A5055 Stoma cap
Also known as: stoma cap, stoma cover, opening cover
A small protective cap that covers the stoma opening between ostomy pouch changes or in patients with continent pouches. Maintains skin health and hygiene.
In Plain Language
small cover for bowel opening; stoma protection cap
Clinical Context
Used between pouch changes or as primary containment in patients with minimal output. Allows skin breathing while protecting stoma.
RVU Information
CPT A5055 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
HCPCS A-codes cover medical supplies, equipment, and transport services. Documentation must establish medical necessity and include a physician order. For durable medical equipment (DME), a Certificate of Medical Necessity (CMN) or detailed written order may be required.
Specialties
Frequently Asked Questions
What is CPT code A5055?
CPT A5055 (Stoma cap) is a A Codes code. A small protective cap that covers the stoma opening between ostomy pouch changes or in patients with continent pouches. Maintains skin health and hygiene.
Does Medicare cover A5055?
Medicare coverage for A5055 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Used between pouch changes or as primary containment in patients with minimal output. Allows skin breathing while protecting stoma. A physician order is typically required.
When is CPT A5055 used?
Used between pouch changes or as primary containment in patients with minimal output. Allows skin breathing while protecting stoma.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.