2013 Ostomy Product Guide Making a Difference in People’s Lives You Enhance Patient Satisfaction... We Want to Help. From improving positive outcomes, to reducing readmission rates, to lowering costs, the quality ConvaTecConcierge.com, featuring a new and ™ of your care has greater implications than improved ConvaTec Starter Kit ordering tool, ever before. Like you, ConvaTec is focused can help enhance your patient care. Login Today! on the patient. We have the clinically proven OR call 877.585.0470 option 1 today to products and innovative services to ensure our be connected with YOUR ConvaTec customers have a positive experience. Concierge™ Specialist! ConvaTecConcierge.com 2 Your Partner in Care. ®/™ indicates trademarks of ConvaTec Inc. ©2013 ConvaTec Inc. 3 Table of Contents Customer Interaction Center Customer Interaction Center ...................................5 The ConvaTec Customer Interaction Center (CIC) has Product Specialists, including WOC (ET) nurses available Disclaimer .................................................5 five days a week to answer ConvaTec product-related Ostomy Skin Care & Accessory Products ...................7 questions and provide reimbursement information (HCPCS codes and utilization limits) for ConvaTec products to Two-Piece Ostomy Systems patients and professionals. ® + SUR-FIT Natura and Natura Products. 13-42 To contact the CIC department, call toll free 1-800-422- SUR-FIT Natura® Skin Barriers .....................15 8811, M-F 8:30am-7:00pm ET, or via the ConvaTec SUR-FIT Natura® Low Pressure Adaptor ..............25 website at: www.convatec.com SUR-FIT Natura® Pouches ........................27 Natura + Pouches .............................36 Surgical Post Operative Kits .......................38 Disclaimer Esteem synergy® and Esteem synergy® + Products ..........44 The reimbursement information provided by ConvaTec is Esteem synergy® Skin Barriers .....................44 intended to provide general information relevant to cod- Esteem synergy® Pouches ........................46 ing and reimbursement of ConvaTec’s products only. Coverage and payment policies for the same insurer can Esteem synergy® + Pouches .....................50 vary from one region to another and may change from time One-Piece Ostomy Systems ............................52 to time because of ongoing changes in government and insurance industry rules and regulations. Therefore, please Esteem® + ......................................54 confirm HCPCS codes with your local DME-MAC, private 55 ActiveLife® ........................................58 insurer, or Medicaid agency before processing claims. Little Ones® Pediatric Ostomy Systems ....................65 ConvaTec does not guarantee coverage or payment of its products listed herein. Wound Pouches ....................................69 Ostomy Resources ...................................73 GLOSSARY OF TERMS .....................................75 MEDICARE UTILIZATION CHARTS. .77 NUMERICAL INDEX ......................................78-80 ALPHABETICAL INDEX ...................................81-82 Trademark Notice Eakin, Eakin Cohesive and Slims are registered trademarks of T.G. Eakin Limited. Ostomysecrets is a registered trademark of Ostomy Secrets, LLC. Unless otherwise indicated, all other marks are registered trademarks or trademarks of ConvaTec Inc. © 2013 ConvaTec Inc. 4 5 Skin Care & Accessories Skin Care & Skin friendly stoma Accessory Products care with a little help from nature AllKare® Protective Barrier Wipe Non-water soluble formula for skin protection. Provides a barrier film layer on the skin under tapes, skin barriers/wafers, adhesives, and hydrocol- Looking after your skin is an loid dressings to help protect against irritation, excoriation and adhesive build-up. essential part of long-term stoma Product Code Wipes per box HCPCS management. But sometimes a 037439 50 A5120 simple appliance is not enough. 037444 100 A5120 That’s why ConvaTec skin care accessories can serve as an Sensi-Care™ Sting-Free Skin Barrier Wipe important accompaniment to your Non-alcohol, silicone based formula for skin protection. Provides a barrier film layer on the skin that protects it from the damaging effects of Skin Care & Accessories daily routine. adhesives, body waste and enzyme attack. Product Code Wipes per box Boxes per case* HCPCS Non-Sterile 413501 30 20 A5120 * sold by the case Sensi-Care™ Sting-Free Barrier Spray (non-aerosol) Non-alcohol, silicone based formula for skin protection. Provides a ConvaTec Stomahesive® Accessories barrier film layer on the skin that protects it from the damaging effects of adhesives, body waste and enzyme attack. contain Pectin – an ingredient derived Product Code Spray bottle size Qty. per box Boxes per Case* HCPCS form citrus fruits. Used correctly, these 420797 28 mL 1 12 A4369 413502 50 mL 1 12 A4369 accessories can help heal and protect * sold by the case peristomal skin, and that means greater ™ comfort for you. Sensi-Care Sting-Free Barrier Foam Applicator, Sterile From the name you trust for Non-alcohol, silicone based formula for skin protection. Provides a barrier film layer on the skin that protects it from the damaging effects of your ostomy needs. adhesives, body waste and enzyme attack. Product Code Applicator Size Individually Boxes per Case* HCPCS packaged Applicators per box 420793 1 mL 5 20 A4369 420794 1 mL 25 4 A4369 420795 3 mL 5 20 A4369 420796 3 mL 25 4 A4369 * sold by the case 6 7 AllKare® Adhesive Remover Wipe Eakin Cohesive® Seal For the gentle removal of all adhesives, including skin barriers, tapes, and hydrocolloid dressings. The AllKare® Adhesive Remover Wipe formula A leak resistant base for effectively removes tape, skin barrier/wafer, and adhesive residues from the skin that can reduce wear times. longer lasting protection Product Code Wipes per box HCPCS 037436 50 A4456 From the name you trust for your 037443 100 A4456 ostomy needs Sensi-Care™ Sting-Free Adhesive Remover Wipe Non-alcohol, silicone based formula that offers fast, painless removal of adhesive residue. Product Code Wipes per box Boxes per case* HCPCS 413500 30 20 A4456 * sold by the case Sensi-Care™ Sting-Free Skin All Seals are Not Adhesive Releaser Non-alcohol, silicone based formula that offers fast, painless release of adhesives from the skin. Created Equal Product Code Aerosol can size Qty. per box Boxes per Case* HCPCS Eakin Cohesive® Absorbs More Moisture1* Non-Sterile 413499 50 mL 1 12 A4455 Eakin Cohesive® Seals, when compared to Sterile 420798 150 mL 1 12 A4455 other ostomy seals were more effective at ab- sorbing moisture. When moisture is controlled, * sold by the case the peristomal skin is protected. Stomahesive® Paste Pectin-based Protective Skin Barrier 4.00 Use as a filler in uneven skin surfaces to help increase ostomy 3.50 system wear time and protect skin. 3.00 Product Code Size Qty. HCPCS 2.50 183910 2 oz. tube 1 tube per box A4406 2.00 1.50 Stomahesive® Protective Powder 1.00 Helps form a protective barrier against excoriated or weeping skin. 0.50 Grams absorbed per gram of product 0.00 Product Code Size Qty. HCPCS Eakin Cohesive® Hollister Adapt® Dansac GX-tra™ 025510 1 oz. bottle per bottle A4371 * As demonstrated in an in vitro lab test. Stomahesive® Skin Barrier Based on absorbed moisture per gram of ® A multipurpose skin barrier designed to help protect peristomal product compared to Hollister Adapt and skin and assist in the management of difficult stomas. Available in sterile Dansac GX-tra™ and non-sterile forms. 1. McGroggan, G. Effects of a hydrocolloid ostomy seal on fecal Product Code Size Qty. per box HCPCS enzyme activity and moisture absorption. Poster presented at: 3rd Non-Sterile Congress of the World Union of Wound Healing Societies; June 4-8, 021712 4” x 4” Wafers 5 A4362 2008; Toronto, Canada 021715 8” x 8” Wafers 3 A5122 Sterile 021901 4” x 4” Wafers 5 A4362 Eakin Cohesive is a registered trademark of T.G. Eakin Ltd. Adapt is a registered trademark of Hollister Inc. GX-Tra is a trademark of Dansac A/S 8 9 Skin Care & Accessories Stomahesive® Strips Visi-Flow® Irrigation Pouches (Moldable Adhesive) Double sided Stomahesive® Strips for use as a filler to protect or fill-in uneven skin surfaces next to an ostomy, fistula, or wound. Visi-Flow® Irrigator with Stoma Cone Product Code Size Qty. per box HCPCS Product Code Qty. HCPCS 025542 3 cards of 15 A4362 per box 5 strips each 401989 1 per box A4398, A4399 Eakin Cohesive® Seals Visi-Flow® Irrigation Sleeve A donut-shape ostomy accessory that can be molded to a variety of Transparent (compatible with SUR-FIT Natura® skin barriers) shapes. It acts as a gasket or barrier, and provides enhanced protection for hard-to-fit stomas. The unique moldable hydrocolloid barrier forms a gel that helps prevent skin damage by sealing the area between the skin and ostomy Product Code Skin Barrier Flange Size Qty. HCPCS Color Match per box appliance. 401911 l 38 mm (1 1/2”) 5 A4397 401912 l 45 mm (1 3/4”) 5 A4397 Product Code Size Qty. per box HCPCS 401913 l 57 mm (2 1/4”) 5 A4397 839002 Small 2” 20 A4385 401914 l 70 mm (2 3/4”) 5 A4397 839001 Large 4” 10 A4385 One tail closure per box. 839005* SLIMS 2” 10 A4385 Visi-Flow® Stoma Cone Eakin Cohesive® Skin Barrier Eakin Cohesive® Skin Barrier is moldable and moisture-absorbing. It Product Code Qty. HCPCS per box is designed to help protect the skin from contact with body fluids. It is used wherever the skin is damaged, excoriated or vulnerable and needs protection 022736 1 A4399 from body wastes and fluids.