MyMedi-AI

A5083 — Continent device, stoma absorptive cover for continent stoma

HCPCS Level II A-code · short descriptor: “Stoma absorptive cover”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Ostomy, tracheostomy & urological supplies
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-17; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-17; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

A5083 Medicare fee schedule (October 2026)

Base (no modifier) Ostomy, tracheostomy & urological supplies

Medicare allowable ranges from $0.92 to $1.07 depending on state and rural status.

Former-CBA payment limits: ceiling $0.92 · floor $0.78

StateNon-ruralRural
AK$0.92—
AL$0.92—
AR$0.92—
AZ$0.92—
CA$0.92—
CO$0.92—
CT$0.92—
DC$0.92—
DE$0.92—
FL$0.92—
GA$0.92—
HI$0.92—
IA$0.92—
ID$0.92—
IL$0.92—
IN$0.92—
KS$0.92—
KY$0.92—
LA$0.92—
MA$0.92—
MD$0.92—
ME$0.92—
MI$0.92—
MN$0.92—
MO$0.92—
MS$0.92—
MT$0.92—
NC$0.92—
ND$0.92—
NE$0.92—
NH$0.92—
NJ$0.92—
NM$0.92—
NV$0.92—
NY$0.92—
OH$0.92—
OK$0.92—
OR$0.92—
PA$0.92—
PR$1.07—
RI$0.92—
SC$0.92—
SD$0.92—
TN$0.92—
TX$0.92—
UT$0.92—
VA$0.92—
VI$0.92—
VT$0.92—
WA$0.92—
WI$0.92—
WV$0.92—
WY$0.92—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related A-codes

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