Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each
Short Description: Ost skn barr convex <=4 sq i Coverage Code: Special coverage instructions apply
Action Code: No maintenance for this code
Date Added: January 1, 2003
Effective Date: January 1, 2006
Termination Date: