18732 18733 18734 Flange Size (44 mm) c 1-3/4" (57 mm) c 2-1/4" 2-3/4" (70 mm) c 1835x 1875x Closed Mini-Pouch Without Integrated Filter Odor-Barrier Rustle-Free Film With Belt Tabs With ComfortWear Panels — Both Sides Pouch Length 9" (23 cm) 9" (23 cm) 9" (23 cm) Box of 30 Box of
New Image Two-Piece Pouching System Non Sterile Kits — Drainable 1900x Box of 5 Colostomy/Ileostomy Kit includes: (1) 1420x (FlexWear) with Tape Border (1) 1800x (Lock ’n Roll Microseal Closure) Ultra-Clear (1) 7767 Loop Ostomy Bridge (in 19006 only) Single-Use Package � � � � HCPCS for 19002, 19003 & 19004: A5063 + A4414 HCPCS for 19006: A5063 + A4415 Ultra-Clear Stock No Flange Size (44 mm) c 1-3/4" 2-1/4" (57 mm) c 2-3/4" (70 mm) c c 4" (102 mm) 19002 19003 19004 19006 Barrier Opening up to 1-1/4" (3
Sterile Kits — Drainable 1905x Box of 5 Colostomy/Ileostomy Kit includes: (1) 1420x (FlexWear) with Tape Border (1) 1800x (Lock ’n Roll Microseal Closure) Ultra-Clear (1) 7767 Loop Ostomy Bridge (in 19056 only) Single-Use Package � � � � HCPCS for 19052, 19053 & 19054: A5063 + A4414 HCPCS for 19056: A5063 + A4415 Ultra-Clear Stock No Flange Size Barrier Opening (44 mm) c 1-3/4" (57 mm) c 2-1/4" 2-3/4" (70 mm) c 4" (102 mm) c 19052 19053 19054 19056 up to 1-1/4" (32 mm) up to 1-3/4" (44 mm) up to 2-1/4
Premier One-Piece Pouching System Premier One-Piece Pouching System
Premier One-Piece Pouching System Hollister Ostomy. Details Matter. www.hollister.
Pre Premier One-Piece Pouching System Drainable Pouches with Flat Barriers 8331 (CUT-TO-FIT) Box of 10 Drainable Pouch Flextend (extended wear) Skin Barrier With Tape Border With Integrated AF300 Filter Lock ’n Roll Closure Odor-Barrier Rustle-Free Film With ComfortWear Panel — Body Side Only � � � � � � � HCPCS: A5056 Transparent Stock No Barrier Opening 8331 Pouch Length up to 2-1/2" (64 mm) 12" (30 cm) 8531/8551 (CUT-TO-FIT) Drainable Pouch Flextend (extended wear) Skin Barrier With Tape Border W
Premier One-Piece Pouching System Drainable Pouches with Flat Barriers (continued) 8081/8181 (CUT-TO-FIT) Drainable Pouch FlexWear (standard wear) Skin Barrier With Tape Border With Integrated AF300 Filter Lock ’n Roll Closure Odor-Barrier Rustle-Free Film With ComfortWear Panels - Transparent — Body Side Only - Beige — Both Sides Box of 10 � � � � � � � HCPCS: A4424 Transparent Stock No 8081 Beige Stock No Barrier Opening 8181 up to 2-1/2" (64 mm) 8031 (CUT-TO-FIT) Drainable Pouch FlexWear (stand
Drainable Pouches with Flat Barriers (continued) 88800/88700 (CUT-TO-FIT) Drainable Mini-Pouch SoftFlex (standard wear) Skin Barrier Without Tape Border With Integrated AF300 Filter Lock ’n Roll Microseal Closure Odor-Barrier Rustle-Free Film With ComfortWear Panels - Transparent — Body Side Only - Beige — Both Sides Box of 20 � � � � � � � HCPCS: A4424 Transparent Stock No 88800 Beige Stock No Barrier Opening 88700 up to 2-1/8" (55 mm) 88302/88402 (OVAL CUT-TO-FIT) Drainable Pouch SoftFlex (stan
Premier One-Piece Pouching System Drainable Pouches with Flat Barriers (continued) 88501 (CUT-TO-FIT) Box of 10 Drainable Pouch SoftFlex (standard wear) Skin Barrier Without Tape Border Without Integrated Filter Clamp Closure Odor-Barrier Film With ComfortWear Panel — Body Side Only � � � � � � � HCPCS: A5061 Ultra-Clear Stock No Barrier Opening 88501 Pouch Length up to 2-1/2" (64 mm) 12" (30 cm) 853x/855x (PRE-SIZED) Drainable Pouch Flextend (extended wear) Skin Barrier With Tape Border Without Inte
Drainable Pouches with Flat Barriers (continued) 864x (PRE-SIZED) Drainable Mini-Pouch Flextend (extended wear) Skin Barrier With Tape Border Without Integrated Filter Clamp Closure Odor-Barrier Rustle-Free Film With ComfortWear Panels — Both Sides Box of 10 � � � � � � � HCPCS: A4388 Beige Stock No Barrier Opening Pouch Length 3/4" (19 mm) 1" (25 mm) 1-1/4" (32 mm) 1-1/2" (38 mm) 1-3/4" (44 mm) 2" (51 mm) 9" (23 cm) 9" (23 cm) 9" (23 cm) 9" (23 cm) 9" (23 cm) 9" (23 cm) 80xx/81xx (PRE-SIZED) Draina
Premier One-Piece Pouching System Drainable Pouches with Flat Barriers (continued) 887xx (PRE-SIZED) Drainable Mini-Pouch SoftFlex (standard wear) Skin Barrier Without Tape Border With Integrated AF300 Filter Lock ’n Roll Microseal Closure Odor-Barrier Rustle-Free Film With ComfortWear Panels - Beige — Both Sides Box of 20 � � � � � � � HCPCS: A4424 Beige Stock No Barrier Opening Pouch Length 88725 88730 88735 88740 1" (25 mm) 1-3/16" (30 mm) 1-3/8" (35 mm) 1-9/16" (40 mm) 7" (18 cm) 7" (18 cm) 7
Drainable Pouches with Convex Barriers (continued) 862x (CUT-TO-FIT) Drainable Pouch Flextend (extended wear) Skin Barrier With Tape Border Without Integrated Filter Clamp Closure Odor-Barrier Rustle-Free Film With Belt Tabs With ComfortWear Panel — Body Side Only Box of 5 � � � � � � � � HCPCS: A4390 Transparent Stock No 8624 8628 86211 Barrier Opening Pouch Length up to 1" (25 mm) up to 1-1/2" (38 mm) up to 2" (51 mm) 12" (30 cm) 12" (30 cm) 12" (30 cm) 851x/859x (PRE-SIZED) Drainable Pouch Flexte
Premier One-Piece Pouching System High Output Drainable Pouches 80070/80110 (CUT-TO-FIT) Box of 10 Non Sterile, Drainable Pouch Flextend (extended wear) Skin Barrier — Flat With Soft Tap With Access Window Odor-Barrier Film With ComfortWear Panel — Body Side Only � � � � � � HCPCS: A6154 Ultra-Clear Stock No Barrier Opening 80070 80110 up to 2-3/4" (70 mm) up to 4-1/3" (110 mm) Pouch Length 12" (30 cm) 12" (30 cm) 81070/81110 (CUT-TO-FIT) Box of 5 Sterile, Drainable Pouch Flextend (extended wear) Skin
Hollister Universal Catheter Access Port 9779 Graduated nipple and punch allows introduction of catheter or drain through pouch Sterile � � Stock No Quantity/Box 9779 8 Wound Drainage Collectors 970x/977x For Management of Draining Wounds, Fistulae, or Draining Tube Sites Available With and Without FlexWear (standard wear) Skin Barriers — Flat Sterile and Non Sterile Drainable Pouches Odor-Barrier Film With Access Window Reclosable Cap Without Starter Hole � � � � � � � HCPCS: A6154 With Barri
Premier One-Piece Pouching System Closed Pouches 82300/82400 (CUT-TO-FIT) Box of 30 Closed Pouch SoftFlex (standard wear) Skin Barrier — Flat Without Tape Border With Integrated AF300 Filter Odor-Barrier Rustle-Free Film With ComfortWear Panels - Transparent — Body Side Only - Beige — Both Sides � � � � � � HCPCS: A4416 Transparent Stock No 82400 Beige Stock No Barrier Opening 82300 up to 2-1/8" (55 mm) Pouch Length 9" (23 cm) 82302/82402 (OVAL CUT-TO-FIT) Box of 30 Closed Pouch SoftFlex (stand
Closed Pouches (continued) 821xx (PRE-SIZED) Box of 30 Closed Mini-Pouch SoftFlex (standard wear) Skin Barrier — Flat Without Tape Border With Integrated AF300 Filter Odor-Barrier Rustle-Free Film With ComfortWear Panels — Both Sides � � � � � � HCPCS: A4416 Beige Stock No Barrier Opening Pouch Length 82125 82130 82135 1" (25 mm) 1-3/16" (30 mm) 1-3/8" (35 mm) 7" (18 cm) 7" (18 cm) 7" (18 cm) Stoma Cap 1796 (PRE-SIZED) Box of 30 Stoma Cap SoftFlex (standard wear) Skin Barrier — Flat Without Tape Bord
Premier One-Piece Pouching System Urostomy Pouches with Convex Barriers 847x/843x (CUT-TO-FIT) Urostomy Pouch Flextend (extended wear) Skin Barrier With Tape Border Odor-Barrier Rustle-Free Film With Belt Tabs With ComfortWear Panels - Transparent — Body Side Only - Beige — Both Sides Box of 5 � � � � � � HCPCS: A4430 Transparent Stock No Beige Stock No 8474 8478 84711 8434 8438 84311 Barrier Opening Pouch Length up to 1" (25 mm) up to 1-1/2" (38 mm) up to 2" (51 mm) 9" (23 cm) 9" (23 cm) 9"
Non Sterile Kits — Drainable (continued) 89002 (CUT-TO-FIT) Box of 5 Kits Colostomy/Ileostomy Kit Includes: (1) 88501 SoftFlex (standard wear) Skin Barrier Without Tape Border Without Integrated Filter Clamp Closure Single-Use Package � � � � � HCPCS: A5061 Ultra-Clear Stock No Barrier Opening 89002 up to 2-1/2" (64 mm) Pouch Length 12" (30 cm) 89003 (CUT-TO-FIT) Box of 5 Kits Colostomy/Ileostomy Kit Includes: (1) 8651 Flextend (extended wear) Skin Barrier With Tape Border Without Integrated Filter Cl
Pouchkins Pediatric Pouching System Pouchkins Pediatric Pouching System
Pouchkins Pediatric Pouching System Hollister Ostomy. Details Matter. www.hollister.
Pou Pouchkins Pediatric Pouching System Premie Pouch 3777 (CUT-TO-FIT) Box of 15 Use as a Premie Closed or Drainable Pouch SoftFlex (standard wear) Skin Barrier — Flat Without Tape Border Without Starter Hole Without Integrated Filter Odor-Barrier Film Soft Wire Closure Without ComfortWear Panels � � � � � � � � HCPCS: A5052 + A4362 Ultra-Clear Stock No Barrier Opening 3777 Pouch Length up to 5/8" (15 mm) 4-1/2" (11.
Pouchkins Pediatric Pouching System One-Piece Pouches (continued) 3797 (CUT-TO-FIT) Box of 10 Urostomy Pouch SoftFlex (standard wear) Skin Barrier — Flat Without Starter Hole Without Tape Border Odor-Barrier Rustle-Free Film With ComfortWear Panels — Body Side Only � � � � � � HCPCS: A5071 Transparent Stock No 3797 Barrier Opening Pouch Length up to 1-1/2" (38 mm) 8-3/4" (22 cm) Two-Piece Skin Barrier 3761 (CUT-TO-FIT) Box of 5 SoftFlex (standard wear) Skin Barrier — Flat Without Starter Hole Without
Two-Piece Pouches (continued) 18382/18392 Closed Mini-Pouch With Integrated AF300 Filter Odor-Barrier Rustle-Free Film With Belt Tabs With ComfortWear Panels - Transparent — Body Side Only - Beige — Both Sides Box of 60 � � � � � HCPCS: A4419 Transparent Stock No Beige Stock No 18382 18392 Flange Size Pouch Length c 1-3/4" (44 mm) 7" (18 cm) 18402/18412 Urostomy Pouch Odor-Barrier Rustle-Free Film With Belt Tabs With ComfortWear Panels - Transparent — Body Side Only - Beige — Both Sid
Ostomy Accessories Ostomy Accessories
Adapt Ostomy Accessories Hollister Ostomy. Details Matter. www.hollister.
Ost Ostomy Accessories Adapt Skin Barrier Accessories 780x Adapt Barrier Rings (Flat) Flextend M (extended wear) Material Box of 10 � � HCPCS: A4385 Stock No Outer Diameter 7805 7806 2" (48 mm) 4" (98 mm) 795xx Adapt Convex Barrier Rings Flextend (extended wear) Material Box of 10 � � HCPCS: A4411 Stock No Inner Diameter 79520 79530 79540 13/16" (20 mm) — can be stretched to 1" (25 mm) 1-3/16" (30 mm) — can be stretched to 1-3/8" (35 mm) 1-9/16" (40 mm) — can be stretched to 1-3/4" (45 mm) 79
Ostomy Accessories Adapt Ostomy Belts 7300/7299 Ostomy Belts Beige Color Box of 10 � � HCPCS: A4367 Stock No Size 7300 7299 23"-43" (58 cm-109 cm) Medium 34"-65" (86 cm-165 cm) Large Skin Barrier 8800 8801 Flextend (extended wear) Skin Barrier � HCPCS for 8800: A4385 HCPCS for 8801: A5122 Stock No Size 8800 8801 4 x 4" (10 cm x 10 cm) 8 x 8" (20 cm x 20 cm) Box of 5 Box of 3 Skin Prepping Product 7917 Skin Gel Protective Dressing Wipes � 12 Cartons of 50 Wipes Each HCPCS: A5120 Stock No 7917
Odor Eliminators 773x m9 Odor Eliminator Spray � HCPCS: No Code Stock No (unscented) Description Quantity 7732 7733 2 oz (60 mL) pump spray 8 oz (240 mL) pump spray Box of 12 Box of 6 Stock No (Green Apple Scented) Description 7734 7735 Quantity 2 oz (60 mL) pump spray 8 oz (240 mL) pump spray Box of 12 Box of 6 771x m9 Odor Eliminator Drops � HCPCS: A4394 Stock No Description Quantity 7715 7717 1 oz (30 mL) bottle 8 oz (240 mL) bottle Box of 12 Box of 6 Cleaner/Decrystallizer 7736 m9 Cl
Ostomy Accessories Skin Care Products (continued) 517220 Restore Skin Conditioning Creme Box of 12 � HCPCS: A6250 Stock No Description 517220 4 oz (120 mL) bottle Irrigation Products 7721 Cone Irrigator Kit Includes: (1) Irrigator (1) Stoma Cone with Connector (1) Cleaning Brush Box 1 � � � � HCPCS: A4398 + A4399 Stock No 7721 7723 Stoma Cone with Connector Replacement Unit Box of 10 � � HCPCS: A4399 Stock No 7723 7740 Adapt Stoma Lubricant For Stoma Irrigation Box of 10 � � HCPCS: A4402 S
Replacement Filters 7766 Box of 5 Packs Hollister Replacement Filters For use with 366x, 383x and 389x 1 pack contains 20 Filters and 2 Plugs � � � HCPCS: A4368 Stock No 7766 Bedside Drainage Collection System with Anti-Reflux Valve 9839 Sample Port Sterile Fluid Pathway Box of 20 � � HCPCS: A4357 Stock No Description 9839 68 oz (2000 mL) Capacity Skin Barrier Pastes and Powders 7910 Karaya 5 Paste Box of 12 � HCPCS: A4405 Stock No Description 7910 4.
CenterPointLock Two-Piece Pouching System Letter Matching System To help you select compatible CenterPointLock Two-Piece System components, every CenterPointLock System product box label features a letter designation: H, I, J, K, or L. Once you’ve selected a CenterPointLock Two-Piece System Skin Barrier, select a pouch, irrigator drain, or stoma cap with a matching letter on the box label.
Flat Skin Barriers with Floating Flanges (continued) 370x (CUT-TO-FIT) Box of 5 HolliHesive (standard wear) Skin Barrier, Flat, Tape Border � HCPCS FOR 3702-3704 & 3707: A4414 HCPCS FOR 3706: A4415 Stock No 3707 3702 3703 3704 3706 Letter Match H I J K L Flange Size 1-1/2" (38 mm) 1-3/4" (44 mm) 2-1/4" (57 mm) 2-3/4" (70 mm) 4" (102 mm) Barrier Opening up to 3/4" (19 mm) up to 1" (25 mm) up to 1-1/2" (38 mm) up to 2" (51 mm) up to 3-1/4" (82 mm) 874x (PRE-SIZED) Box of 5 Flextend (extended wear) Skin B
CenterPointLock Two-Piece Pouching System Convex Skin Barriers with Floating Flanges (continued) 373x (PRE-SIZED) Box of 5 FlexWear (standard wear) Skin Barrier, Convex, Tape Border � HCPCS: A4373 Stock No 3730 3731 3732 3733 3734 3735 3736 3737 3738 3739 37310 37311 Letter Match Flange Size Barrier Opening H H H I I J J J J K K K 1-1/2" (38 mm) 1-1/2" (38 mm) 1-1/2" (38 mm) 1-3/4" (44 mm) 1-3/4" (44 mm) 2-1/4" (57 mm) 2-1/4" (57 mm) 2-1/4" (57 mm) 2-1/4" (57 mm) 2-3/4" (70 mm) 2-3/4" (70 mm) 2-3/4" (
Drainable Pouches (continued) 387x Box of 10 High Output Drainable Pouch, Without Integrated Filter, Clamp Closure, Odor-Barrier Film, Belt Tabs Without ComfortWear Panels � HCPCS: A4412 Transparent Stock No Letter Match Flange Size I J K 1-3/4" (44 mm) 2-1/4" (57 mm) 2-3/4" (70 mm) 3872 3873 3874 Pouch Length 16" (40 cm) 16" (40 cm) 16" (40 cm) 384x Box of 10 Drainable Mini-Pouch, Without Integrated Filter, Clamp Closure, Odor-Barrier Rustle-Free Film, Belt Tabs, Without ComfortWear Panels � HCPCS
CenterPointLock Two-Piece Pouching System Urostomy Pouches (continued) 390x Box of 10 Urostomy Pouch, Odor-Barrier Rustle-Free Film, Belt Tabs, Without ComfortWear Panels � HCPCS: A4432 Transparent Stock No 3907 3902 3903 3904 Letter Match Flange Size H I J K 1-1/2" (38 mm) 1-3/4" (44 mm) 2-1/4" (57 mm) 2-3/4" (70 mm) Pouch Length 9" (23 cm) 9" (23 cm) 9" (23 cm) 9" (23 cm) Stoma Cap 340x Box of 25 Stoma Cap, Integrated Filter, Odor-Barrier Rustle-Free Film Without ComfortWear Panels � HCPCS: A505
Karaya 5 One-Piece Pouching System Drainable Pouches 366x (PRE-SIZED) Box of 10 Drainable Pouch, Karaya 5 (standard wear) Skin Barrier — Convex, Tape Border, Replaceable Filter, Pouch Clamp Closure, Odor-Barrier Rustle-Free Film, Belt Tabs, Without ComfortWear Panels.
Karaya 5 One-Piece Pouching System Drainable Pouches (continued) 327x (PRE-SIZED) Box of 30 Drainable Pouch, Karaya 5 (standard wear) Skin Barrier — Convex, Tape Border, Without Integrated Filter, Pouch Clamp Closure, Odor-Barrier Film, Belt Tabs, Without ComfortWear Panels � HCPCS: A4389 Transparent Stock No 3278 3273 3279 3274 3275 3276 Pouch Size Barrier Opening 1-1/4" (32 mm) 1-1/2" (38 mm) 1-3/4" (44 mm) 2" (51 mm) 2-1/2" (64 mm) 3" (76 mm) 7/8" (22 mm) 1-1/8" (29 mm) 1-3/8" (35 mm) 1-1/2" (38 mm)
Other One-Piece Pouching System Closed Pouches 314x (PRE-SIZED) Box of 30 Closed Mini-Pouch, Tape Adhesive, Integrated Filter, Odor-Barrier Film, Without ComfortWear Panels � HCPCS: A4418 Transparent Stock No 3142 3148 3143 3149 3144 Barrier Opening Pouch Length 1" (25 mm) 1-1/4" (32 mm) 1-1/2" (38 mm) 1-3/4" (44 mm) 2" (51 mm) 7" (18 cm) 7" (18 cm) 7" (18 cm) 7" (18 cm) 7" (18 cm) Stoma Cap 318x (PRE-SIZED) Box of 30 Stoma Cap, Tape Adhesive, Integrated Filter, Odor-Barrier Film, Without ComfortWear
Glossary • Ostomy Care AF300 Filter: “AF” stands for Air Flow and “300” represents the 300 mm2 air flow surface area on every AF300 Filter Closed Pouch: A pouch without a spout or a clamp. Quick and easy to discard. It must be removed to be emptied Colostomy: An ostomy (surgical opening) created in the colon, part of the large intestine ComfortWear Pouch Panels: Lining over the plastic of the pouch to enhance comfort and discretion.
Irrigation: A procedure used to control the time of elimination from colostomy. It is not for everyone and requires special equipment and teaching Karaya 5 Skin Barrier: Karaya is a natural skin barrier that is well-suited for thin, fragile, and sensitive skin or in some cases where irritant dermatitis has occurred. It is mildly adhesive and needs a belt or tape to secure the pouching system Lock ’n Roll Microseal Closure: An integrated system for closing the bottom of drainable pouches.
Educational Resources Educational Resources
Secure Start services are here for your patients every step of the way offering: r Dedicated Support r Education & Resources r Insurance Matching r Ostomy Products To learn more call 1.888.808.7456, or visit www.hollister.
Educational Resources • Ostomy All of the Hollister educational materials listed below are available on our website: www.hollister.com Educational DVDs Ostomy Educational Theatre Literature No 921901 Online Education Program available at www.hollister.com Living with a Stoma available at www.hollister.com Secure Start Video Diaries available at www.hollister.
Pediatrics Product Adaptations in Pediatric Ostomy Care Literature No 908803 Psychosocial Adaptation Literature No Overcoming Life Discontinuity Following Ileostomy Surgery 908804 (online only) Associations between Financial Responsibility for Ostomy 910291 Pouching Systems, Pouching System Change Habits and Peristomal Skin Condition (online only) Post-Surgery Return to Sexual Activity (online only) 910296 Post-Surgery Social Isolation (online only) 910298 Ostomate Recollections of What They Really Needed
Educational Resources • Ostomy Instructional Materials Literature No Understanding Your Colostomy Booklet 907411 Understanding Your Ileostomy Booklet 907412 Understanding Your Urostomy Booklet 907413 Understanding Your Colostomy/Ileostomy/ 909961 Urostomy Booklet (English) (online only) Understanding Your Colostomy/Ileostomy/ 910130 Urostomy Booklet (Spanish) (online only) Understanding Your Colostomy/Ileostomy/ 910813 Urostomy Booklet (Russian) (online only) 921793 NEW! Understanding Your Colostomy/Ileosto
Ostomy Care Tips (Pads of 25) (continued) Literature No Pouchkins One-Piece Pouching System 907874 Pouchkins Premie & Newborn Pouching System 907876 Pouchkins Two-Piece Pouching System 907875 Routine Care of Your Ostomy 910399 Routine Care of Your Ostomy (Spanish) 910800 Skin Barriers 906756 Skin Gel Wipes 907250 Stoma Complications 907252 Stoma Site Selection 910134 Two-Piece Pouching System 910402 Two-Piece Pouching System (Spanish) 911173 Two-Piece Pouching System with FormaFlex Skin Barrier 911296 Types
Educational Resources • Ostomy Consumer Support Groups (continued) United Ostomy Associations of America, Inc. (UOAA) www.uoaa.org 1.800.826.0826 Crohn’s and Colitis Foundation of America (CCFA) www.ccfa.org 1.800.932.2423 C3Life www.C3Life.com Get Your Guts In Gear www.ibdride.org 1.866.9iGOTGUTS (944.6848) Shadow Buddies www.shadowbuddies.org 1.913.642.4646 Youth Rally Committee www.rally4youth.org Professional Organizations: Wound, Ostomy and Continence Nurses Society (WOCN) www.wocn.org 1.888.224.
Index • Stock Number Stock No Page(s) 10xx. . . . . . . . . . . . . 92 1410x. . . . . . . . . . . . 27 1420x. . . . . . . . . . . . 25 143x. . . . . . . . . . . . . 78 1430x. . . . . . . . . . . . 26 1440x. . . . . . . . . . . . 28 1450x. . . . . . . . . . . . 29 1460x. . . . . . . . . . . . 25 1470x. . . . . . . . . . . . 26 1480x. . . . . . . . . . . . 28 149xx. . . . . . . . . . . . 29 1520x. . . . . . . . . . . . 25 1540x. . . . . . . . . . . . 28 1550x. . . . . . . . . . . . 29 1560x. . . . . . . . .
Stock No Page(s) 529974 . . . . . . . . . 135 529975 . . . . . . . . . 137 529976 . . . . . . . . . 137 529977 . . . . . . . . . 138 529978 . . . . . . . . . 138 529979 . . . . . . . . . 138 716x. . . . . . . . . . . . . 78 7299 . . . . . . . . . . . . 68 7300 . . . . . . . . . . . . 68 7331 . . . . . . . . . . . . 69 7700 . . . . . . . . . . . . 71 771x. . . . . . . . . . . . . 69 7721 . . . . . . . . . . . . 70 7723 . . . . . . . . . . . . 70 7724 . . . . . . . . . . . . 70 7728 . . . . . . . . . . . .
Index • Product Name Name Page(s) ActiFlo Accessories............................................................................................109 ActiFlo Catheter Kits with Disposable Odor-Barrier Collection Bags.......................108 ActiFlo Catheter Kits with Drainable Odor-Barrier Collection Bag..........................108 Adapt Odor Eliminator and Lubricant.....................................................................67 Adapt Ostomy Belts.................................................
Name Page(s) New Image Closed Pouches.......................................................................... 32–33 New Image Convex Skin Barriers with Integrated Floating Flanges.................. 28–29 New Image Drainable Pouches...................................................................... 30–31 New Image Flat Skin Barriers with Integrated Floating Flanges........................ 25–27 New Image High Output Drainable Pouches..........................................................
Index • Product Name Name Page(s) Restore Hydro-Shield Foam Dressing..................................................................134 Restore Hydro-Shield Foam Dressing without Border...........................................134 Restore LITE Foam Dressing without Border........................................................133 Featuring TRIACT ADVANCED Technology Restore Non-Adhesive Foam Dressing with Silver and.........................................
HCPCS Cod Index • HCPCS Codes HCPCS Page(s) A4326 . . . . . . . . . . . . . . . . . . . . . . 98 A4328 . . . . . . . . . . . . . . . . . . . . . . 98 A4330 . . . . . . . . . . . . . . . . . . . . . 110 A4331 . . . . . . . . . . . . . . . . . . . . . . 97 A4349 . . . . . . . . . . . . . . . . . . . . . . 95 A4351 . . . . . . . . . . . . . . . . . . . . . . 92 A4352 . . . . . . . . . . . . . . . . . . . . . . 92 A4353 . . . . . . . . . . . . . . . . . . . 93, 94 A4357 . . . . . . . . . . . . . . . .
Hollister and logo, Hollister, ActiFlo, Adapt, Advance Plus, AF300, Anchor Fast, Apogee, Apogee Plus, CenterPointLock, ComfortWear, Extended Wear, Everyday, Flextend, FlexWear, FormaFlex, HolliHesive, InstaFlo, InView, Karaya 5, Lock ’n Roll, m9, New Image, Pouchkins, Premier, Premium, QuietWear, and SoftFlex are trademarks of Hollister Incorporated. C3Life, Secure Start, and “Hollister Ostomy. Details Matter.” are service marks of Hollister Incorporated.
Hollister Consumer Programs For consumer and healthcare professional product questions and sampling needs: 1.888.740.8999 For dealers, distributors, institutions, and pharmacy questions or orders: 1.800.323.4060 fax 1.847.680.1017 For helping new patients adjust to life with an ostomy or bladder management: Secure Start Services 1.888.808.7456 For additional information on Hollister Wound Care: www.hollisterwoundcare.
