Product Guide

Transcription

Product Guide
Product Guide
Continence, Ostomy, Skin and Wound Care
Effective September 2014
A legacy of personal care
Coloplast is among the world’s leading manufacturers
of intimate healthcare products through a philosophy
that has served us well for many decades. We listen
carefully to people with conditions of a very private nature.
We understand their personal needs. Then we create
innovative solutions that make a significant difference
in their lives.
It began more than 50 years ago when a nurse named
Elise Sørensen came up with an ingenious idea after her
sister Thora had ostomy surgery. She created the world’s
first disposable ostomy bag with an adhesive ring. It gave
Thora the chance to live a normal life again.
That simple idea led to the formation of Coloplast and it
has evolved into a multitude of ostomy care products for
a wide range of needs. Coloplast has also expanded to
become a leader in urology and continence care products
as well as wound and skin care products.
Today, our passion for excellence has not waned. We
still listen to people with intimate conditions and the
professionals who care for them. And we dedicate
ourselves to finding solutions that improve their quality
of life. That is what made us a global leader in ostomy
products. It is how we will continue to lead well into
the future.
3
4
Table of Contents
Continence Care�����������������������������������������������7-44
Straights����������������������������������������������������������������������� 10-13
Coudes������������������������������������������������������������������������� 14-15
Closed Systems / Sets�������������������������������������������������� 16-19
Anal Irrigation................................................................. 20-21
Male External Catheters������������������������������������������������ 22-24
Leg and Drain Bags������������������������������������������������������ 25-27
Indwelling Catheters������������������������������������������������������ 28-29
Accessories������������������������������������������������������������������ 30-31
Discontinued Products�������������������������������������������������� 32-44
Wound Care����������������������������������������������������45-60
Foam Dressings������������������������������������������������������������ 49-52
Alginate Dressings��������������������������������������������������������� 53-54
Skin Sealant / Hydrocolloid Dressings���������������������������������55
Hydrocolloid Dressings��������������������������������������������������������56
Hydrophilic Paste / Wound Cleansers / Hydrogels���������������57
Contact Layer......................................................................58
Super Absorbents................................................................59
Discontinued Products��������������������������������������������������������60
Skin Care���������������������������������������������������������61-80
Cleansers���������������������������������������������������������������������� 66-67
Moisturizers������������������������������������������������������������������� 68-69
Skin Protectants������������������������������������������������������������ 70-71
Antifungals��������������������������������������������������������������������������72
Skin Fold Management�������������������������������������������������������73
Hand Hygiene���������������������������������������������������������������������74
Accessories������������������������������������������������������������������������75
Discontinued Products�������������������������������������������������� 76-80
Ostomy Care�������������������������������������������������81-188
Accessories������������������������������������������������������������������ 87-94
2-Piece Click��������������������������������������������������������������� 96-118
2-Piece Flex�������������������������������������������������������������� 119-132
1-Piece��������������������������������������������������������������������� 133-156
Post-op / Wound Management��������������������������������� 157-166
Pediatric�������������������������������������������������������������������� 167-177
Discontinued Products���������������������������������������������� 179-188
Reference Tools������������������������������������������189-224
Education
Continence Care���������������������������������������������������������������191
Ostomy Care������������������������������������������������������������� 192-193
Wound & Skin Care��������������������������������������������������� 194-195
Cross Reference
Continence Care ������������������������������������������������������ 196-200
Ostomy Care������������������������������������������������������������� 201-206
Skin Care������������������������������������������������������������������ 207-215
Wound Care�������������������������������������������������������������� 217-219
Medicare Utilization
Continence�����������������������������������������������������������������������220
Ostomy��������������������������������������������������������������������� 221-222
Wound Care����������������������������������������������������������������������223
HCPCS Codes���������������������������������������������������������� 224-227
Index������������������������������������������������������������������ 229
Continence Care | Effective September 2014
Continence
Product Guide
Continence
Important safety information
SpeediCath® Catheters are indicated for use by patients with chronic urine retention
and patients with a post void residual volume (PVR) due to neurogenic and nonneurogenic voiding dysfunction. The catheter is inserted into the urethra to reach the
bladder allowing urine to drain. There is a separate SpeediCath Compact Set device
intended for either males or females only. This is a single-use only product. Patients
are to contact their healthcare professional before performing self-cathetherization for
the first time and follow the instructions carefully. See the device manual for further
information or, call Coloplast Corp. at 1-866-226-6362 and/or consult the company
website at www.coloplast.us. Rx Only.
Self-Cath® Plus Intermittent Urinary Catheters are intended for use in male or female
patients requiring bladder drainage as determined by their physician. This device is
indicated for those individuals unable to promote a natural urine flow or for those who
have a significant volume of residual urine following a natural bladder voiding episode.
The device can be used by the patient once appropriate training has taken place or by
a trained healthcare professional. Single-use only. See the device manual for detailed
information regarding the procedure, contraindications, warnings, precautions, and
potential complications/adverse events. For further information, call
Coloplast Corp. at 1-866-226-6362 and/or consult the company website at www.
coloplast.us. Rx Only.
Ensure your patients get the
product you recommend.
Ask for SpeediCath® and
Self-Cath® by name.
Catheter users who have insurance can pay the
same price when buying any catheter within the
same category: straight,1 coudé,2 or catheter sets.3
1. HCPCS A4351 (straight)** 2. HCPCS A4352 (coudé)**
3. HCPCS A4353 (catheter set)**
DAW*
Self-Cath® Catheters are intended for use in male, female, and pediatric patients
(neonates, infants, children, adolescents, and transitional adolescents) requiring
bladder drainage as determined by their physician. This device is indicated for those
individuals unable to promote a natural urine flow or for those individuals who have a
significant volume of residual urine following a natural bladder-voiding episode. Singleuse only. See the device manual for detailed information regarding the procedure,
contraindications, warnings, precautions, and potential complications/adverse events.
For further information, call Coloplast Corp. at 1-866-226-6362 and/or consult the
company website at www.coloplast.us. Rx Only.
SureCath® Catheters are indicated for use by patients for intermittent catheterization
for the purpose of bladder drainage. See the device manual for detailed information
regarding the instructions for use, contraindications, warnings, precautions, and
potential complications/adverse events. For further information, call Coloplast Corp. at
1-866-226-6362 and/or consult the company website at www.coloplast.us. Rx Only.
Indications: The Peristeen® Anal Irrigation System is intended to instill water into the
colon through a rectal catheter, which incorporates an inflatable balloon, inserted into
the rectum to promote evacuation of the contents of the lower colon. The Peristeen
Anal Irrigation System is indicated for use by children (2 years - <12 years old),
adolescent (12 years - < 18 years old), transitional adolescent (18 - <21 years old) and
adult patients with neurogenic bowel dysfunction who suffer from fecal incontinence,
chronic constipation, and/or time-consuming bowel management procedures
No
Substitution
*D
ispense as written; exact
language to specify brand
dispensed varies by state.
Contact your Coloplast Sales
Rep or National Association of
Boards of Pharmacy for more
information.
Advise your patients to find a supplier who takes
assignment for the catheter you prefer by contacting
Coloplast Consumer Care at 1-866-226-6362.
Steps to ensuring patients get the catheter they want:
1. Include the following on each prescription:
Contraindications: Peristeen Anal Irrigation must not be used in the following
situations:
Patient Name
Address
• Known obstruction of the large bowel due to strictures or tumors
• Acute inflammatory bowel disease
• Diverticulitis
• Complex diverticular disease
• Abdominal or anal surgery within the last 3 months
• In patients who are pregnant and have not used the system before*
Rx SpeediCath Compact Set 28422
Dx: Urine retention
5 catheters / day x 30 days / month = 150 catheters / month
*If the patient is pregnant and has never used anal irrigation before, they should not
start the irrigation procedure during pregnancy
Warning: Anal irrigation procedure should always be carried out with care. Bowel
perforation is an extremely rare, but serious and potentially lethal complication to anal
irrigation and will require immediate admission to a hospital, often requiring surgery.
See the device manual for detailed information regarding the implant procedure,
contraindications, warnings, precautions, and potential complications/adverse
events. For further information, call Coloplast Corp at1-800-258-3476 or consult the
company website at www.coloplast.us. Rx Only.
For important information regarding the use of HCPCS codes listed and code
definitions, please see page 224.
8
No
d
i
l
a
V
t
Brand of catheter
Do not refill
Refill
Date
Times
Type of catheter (straight,
coudé, kit / closed system)
Frequency of catheterizations / day
and total catheters needed / month
M.D
D.E.A Number
Print Last Name
2. Enroll your patients in Coloplast Care
Call - contact Coloplast Care at 1-866-226-6362
Email - send request to [email protected]
Fax - send patient enrollment form to 1-800-501-8533
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 8
9
The world’s first ready-to-use hydrophilic-coated catheter
Easy to carry, store and use. The catheter comes prehydrated in a ready-to-use package. Therefore; no need to
wait for the catheter to hydrate. Hydrophilic coating is smooth
and uniform for minimal friction. Polished eyelets for comfort.
Uncoated Grip Zone™ area for control in handling. This
device is not made with natural rubber latex and is DEHP and
phtalate free.
Straights
Straights
SpeediCath®
SpeediCath® Compact and
SpeediCath Compact Plus
The compact ready-to-use hydrophilic-coated
catheter for women
Ready-to-use hydrophilic-coated catheter designed for
females. SpeediCath Compact Plus is about an inch longer
for those women who need a little more length to reach their
bladder. Compact discreet packaging makes it easy to store
and carry. This device is not made with natural rubber latex
and is DEHP and phtalate free.
SpeediCath® Single Units
SpeediCath catheter only. No insertion supplies.
SpeediCath® Compact Single Units
Straights
Code
28408
28410
28412
28414
28416
28418
SpeediCath Compact catheter only.
Size
8 FR
10 FR
12 FR
14 FR
16 FR
18 FR
Units
30
30
30
30
30
30
Description
14" length
14" length
14" length
14" length
14" length
14" length
HCPCS*
A4351
A4351
A4351
A4351
A4351
A4351
Size
8 FR
10 FR
12 FR
14 FR
Units
30
30
30
30
Description
2.75" length
2.75" length
2.75" length
2.75" length
HCPCS*
A4351
A4351
A4351
A4351
SpeediCath® Compact Plus
Female
28506
28508
28510
28512
28514
28516
Code
28578
28580
28582
28584
6 FR
8 FR
10 FR
12 FR
14 FR
16 FR
30
30
30
30
30
30
6" length
6" length
6" length
6" length
6" length
6" length
A4351
A4351
A4351
A4351
A4351
A4351
6 FR
8 FR
10 FR
6 FR
8 FR
10 FR
12 FR
30
30
30
30
30
30
30
6" length
6" length
6" length
10" length
10" length
10" length
10" length
A4351
A4351
A4351
A4351
A4351
A4351
A4351
SpeediCath Compact Female with additional catheter length for
women who want discretion but require a longer catheter.
Code
28810
Size
10 FR
Units
30
Description
3.5" length
HCPCS*
A4351
28812
12 FR
30
3.5" length
A4351
28814
14 FR
30
3.5" length
A4351
Pediatric
28706
28708
28710
28606
28608
28610
28612
10
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 8
11
Self-Cath®
for Intermittent Self-Catheterization
Single-use catheters designed for intermittent selfcatheterization
The hydrophilic coating activates immediately upon exposure
to water. The Self-Cath Plus has a unique, uncoated Grip
Zone™ area for control in handling. This device is not made
with natural rubber latex.
Self-Cath® Plus
Self-Cath® Straight Tip
Hydrophilic-coated catheter.
Straight
Code
4408
4410
4412
4414
4416
4418
Size
8 FR
10 FR
12 FR
14 FR
16 FR
18 FR
Units
30
30
30
30
30
30
Description
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
HCPCS*
A4351
A4351
A4351
A4351
A4351
A4351
10 FR
12 FR
14 FR
30
30
30
6" length, funnel end
6" length, funnel end
6" length, funnel end
A4351
A4351
A4351
6 FR
8 FR
10 FR
30
30
30
10" length, funnel end
10" length, luer end
10" length, luer end
A4351
A4351
A4351
Units
30
30
30
30
Description
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
HCPCS*
A4351
A4351
A4351
A4351
Female
4210
4212
4214
Pediatric
4306
4308
4310
Self-Cath® Plus Soft
Code
4110
4112
4114
4116
Size
10 FR
12 FR
14 FR
16 FR
Self-Cath uncoated catheters have fire-polished eyelets for
comfort, a siliconized surface for smooth insertion, and are
available in a variety of options. This device is not made with
natural rubber latex.
Straights
Straights
Self-Cath® Plus
The Self-Cath Straight Tip catheter with fire-polished
eyelets and a siliconized surface for smooth insertion.
Code
408
410
412
414
416
418
450
460
Size
8 FR
10 FR
12 FR
14 FR
16 FR
18 FR
14 FR
Units
30
30
30
30
30
30
50
12 FR
50
Description
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end,
curved packaging
16" length, funnel end,
curved packaging
HCPCS*
A4351
A4351
A4351
A4351
A4351
A4351
A4351
A4351
Self-Cath® Female
The Self-Cath Female catheter has been
designed for the shorter female urethra.
Code
208
210
212
214
240
Size
8 FR
10 FR
12 FR
14 FR
14 FR
Units
30
30
30
30
30
Description
6" length, funnel end
6" length, funnel end
6" length, funnel end
6" length, funnel end
6" length, luer end
HCPCS*
A4351
A4351
A4351
A4351
A4351
Self-Cath® Soft
The Self-Cath Soft catheter is a softer, clear,
catheter that is firmer than a red rubber catheter
for easy insertion.
Code
110
112
114
116
Size
10 FR
12 FR
14 FR
16 FR
Units
30
30
30
30
Description
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
HCPCS*
A4351
A4351
A4351
A4351
Self-Cath® Pediatric
Self-Cath Pediatric catheters have been
designed to accurately fit pediatrics.
Code
305
306
308
310
12
www.coloplast.us
1.800.533.0464
Size
5 FR
6 FR
8 FR
10 FR
Units
30
30
30
30
Description
10" length, funnel end
10" length, funnel end
10" length, luer end
10" length, luer end
HCPCS*
A4351
A4351
A4351
A4351
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 8
13
Self-Cath®
The world’s first ready-to-use hydrophilic-coated catheter
Single-use catheters designed for intermittent selfcatheterization
Easy to carry, store and use. The catheter comes prehydrated in a ready-to-use package. Therefore; no need to
wait for the catheter to hydrate. Hydrophilic coating is smooth
and uniform for minimal friction. Polished eyelets for comfort.
Uncoated Grip Zone™ area for control in handling. This
device is not made with natural rubber latex and is DEHP and
phtalate free.
SpeediCath Tapered Tip Coudé
®
Code
28490
28492
28494
28496
Size
10 FR
12 FR
14 FR
16 FR
Units
30
30
30
30
Description
14" length
14" length
14" length
14" length
HCPCS*
A4352
A4352
A4352
A4352
Self-Cath® Plus
for Intermittent Self-Catheterization
The hydrophilic coating activates immediately upon exposure
to water—for fast, clean lubrication and maximum ease of
use. The Self-Cath Plus has a unique, uncoated Grip Zone™
area for total control in handling. This device is not made with
natural rubber latex.
Self-Cath Plus Olive Tip Coudé
with Guide Stripe®
Size
8 FR
10 FR
12 FR
14 FR
16 FR
Units
30
30
30
30
30
The Guide Stripe® indicator allows for monitoring of the
catheter tip position throughout the catheterization process.
The eyelets have been repositioned to the sides of the
catheter.
Self-Cath® Olive Tip Coudé
with Guide Stripe®
Code
806
808
810
812
814
816
818
Size
6 FR
8 FR
10 FR
12 FR
14 FR
16 FR
18 FR
Units
30
30
30
30
30
30
30
Description
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
HCPCS*
A4352
A4352
A4352
A4352
A4352
A4352
A4352
Self-Cath® Tiemann/Tapered Tip Coudé
with Guide Stripe®
®
Code
4808
4810
4812
4814
4816
Self-Cath catheters have fire-polished eyelets for comfort,
a siliconized surface for smooth insertion, and are available
in a variety of options. This device is not made with natural
rubber latex.
Coudes
Coudes
SpeediCath®
Description
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
HCPCS*
A4352
A4352
A4352
A4352
A4352
Code
608
610
612
614
Size
8 FR
10 FR
12 FR
14 FR
Units
30
30
30
30
Description
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
HCPCS*
A4352
A4352
A4352
A4352
Self-Cath® Plus Tapered Tip Coudé
with Guide Stripe®
Code
4608
4610
4612
4614
14
Size
8 FR
10 FR
12 FR
14 FR
www.coloplast.us
Units
30
30
30
30
Description
16" length, funnel end
16" length, funnel end
16" length, funnel end
16" length, funnel end
HCPCS*
A4352
A4352
A4352
A4352
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 8
15
SureCath® Set
An instantly ready-to-use hydrophilic catheter in a compact
design with an integrated bag for both males and females. It is
discreet and easy to use. This device is not made with natural
rubber latex and is DEHP and phtalate free.
for Intermittent Self-Catheterization
SpeediCath® Compact Set
Female
Code
Size
Units
Hydrophilic-coated catheter set with sterile solution enclosed
in a single-use, ready-to-use collection bag. This device is not
made with natural rubber latex.
SureCath® Set with Insertion Supplies
Description
HCPCS*
28520
28522
28524
10 FR
12 FR
14 FR
30
20
30
3.5" length
3.5" length
3.5" length
A4353
A4353
A4353
Male
28422
12 FR
20
13.2" length
A4353
SpeediCath® with Insertion Supplies
SureCath Set catheter and collection bag, one pair of exam gloves,
one CSR wrap and two iodine prep pads.
Straight Tip 700mL
Code
28032
28022S
28023S
28024S
28032S
28033S
Size
14 FR
8 FR
10 FR
12 FR
14 FR
16 FR
The world’s first ready-to-use hydrophilic-coated catheter
Straight Tip 1200mL
Easy to carry, store and use. The catheter comes prehydrated in a ready to use package. Therefore; no need to
wait for the catheter to hydrate. Hydrophilic coating is bound
to catheter. polished eyelets for comfort. Uncoated Grip
Zone™ area for total control in handling. This device is not
made with natural rubber latex and is DEHP and phtalate free.
28036
28037
28036S
28037S
14 FR
16 FR
14 FR
16 FR
Units
Description
HCPCS*
20
100
100
100
100
100
14" length
14" length
14" length
14" length
14" length
14" length
A4353
A4353
A4353
A4353
A4353
A4353
20
20
100
100
14" length
14" length
14" length
14" length
A4353
A4353
A4353
A4353
Closed Systems / Sets
Closed Systems / Sets
SpeediCath® Compact Set
SureCath® Set without Insertion Supplies
Straight Tip 700mL
SpeediCath® with Insertion Supplies
SpeediCath catheter with one pair of non-latex exam gloves, one
waterproof drape, two iodine prep pads and urine collection bag.
Straights
Code
28481
28482
28483
28484
28485
28486
Size
Units
Description
HCPCS*
8 FR
10 FR
12 FR
14 FR
16 FR
18 FR
100
100
100
100
100
100
14" length
14" length
14" length
14" length
14" length
14" length
A4353
A4353
A4353
A4353
A4353
A4353
6 FR
8 FR
10 FR
12 FR
14 FR
16 FR
100
100
100
100
100
100
6" length
6" length
6" length
6" length
6" length
6" length
A4353
A4353
A4353
A4353
A4353
A4353
Female
28499
28500
28501
28502
28503
28504
16
www.coloplast.us
1.800.533.0464
Code
28009
28005S
28006S
28007S
28008S
28009S
Size
16 FR
8 FR
10 FR
12 FR
14 FR
16 FR
Units
Description
HCPCS*
20
100
100
100
100
100
14" length
14" length
14" length
14" length
14" length
14" length
A4353
A4353
A4353
A4353
A4353
A4353
20
20
100
100
100
100
14" length
14" length
14" length
14" length
14" length
14" length
A4353
A4353
A4353
A4353
A4353
A4353
Straight Tip 1200mL
28027
28028
28026S
28027S
28028S
28029S
12 FR
14 FR
10 FR
12 FR
14 FR
16 FR
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 8
17
Self-Cath Closed System
for Intermittent Self-Catheterization
The Self-Cath Closed System is a unisex closed system for
catheterization. The ring on the cap makes it easy to remove
and the EasyOff ™ tear tab makes the bag easier to empty.
This device is not made with natural rubber latex.
Self-Cath® Closed Systems with Insertion Supplies
Self-Cath pre-lubricated catheter,
gloves, 1100 mL seamless collection
bag, povidone-iodine swabsticks,
BZK wipe (towelette), underpad
and instructions for use.
Straight Tip
Code
1108
1110
1112
1114
1116
Size
8 FR
10 FR
12 FR
14 FR
16 FR
Units
50
50
50
50
50
Description
16" length
16" length
16" length
16" length
16" length
HCPCS*
A4353
A4353
A4353
A4353
A4353
14 FR
50
6" length
A4353
14 FR
50
16" length
A4353
16" length
16" length
A4353
A4353
Female
2214
Soft
Straight Tip
Code
1008
1010
1012
1014
1016
Self-Cath pre-lubricated catheter
and 1100 mL collection bag only.
No additional insertion supplies.
Size
8 FR
10 FR
12 FR
14 FR
16 FR
Units
50
50
50
50
50
Description
16" length
16" length
16" length
16" length
16" length
HCPCS*
A4353
A4353
A4353
A4353
A4353
14 FR
50
6" length
A4353
14 FR
50
16" length
A4353
16" length
16" length
A4353
A4353
2114
Closed Systems / Sets
Closed Systems / Sets
Self-Cath® Closed System Single Units
®
Olive Tip Coude with Guide Stripe®
2814
2816
14 FR
16 FR
50
50
Tapered Tip Coude with Guide Stripe®
2614
14 FR
50
16" length
A4353
Female
3214
Soft
3114
Olive Tip Coude with Guide Stripe®
3814
3816
14 FR
16 FR
50
50
Tapered Tip Coude with Guide Stripe®
3614
18
14 FR
www.coloplast.us
50
16" length
A4353
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 8
19
Peristeen
makes a
difference
Peristeen is an innovative anal irrigation system from Coloplast
for people who suffer from fecal incontinence or chronic
constipation. Using Peristeen minimizes the likelihood of
involuntary bowel leakage.
The system has been specially designed to make it portable
and easy to use. This offers independence and a sense of
security to the user. In clinical trials with patients with spinal
cord injuries, the Peristeen system reduced fecal incontinence
and constipation and improved quality of life.1
Anal Irrigation
Anal Irrigation
Peristeen® Anal Irrigation
Peristeen® Anal Irrigation
Code
Want to learn about a new
bowel management system?
Introducing Peristeen®
Anal Irrigation
For people who suffer from fecal
incontinence (leaking) or chronic
constipation from neurogenic bowel
syndrome, using Peristeen minimizes the
likelihood of involuntary bowel leakage.
29129
System
1 control unit
1 bag (with lid)
2 leg straps
1 toiletries bag
29122
Accessory
unit
29124
Strap
1 set of 2 leg straps
29125
Tube
2 tubes with blue connectors
29127
Accessory
unit
15 small size rectal catheters
1 bag (no lid)
15 standard size rectal catheters
1 bag (no lid)
FDA approved. Application for HCPCS* code pending. Available via prior
authorization process for Medicaid and private insurance.
To learn more visit www.peristeen.us
1. C
hristensen P et al. A randomized, controlled trial of transanal irrigation versus conservative bowel
management in spinal cord injured patients. Gastroenterology 2006; 131:738-747
20
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 8
21
Male External Catheters (Condom Catheters)
Coloplast offers a complete line of latex and non-latex male
external catheters. A variety of adhesive styles, sheath lengths
and one- and two-piece configurations are designed to suit
a variety of end-user needs. A complete incontinence system
can be achieved by combining a Coloplast male external
catheter and a Coloplast leg bag.
Conveen® Optima
Self-adhering silicone catheter is packaged
in a discreet, recyclable smart pack. Easy-on application
is both simple and trouble-free with the double-grip strip.
The triple-action anti-leak system with anti-kink bellow,
sure-grip ribs and push ring ensures maximum security
to our collection bag. The comfortable wear silicone
is soft and breathable, and the balanced adhesive
provides reliability and skin friendliness.
Not made with natural rubber latex.
Size
25 mm
30 mm
35 mm
40 mm
Units
30
30
30
30
HCPCS*
A4349
A4349
A4349
A4349
21 mm
25 mm
30 mm
35 mm
30
30
30
30
A4349
A4349
A4349
A4349
Sport Length
22121
22125
22130
22135
Code
5100
5200
5300
5400
5500
Size
23 mm
28 mm
31 mm
35 mm
40 mm
Units
100
100
100
100
100
HCPCS*
A4349
A4349
A4349
A4349
A4349
Conveen® Security+ Self-Sealing Male
External Catheter
Standard Length
Code
22025
22030
22035
22040
The Freedom Clear catheter offers a silicone
sheath designed for comfortable, everyday wear.
It features an anti-kink resevoir designed to prevent
urine backflow. Not made with natural rubber latex.
A self-sealing male external catheter features a
placement ring to assist with anatomical positioning and
an anti-kink reservoir designed to prevent urine backflows.
Integrated skin-friendly adhesive is gentle yet stays in
place. Pull-tab enables easy application. Transparent to
allow easy monitoring of the skin. Not made with natural
rubber latex.
Code
5221
5225
5230
5235
5240
5225H
5230H
5235H
5240H
Size
21 mm
25 mm
30 mm
35 mm
40 mm
25 mm
30 mm
35 mm
40 mm
Units
35
35
35
35
35
100
100
100
100
Male External Catheters
Male External Catheters
Freedom Clear®
HCPCS*
A4349
A4349
A4349
A4349
A4349
A4349
A4349
A4349
A4349
Freedom Clear Advantage® with Aloe
The Clear Advantage catheter is a premium,
self-adhering, silicone catheter designed for
maximum wear time. It features aloe in the adhesive
and an anti-kink reservoir designed to prevent
urine backflow. Not made with natural rubber latex.
Code
6100
6200
6300
6400
6500
6130
6230
6330
6430
6530
22
www.coloplast.us
Size
23 mm
28 mm
31 mm
35 mm
40 mm
23 mm
28 mm
31 mm
35 mm
40 mm
Units
100
100
100
100
100
30
30
30
30
30
Freedom Clear® LS
HCPCS*
A4349
A4349
A4349
A4349
A4349
A4349
A4349
A4349
A4349
A4349
1.800.533.0464
The Freedom Clear LS (Long Seal) is designed
with a longer-length adhesive seal on a thin
silicone sheath, providing added security and
comfort. Features an anti-kink reservoir designed to
prevent urine backflow. Not made with natural
rubber latex.
Code
5190
5290
5390
5490
5590
Size
23 mm
28 mm
31 mm
35 mm
40 mm
Units
100
100
100
100
100
HCPCS*
A4349
A4349
A4349
A4349
A4349
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
23
Manhood® Absorbent Pouch
The Freedom Clear SS (Sport Sheath) offers a thin,
brief silicone sheath for less roll-up at the base of
the catheter. It is a good choice for individuals with
penis retractions. Features an anti-kink reservoir
designed to prevent urine backflow. Not made with
natural rubber latex
Manhood Absorbent Pouch is designed for light to
moderate incontinence. Using a super-absorbent
polymer, the pouch can hold 250 mL of liquid.
Code
5110
5210
5310
5410
Size
23 mm
28 mm
31 mm
35 mm
Freedom Cath
Code
4200-B
Units
100
100
100
100
HCPCS*
A4349
A4349
A4349
A4349
Size
23 mm
28 mm
31 mm
35 mm
23 mm
28 mm
31 mm
35 mm
Units
100
100
100
100
30
30
30
30
HCPCS*
A4349
A4349
A4349
A4349
A4349
A4349
A4349
A4349
Freedom Active Cath®
Size
23 mm
28 mm
31 mm
35 mm
HCPCS*
One size fits most
Conveen® Security + Leg Bags
Conveen® Security+ Leg Bag
Secure and reliable urine collection bag with
anti-kink tubing to prevent accidental leakage.
Free of PVC and phthalates.
Code
Size
Units
Description
HCPCS*
Non-Sterile
21026
17 oz. (500 mL)
10
21027
34 oz. (1000 mL)
10
21029
17 oz. (500 mL)
10
21034
17 oz. (500 mL)
10
21053
34 oz. (1000 mL)
10
21054
34 oz. (1000 mL)
10
50 cm, clamp,
flocked backing,
straps
50 cm, clamp,
flocked backing,
straps
A4358
6 cm, lever tap,
straps
50 cm, lever tap,
straps
6 cm, lever tap,
straps
50 cm, lever tap,
straps
A4358
A4358
Sterile
Active Cath catheter is a self-adhering, extended
wear, one-piece latex catheter. Combines a
shortened latex sheath with a wide, watertight
adhesive seal. Anti-kink reservoir designed to
prevent urine backflow.
Code
8100
8300
8305
8500
Units
30
Features a discreet design and color scheme to be less visible
under clothing. Two types are available, clamp or lever
tap, anti-kink tubing, soft cloth backing, straps and extended
outlet tubing for urine emptying process.
®
Freedom Cath catheter is a self-adhering,
one-piece latex catheter for secure everyday
use. Combines a comfortable latex sheath with
a wide, watertight adhesive seal. Anti-kink reservoir
prevents backflow of urine.
Code
8000
8200
8205
8400
8030
8230
8235
8430
Size
250 mL
Leg and Drain Bags
Male External Catheters
Freedom Clear® SS
Units
100
100
100
100
HCPCS*
A4349
A4349
A4349
A4349
A4358
A4358
A4358
Freedom Gizmo™
The Gizmo male external catheter is a latex catheter
with a single-sided adhesive strip. It features a pure,
soft, natural latex-reinforced funnel end with an anti-kink
reservoir designed to prevent urine backflow. No
adhesive comes into contact with skin.
Code
7275
7250
7200
24
Size
23 mm
28 mm
35 mm
www.coloplast.us
Units
100
100
100
HCPCS*
A4349
A4349
A4349
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
25
Reusable Latex Leg Bags
Only the Coloplast Alpine® Leg Bag has the patented
KRAYLEX® odor barrier, offset port options and integrated
loops providing total confidence and comfort.
Deluxe leg bag with pre-attached, adjustable,
anti-kink tubing. Secure, user-friendly closure,
soft cloth backing, anti-reflux valve, and
chambered panels for discretion and low
profile. Not made with natural rubber latex.
Code
5170
Size
Units
21 oz. (600 mL)
10
5171
21 oz. (600 mL)
10
5174
28 oz. (800 mL)
10
Description
Medium with
18" tubing
Medium with
18" tubing, Sterile
Large with
18" tubing
HCPCS*
A4358
A4358
A4358
Alpine® Reusable Leg Bag
Code
Capacity Port
68006 R or L 15 oz.
Extra-large drainage bag with anti-reflux valve,
volume markings and soft cloth backing. Secure,
user-friendly closure. Not made with natural rubber latex.
Size
Units
51 oz. (1500 mL)
10
Description
Extra Large with
36" tubing
68004
HCPCS*
A4357
Units
30
10
26 oz.
Description
Non-Sterile
Sterile
A5112
Straight
A5112
13 x 5"
(33 x 12.7 cm)
Long Slim
68003 R or L 26 oz.
Offset R or L 20 x 5"
(50.8 x 12.7 cm)
A5112
32 oz.
Straight
17 x 5"
(43.2 x 12.7 cm)
A5112
44 oz.
Straight
20 x 5"
(50.8 x 12.7 cm)
A5112
Large
Large volume (2 liters) bedside drainage bag. Non-sterile
package includes 30 bags and tubes and 3 hangers.
Sterile package includes 10 bags and 2 hangers.
Not made with natural rubber latex.
Size
2 liters
2 liters
Offset R or L 11 x 4"
(27.9 x 10.2 cm)
Short Wide
Moveen® Drainage Bag
Code
21346
21356
HCPCS*
Sport/Small
Security+ Extra Large
Drainage Bag
Code
5062
Size
Leg and Drain Bags
Leg and Drain Bags
Security+ Contoured Leg Bag with
Non-Latex Fabric Leg Bag Straps
68001
HCPCS*
A4357
A4357
Extra Large
68007
Conveen® Active Leg Bag
The Conveen Active Leg bag provides a reliable and
discreet solution for patients. It wraps around the thigh
with the bag facing inward for minimal visibility, even
when wearing shorts. The bag’s fabric fastening system
enables hassle-free fitting and keeps the bag in place,
even during sport activities. Not made with natural
rubber latex.
Code
25502
26
Size
Units
8.5 oz. (250 mL)
30
www.coloplast.us
Description
Non-sterile
HCPCS*
A4358
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
27
Folysil® 100% Silicone Indwelling Catheters.
Folysil® 2-way Coude
Code
Folysil® 2-way Pediatric
Code
Straights
AA 6106
AA 6108
AA 6110
Maximum
Balloon
Capacity
Size
Description
1.5 cc
3 cc
3 cc
6 FR
8 FR
10 FR
12" length
12" length
12" length
5
5
5
A4344
A4344
A4344
3 cc
3 cc
8 FR
10 FR
12" length
12" length
5
5
A4340
A4340
Coudé
AA 6308
AA 6310
Open-tip
AA 6408
AA 6410
Units HCPCS*
3 cc
3 cc
8 FR
10 FR
10" length
12" length
5
5
A4344
A4344
AA 6112
AA 6114
AA 6116
AA 6118
AA 6120
AA 6122
AA 6124
AA 6C18
AA 6C20
AA 6C22
AA 6C24
28
Maximum
Balloon
Capacity
10 cc
10 cc
15 cc
15 cc
15 cc
15 cc
15 cc
30 cc
30 cc
30 cc
30 cc
www.coloplast.us
Size
Description
12 FR
14 FR
16 FR
18 FR
20 FR
22 FR
24 FR
18 FR
20 FR
22 FR
24 FR
16" length
16" length
16" length
16" length
16" length
16" length
16" length
16" length
16" length
16" length
16" length
10 cc
10 cc
15 cc
15 cc
15 cc
15 cc
15 cc
Size
Description
12 FR
14 FR
16 FR
18 FR
20 FR
22 FR
24 FR
16" length
16" length
16" length
16" length
16" length
16" length
16" length
Units HCPCS*
5
5
5
5
5
5
5
A4340
A4340
A4340
A4340
A4340
A4340
A4340
Folysil® 2-way Open Tip
Code
Folysil® 2-way Straight
Code
AA 6312
AA 6314
AA 6316
AA 6318
AA 6320
AA 6322
AA 6324
Maximum
Capacity
Indwelling Catheters
Indwelling Catheters
Cysto-Care®
AA 6412
AA 6414
AA 6416
AA 6418
AA 6420
AA 6422
AA 6424
Maximum
Capacity
10 cc
10 cc
15 cc
15 cc
15 cc
15 cc
15 cc
Size
Description
12 FR
14 FR
16 FR
18 FR
20 FR
22 FR
24 FR
16" length
16" length
16" length
16" length
16" length
16" length
16" length
Units HCPCS*
5
5
5
5
5
5
5
A4344
A4344
A4344
A4344
A4344
A4344
A4344
Units HCPCS*
5
5
5
5
5
5
5
5
5
5
5
A4344
A4344
A4344
A4344
A4344
A4344
A4344
A4344
A4344
A4344
A4344
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
29
Alpine® Quick Valve
Code
68300
Intermittent Catheter Extension Tube
Code
475
Size
24"
Units
12
HCPCS*
A4331
Male External Catheter/Bag Accessories
Deluxe Leg Bag Straps
Units
1
HCPCS*
A4335
Bag Hanger
Reusable, sturdy, plastic drainage bag hanger
secures tubing and ensures bag stability.
• Not made with natural rubber latex
Code
5070
Size
One size
Units
1
HCPCS*
A4421
Security+ Fabric Leg Bag Straps
Stretchable Velstretch®.
Not made with natural rubber latex.
Code
7080
Size
10"
Accessories
Accessories
Intermittent Catheter Accessories
Size
2"
Units
2
HCPCS*
A5114
Units
2
HCPCS*
A5114
Soft, reusable, elastic fabric straps.
Not made with natural rubber latex.
Code
50501
Size
15" length
Units
10 pair
HCPCS*
A5114
Comfort Leg Bag Straps
Adjustable/Stretchable.
Not made with natural rubber latex.
Code
7090
Size
1"
Alpine® Fresh Cleaner
For use with Alpine reusable leg bags.
Clear Tube and Connector Kit
Not made with natural rubber latex.
Code
7092
Size
18"
Units
1 kit
HCPCS*
A4331
Code
90000
Units
1
Size/Description
16 fl. oz. bottle
HCPCS*
A5131
Alpine® Deluxe Leg Bag Straps
The Alpine Leg Bag includes two latex straps. However, for added
comfort and even distribution of weight, Coloplast recommends
Alpine Deluxe Leg Bag Straps, which are not made with natural
rubber latex. They are gentle on the skin, reusable and washable.
Plus, their unique finger loop allows for ease of use.
Code
22312
30
Size
Units
Combination
2
www.coloplast.us
Description
1 small & 1 medium
HCPCS*
A5114
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
31
www.coloplast.us
1.800.533.0464
Self-Cath® Coude
Cysto-Care® Closed System with
Insertion Supplies
Cysto-Care® Closed System Single
Units
Convert from
Cysto-Care® Coude/Tiemann Red
Rubber Latex Urethral Catheter
Cysto-Care® Red Rubber Latex
Urethral Catheter
Convert from
588
586
582
486
CS 1120
CS 1140
CS 1160
8 FR
10 FR
12 FR
14 FR
20FR
22FR
CS 0120
CS 0140
CS 0160
Size
UC 6020
UC 6022
12FR
14FR
16FR
18FR
8FR
10FR
12FR
14FR
16FR
18FR
20FR
22FR
24FR
Size
Code
UC 6012
UC 6014
UC 6016
UC 6018
UC 1008
UC 1010
UC 1012
UC 1014
UC 1016
UC 1018
UC 1020
UC 1022
UC 1024
Code
20
20
20
20
10
10
Units
10
10
10
10
10
10
10
10
10
10
10
10
10
Units
Self-Cath® Coude with Guide Stripe
Convert to
Folysil® 2-way Coude
Folysil® 2-way Indwelling Catheter
Convert to
608
610
612
614
AA 6320
AA 6322
Code
AA 6312
AA 6314
AA 6316
AA 6318
AA 6108 pediatric
AA 6110 pediatric
AA 6112
AA 6114
AA 6116
AA 6118
AA 6120
AA 6122
AA 6124
Code
8 FR
10 FR
12 FR
14 FR
20FR
22FR
Size
12FR
14FR
16FR
18FR
8FR
10FR
12FR
14FR
16FR
18FR
20FR
22FR
24FR
Size
30
30
30
30
5
5
Units
5
5
5
5
5
5
5
5
5
5
5
5
5
Units
Discontinued Products
Conversion sheet: Intermittent Catheters
Discontinued Products
32
33
www.coloplast.us
1.800.533.0464
Self-Cath Female Coude, Olive-Tip
Straight Tip (Kit)
Self-Cath® Hydrogel
Straight Tip
SureCath® Set
20/box
Convert from
SpeediCath® Compact w/ Acc.
w/ Acc.
SpeediCath® Complete
Single
®
14 FR
28644
9408
9410
9412
9414
9416
19408
19410
19412
19414
19416
28005
28006
28007
28008
8 FR
10 FR
12 FR
14 FR
16 FR
8 FR
10 FR
12 FR
14 FR
16 FR
8 FR
10 FR
12 FR
14 FR
Size
12 FR
28642
Code
10 FR
8 FR
10 FR
12 FR
14 FR
10 FR
12 FR
14 FR
12 FR
14 FR
Size
28640
28638
28191
28192
28194
28241
28242
28244
8212
8214
Code
50
50
50
50
50
50
50
50
50
50
20
20
20
20
Units
120
120
120
120
20
20
20
100
100
100
30
30
Units
Closed System Kits
Self-Cath® Closed System/Self-Cath
Closed System Singles
SureCath® Set
100/box
Convert to
SpeediCath® Compact/ SpeediCath
Female w/ Acc.
SureCath® Set
Self-Cath Coude, Olive-Tip
®
Convert to
1108 or 408
1110 or 410
1112 or 412
1114 or 414
1116 or 416
1008 or 408
1010 or 410
1012 or 412
1014 or 414
1016 or 416
28005S
28006S
28007S
28008S
Code
28584 or 28503
28582 or 28502
28580 or 28501
28578 or 28500
28026S
28027
28028
28023S
28024S
28036S
812
814
Code
8 FR
10 FR
12 FR
14 FR
16 FR
8 FR
10 FR
12 FR
14 FR
16 FR
8 FR
10 FR
12 FR
14 FR
Size
14 FR
12 FR
10 FR
8 FR
10 FR
12 FR
14 FR
10 FR
12 FR
14 FR
12 FR
14 FR
Size
50 or 30
50 or 30
50 or 30
50 or 30
50 or 30
50 or 30
50 or 30
50 or 30
50 or 30
50 or 30
100
100
100
100
Units
30 or
100
30 or
100
30 or
100
30 or
100
100
20
20
100
100
100
30
30
Units
Discontinued Products
Convert from
Discontinued Products
34
35
www.coloplast.us
1.800.533.0464
Conveen Ultra Secure Self-Sealing
MEC
Conveen® Latex MEC and Liner
Conveen® Latex Self-Sealing MEC
Convert from
Conveen® Security+ MEC and Liner
®
5125
5130
5135
5140
5130H
5135H
5140H
5212
5200
5205
5210
5215
5200H
5205H
5210H
Code
5021
5025
5030
5035
5040
5025H
5030H
5035H
5040H
22011
22012
22013
22014
Code
25 mm
30 mm
35 mm
40 mm
30 mm
35 mm
40 mm
20 mm
25 mm
30 mm
35 mm
40 mm
25 mm
30 mm
35 mm
Size
21 mm
25 mm
30 mm
35 mm
40 mm
25 mm
30 mm
35 mm
40 mm
21 mm
25 mm
30 mm
35 mm
Size
35
35
35
35
100
100
100
35
35
35
35
35
100
100
100
Units
35
35
35
35
35
100
100
100
100
35
35
35
35
Units
Gizmo™ Latex MEC
Freedom® Cath
Convert to
Conveen® Security+ Self-Sealing MEC
Conveen Optima Sport Length
®
Convert to
7275
7250
7200
n/a
7250
7200
n/a
8030
8230
8235
8430
n/a
8200
8205
8400
Code
5221
5225
5230
5235
5240
5225H
5230H
5235H
5240H
22121
22125
22130
22135
Code
100
100
100
100
100
28 mm
35 mm
100
100
100
28 mm
31 mm
35 mm
23 mm
28 mm
35 mm
30
30
30
30
Units
35
35
35
35
35
100
100
100
100
30
30
30
30
Units
23 mm
28 mm
31 mm
35 mm
Size
21 mm
25 mm
30 mm
35 mm
40 mm
25 mm
30 mm
35 mm
40 mm
21 mm
25 mm
30 mm
35 mm
Size
Discontinued Products
Convert from
Discontinued Products
36
37
www.coloplast.us
1.800.533.0464
5120
5120H
Conveen® Latex MEC and Liner
35/box
100/box
Security + MEC and Liner
5221H
22011H
22012H
22013H
22014H
Code
7875
7850
7800
5510
20 mm
20 mm
21 mm
21 mm
25 mm
30 mm
35 mm
Size
23 mm
28 mm
35 mm
40 mm
23 mm
28 mm
31 mm
35 mm
40 mm
Extra Large
5130
5230
5330
5430
5530
Large
5607
Size
5606
Conveen® Security + Self-Sealing MEC
100/box
Conveen® UltraSecure
100/box
Convert from
Uro-San Plus
Freedom® Clear SS
Freedom® Clear
30/box
Net Pants
Code
35
100
100
100
100
100
100
Units
100
100
100
100
30
30
30
30
30
100
100
Units
Security + MEC and Liner
Freedom® Cath
Freedom® Cath
Conveen® Security + Self-Sealing MEC
35/box
Conveen® Optima Sport
Convert to
Freedom® Cath
Conveen® Optima
Freedom® Clear
100/box
Convert to
8030
8000
5221
22121
22125
22130
22135
Code
8000
8200
8400
22040
5100
5200
5300
5400
5500
n/a
n/a
Code
23 mm
23 mm
21mm
21 mm
25 mm
30 mm
35 mm
Size
23 mm
28 mm
35 mm
40mm
23mm
28 mm
31 mm
35 mm
40 mm
Size
30
100
35
30
30
30
30
Units
100
100
100
30
100
100
100
100
100
Units
Discontinued Products
Convert from
Discontinued Products
38
39
www.coloplast.us
1.800.533.0464
9004
9006
9005
9007
Code
500 mL
500 mL
500 mL
500 mL
500 mL
1000 mL
500 mL
1000 mL
Freedom® Fas-Tap Drainage Port Leg Bags
Singles
9000
9002
Kits
9001
9003
250 mL
500 mL
1000 mL
1000 mL
9010
7094
7096
500 mL
7097
Size
500 mL
1000 mL
7093
Code
7078
7088
500 mL
1000 mL
500 mL
1000 mL
500 ml
1000 ml
500 ml
1000 ml
Size
Security+ Leg with Non-Latex Fabric Leg bag straps
5161
51619
5167
51670
Freedom® Twist Drainage Port Leg Kits
Freedom® Twist Drainage Port Legs
Convert from
Freedom® T-Tap Drainage Leg Bag Kit
7077
7087
Freedom® Comfort Strap T-Tap Drainage Leg Bags
Freedom® Comfort Strap T-Tap Drainage Leg Bags
7079
7089
Kits
Freedom Leg Bags - Fas-Tap
Singles
®
1
1
1
1
1
1
1
1
1
Units
1
1
1
1
1
1
1
1
1
1
Units
Conveen® Sec + Lever
Conveen® Sec + Clamp
Conveen® Sec + Clamp
Conveen® Sec + Lever
Convert to
Conveen® Sec + Clamp
Conveen® Sec + Lever
Conveen® Sec + Clamp
Conveen® Sec + Lever
Convert to
21034
21054
21026
21027
21026
21026
21026
21026
21026
21026
21027
21054
21034
Code
21026
21027
21034
21054
21026
21027
21034
21054
21026
21027
Code
500 mL
1000 mL
500 mL
1000 mL
500 mL
500 mL
500 mL
500 mL
500 mL
500 mL
1000 mL
1000 mL
500 mL
Size
500 mL
1000 mL
500 mL
1000 mL
500 mL
1000 mL
500 ml
1000 ml
500 ml
1000 ml
Size
1
1
1
1
1
1
1
1
1
1
1
1
1
Units
1
1
1
1
1
1
1
1
1
1
Units
Discontinued Products
Convert from
Discontinued Products
40
41
www.coloplast.us
1.800.533.0464
Cysto-Care 2-way Coude/Tiemann
Indwelling Catheter
Adhesive Remover 8oz
Deluxe Leg Bag Straps
EZ-Hold
Adjustable Leg Strap with Tube
Holder
Drip Collector
Convert from
Cysto-Care® 3-way Irrigation
Indwelling Catheter
®
3408
7080
4060
8 oz
2"
1"
80 mL
100 mL
10cc
30cc
30cc
5410
5420
Size
Code
16FR
18FR
20FR
12FR
14FR
16FR
18FR
20FR
22FR
24FR
Size
UT 7015
UT 7030
UT 7035
UC 3516
UC 3518
UC 3520
UC 6512
UC 6514
UC 6516
UC 6518
UC 6520
UC 6522
UC 6524
Code
1
2
1
31
31
20
20
20
Units
10
10
10
10
10
10
10
10
10
10
Units
Adhesive Remover
Comfort Leg Bag Straps
N/A
Manhood Absorbent Pouch
Convert to
Folysil® 3-way Neo Bladder
Folysil® 2-way Coude
Convert to
34050
7090
4200-B
4200-B
N/A
N/A
N/A
Code
n/a
n/a
n/a
AA 6312
AA 6314
AA 6316
AA 6318
AA 6320
AA 6322
AA 6324
Code
Wipes
1"
250 mL
250 mL
Size
12FR
14FR
16FR
18FR
20FR
22FR
24FR
Size
50
2
30
30
Units
5
5
5
5
5
5
5
Units
Discontinued Products
Convert from
Discontinued Products
42
43
44
www.coloplast.us
1.800.533.0464
Product Guide
Wound Care | Effective September 2014
Wound
Important safety information
Wound
Biatain® Ag Foam Adhesive and Non-Adhesive Dressings are indicted
for wounds with moderate to high amounts of exudates, including
leg ulcers and Category II-IV pressure ulcers and for second-degree,
donor sites, diabetic foot ulcers, post-operative wounds and skin
abrasions with delayed healing due to bacteria, or where there is a
risk of infection. The dressings may be used to support moist wound
healing in patients who are in treatment for a local or systemic infection
under the discretion of a healthcare professional and are suitable
for use in combination with compression therapy. Depending on
prognosis of wound, Biatain Ag may be used throughout the healing
process to provide protection for the indicated types of wound. Biatain
Ag foam filler/cavity is indicated for deep exuding wounds including
leg, ulcers, pressure ulcers, diabetic foot ulcers and acute wounds.
Biatain dressings are single-use only. See the device manual for
detailed information regarding complete instructions, contraindications,
warnings, precautions, and potential adverse events. For further
information, call Coloplast Corp. at 1-800-533-0464 and/or consult
the company website at www.coloplast.us.
Wound Dressing
Selection: 4-Quad Wound
Mangement System
Four quadrants of drainage and depth
standardize the routine dressing decisions
• Ensure every wound gets the right dressing
• Coloplast dressings enable a simple formulary
Biatain® Silicone Ag Foam Dressings are indicated for use in the
management of moderately to highly exuding leg ulcers and pressure
ulcers. The dressing can also be used for 2nd degree burns, donor
sites, post operative wounds and skin abrasions. Biatain dressings
are single-use only. See the device manual for detailed information
regarding complete instructions, contraindications, warnings,
precautions, and potential adverse events. For further information,
call Coloplast Corp. at 1-800-533-0464 and/or consult the company
website at www.coloplast.us.
Biatain® Alginate Ag Dressings are indicted for wounds with
moderately to heavily exuding partial to full thickness wounds such
as post operative wounds, trauma wounds, leg ulcers, pressure
ulcers, diabetic ulcers, postoperative wounds and skin abrasions with
delayed healing due to bacteria, or where there is a risk of infection.
The dressings may be used to support moist wound healing in
patients who are in treatment for a local or systemic infection under
the discretion of a healthcare professional; are suitable for use in
combination with compression. The Biatain dressings are singleuse only. See the device manual for detailed information regarding
complete instructions, contraindications, warnings, precautions, and
potential adverse events. For further information, call Coloplast Corp.
at 1-800-533-0464 and/or consult the company website at www.
coloplast.us.
Comfeel® Plus Transparent Dressings may be used for superficial
burns, superficial partial-thickness burns, donor sites, post-operative
wounds and skin abrasions. Do not use on third degree burns.
This product is single use only. See the device manual for detailed
information regarding complete instructions, contraindications,
warnings, precautions, and potential adverse events. For further
information, call Coloplast Corp. at 1-800-533-0464 and/or consult
the company website at www.coloplast.us. Caution: Federal law (USA)
restricts this device to sale by or on the order of a physician.
For important information regarding the use of HCPCS codes listed
and code definitions, please see page 224.
46
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 46
47
Foam Dressings
Biatain® Foam Dressings are unique in their ability to manage
low-to-high levels of wound exudate across a variety of wound
types. 3D Polymer foam structure absorbs and locks away
exudate without sticking to the wound bed. Highly permeable
top film layer allows for optimal moist wound environment and
protects from water and external contaminants. Broad range
of non-adhesive and adhesive options, including specialized
shapes for the heel and sacrum. Not made with natural rubber
latex (sterile).
Biatain® Silicone.
It’s all in the foam.
Biatain® Silicone Foam Dressing
The superior absorption and fluid handling properties of
Biatain® Silicone ensures the optimal management of exudate.
The unique 3D foam structure absorbs the exudate vertically
and locks the fluid away within its structure, while leaving the
wound moist for optimal wound healing conditions.
With Biatain® Silicone you get:
• superior absorption
• easy application
• soft and flexible fit
The Biatain Silicone family
also includes:
®
• Biatain® Silicone Ag
- sustained release of silver
• Biatain® Silicone Lite
- for increased mobility
Exceptional
Conformability
When managing exudate
the Biatain® Silicone foam
conforms closely to the
wound bed for superior
absorption and
retention- even under
compression.
• Conforms to the wound bed for superior
absorption1 — even under body pressure
• Soft and flexible dressing with a silicone
adhesive for easy removal with minimal
damage or irritation to the skin2
Code
Size
Units
HCPCS*
33434
3 x 3" (7.5 x 7.5 cm)
10
A6212
33435
4 x 4" (10 x 10 cm)
10
A6212
33436
5 x 5" (12.5 x 12.5 cm)
10
A6212
33437
6 x 6" (15 x 15 cm)
5
A6212
33438
7 x 7" (18 x 18 cm)
5
A6213
Exudate Level
Biatain® Silicone Lite Foam Dressing
• Same benefits as Biatain Silicone
• Thinner foam for increased mobility
• Ideal for hard-to-dress areas or frequent
dressing changes
Code
Size
Units
HCPCS*
33444
3 x 3" (7.5 x 7.5 cm)
10
A6212
33445
4 x 4" (10 x 10 cm)
10
A6212
33446
5 x 5" (12.5 x 12.5 cm)
10
A6212
Exudate Level
For more information about Biatain® Silicone call
1-800-533-0464 or visit www.coloplast.us.
48
www.coloplast.us
1.800.533.0464
1. Anderson K, et al. A randomized, controlled study to compare the effectiveness of
two foam dressings in the management of lower leg ulcers. OWM. 2002:48(8):34-41.
2. Cooper P. Biatain Silicone: an atraumatic foam dressing for local exudate
management. Wounds UK. 2010:6(4):168-72.
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 46
49
• Unique foam structure manages moderate-to-high
wound exudate levels and protects the sacral area
• Hydrocolloid border optimizes adhesion
• Soft and flexible dressing with beveled edges
• Ideal for compression wraps and fragile skin
Code
Size
Units
HCPCS*
Code
Size
6105
2 x 2 3⁄4" (5 x 7 cm)
10
A6209
3485*
9 x 9" (23 x 23 cm)
3410*
4 x 4" (10 x 10 cm)
10
A6209
3413*
6 x 6" (15 x 15 cm)
5
A6210
3416
8 x 8" (20 x 20 cm)
5
A6211
Units
HCPCS*
5
A6213
Exudate Level
Exudate Level
Foam Dressings
Foam Dressings
Biatain® Sacral Foam Dressing
Biatain® Non-Adhesive Foam Dressing
Biatain® Ag Foam Dressings combine optimum exudate
absorptive capacity with controlled ionic silver-release
technology. The dressings demonstrate in-vitro antibacterial
activity in certain strains known to be detrimental to wound
healing such as MRSA and VRE.1 Clinical evidence shows a
45-56% ulcer size reduction within 4 weeks.2-5 Not made with
natural rubber latex (sterile).
Biatain Soft-Hold Foam Dressing
®
• Skin-friendly contact adherent provides a
“third hand” during dressing changes
• Helps minimizes adhesive trauma, easy to apply
and remove
• Manages moderate-to-high wound exudate levels
Code
Size
Units
HCPCS*
3473
2 x 2 3⁄4" (5 x 7 cm)
5
A6209
3470
4 x 4" (10 x 10 cm)
5
A6209
3475
6 x 6" (15 x 15 cm)
5
A6210
Exudate Level
Biatain® Adhesive Foam Dressing
• Optimal absorption and retentive foam with
skin-friendly, hydrocolloid-based adhesive border
• Hydrocolloid border reduces need for secondary
dressing
Biatain® Ag Non-Adhesive Foam Dressing
• Combines effective antimicrobial technology
with effective exudate management
• Manages moderate-to-high wound exudate levels
• Ideal under compression
Code
Size
Units
HCPCS*
9622
4 x 4" (10 x 10 cm)
5
A6209
9625
6 x 6" (15 x 15 cm)
5
A6210
Exudate Level
Code
Size
Units
HCPCS*
3430
4 x 4" (10 x 10 cm) circle pad
10
A6212
3420*
5 x 5" (12.5 x 12.5 cm)
10
A6212
3423*
7 x 7" (18 x 18 cm)
5
A6213
Biatain® Ag Adhesive Foam Dressing
• Combines effective antimicrobial technology
with effective exudate management
• Manages moderate-to-high wound exudate levels
• Hydrocolloid border reduces need for secondary dressing
Exudate Level
Biatain® Heel Foam Dressing
• Unique foam structure manages moderate-tohigh wound exudate levels and protects the heel
• Hydrocolloid border reduces need for
secondary dressing
Code
Size
3488*
7 1⁄2" x 8" (19 x 20 cm)
Code
Size
Units
HCPCS*
9632
5 x 5" (12.5 x 12.5 cm)
5
A6212
9635
7 x 7" (18 x 18 cm)
5
A6213
Exudate Level
Units
HCPCS*
5
A6212
Exudate Level
1. Data on file at Coloplast Corp.
2. Münter K-C et al. Effect of a sustained silver-releasing dressing on ulcers
with delayed healing: the CONTOP study. Journal of Wound Care 2006, 15(5),
199-206.
3. J ørgensen B et al. The silver-releasing foam dressing, Contreet Foam,
promotes faster healing of critically colonised venous leg ulcers: a
randomised, controlled trial. International Wound Journal 2005, 2(1), 64-73.
*Also available with Silver. See Antimicrobial Dressings on page 51-52
4. R
ayman et al. Sustained silver-releasing dressing in the treatment of
diabetic foot ulcers. British Journal of Nursing 2005, 14(2), 109-114.
5. Karlsmark T. et al. Clinical performance of a new silver dressing, Contreet
Foam, for chronic exuding venous leg ulcers. Journal of Wound Care 2003,
12(9), 351-354.
50
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 46
51
• Unique 3D foam that conforms to the wound
bed for superior absorption and continuous
release of silver to the wound
• Sustained release of silver during the entire
wear time (up to 7 days)
• Silicone adhesive for easy removal
Code
Size
Units
HCPCS*
39636
3 x 3" (7.5 x 7.5 cm)
5
A6212
39637
4 x 4" (10 x 10 cm)
5
A6212
39638
5 x 5" (12.5 x 12.5 cm)
5
A6212
Units
HCPCS*
5
A6212
Biatain® Alginate Dressings are made of a unique combination
of alginate and carboxymethylcellulose (CMC) for superior
absorption† and one-piece removal. Fast gelling effect when
in contact with wound exudate and maintains an optimal moist
wound environment. Not made with natural rubber
latex (sterile).
Alginate Dressings
Foam Dressings
Biatain® Alginate - formerly
SeaSorb® Soft Alginate
Biatain® Silicone Ag Foam Dressing
Exudate Level
Biatain® Ag Heel Foam Dressing
• Combines effective antimicrobial technology
with effective exudate management
• Unique foam structure manages wound
exudate and protects the heel
• Hydrocolloid border for optimal adhesion
Code
Size
9643
7 1⁄2 x 7 3⁄4" (19 x 20 cm)
Exudate Level
Biatain® Ag Sacral Foam Dressing
• Combines effective antimicrobial technology
with effective exudate management
• Unique foam structure manages wound exudate
and protects the sacral area
• Hydrocolloid adhesive border for optimal adhesion
Code
Size
9641
9 x 9" (23 x 23 cm)
Biatain® Alginate Dressing
Units
HCPCS*
5
A6213
Exudate Level
• Fast-gelling alginate
• One-piece removal
• Manages moderate-to-high levels of wound exudate
Code
Size
Units
HCPCS*
3705*
2 x 2" (5 x 5 cm)
30
A6196
3710*
4 x 4" (10 x 10 cm)
10
A6196
3715*
6 x 6" (15 x 15 cm)
10
A6197
Exudate Level
Biatain® Alginate Rope
• Fast-gelling alginate
• One-piece removal
• Manages moderate-to-high levels of wound exudate
Code
Size
3740*
1 x 17 1⁄2" rope (44 cm)
Units
HCPCS*
6
A6199
Exudate Level
†
References on file at Coloplast Corp.
*Also available with Silver. See Antimicrobial Dressings on page 54.
52
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 46
53
• Combines absorption qualities with controlled,
silver-release technology
• One-piece removal
• Manages moderate-to-high levels of wound exudate
Protective Skin Barrier
• Clear film forms a
breathable barrier against skin
irritants such as adhesives,
urine and stool
• No need to remove between applications
• Not made with natural rubber latex
Code
Size
Units
HCPCS*
3755
2 x 2" (5 x 5 cm)
30
A6196
Code
Size
Units
HCPCS*
3760
4 x 4" (10 x 10 cm)
10
A6196
2041
Single application packet 54/Box
12
A5120
A6197
0925
2 fl. oz./59 mL
12
A4369
6 x 6" (15 x 15 cm)
3765
10
Exudate Level
Biatain Alginate Ag Rope
(Formerly SeaSorb®)
®
• Combines absorption qualities with controlled,
silver-release technology
• One-piece removal
• Manages moderate-to-high levels of wound exudate
Code
Size
3780
1 x 17 1⁄2" rope (44 cm)
Units
HCPCS*
10
A6199
Comfeel® Plus Dressings have a unique combination of
alginate and hydrocolloid.
•Exudate management with fewer dressing changes and less
disruption to wound bed
•Specialty shapes and sizes for difficult-to-dress areas
•Color guide indicates best time to change dressing
•No-touch application system for ease-of-use
•Not made with natural rubber latex (sterile).
Comfeel® Plus Transparent Dressing (Thin)
Exudate Level
Skin Sealant / Hydrocolloid Dressings
Alginate Dressings
PREP™
Biatain® Alginate Ag Dressing
(Formerly SeaSorb®)
• Comfortable, flexible hydrocolloid adaptable to
wound and body contours
• Clear dressing allows visual inspection without
disturbing wound
• Does not contain alginate
Code
Size
Units
HCPCS*
3530
2 x 2 3⁄4" (5 x 7 cm)
10
A6234
3533
4 x 4" (10 x 10 cm)
10
A6234
3536
3 1⁄2 x 5 1⁄2" (9 x 14 cm)
10
A6235
3539
6 x 6" (15 x 15 cm)
5
A6235
Exudate Level
Comfeel® Plus Ulcer Dressing
• Ideal hydrocolloid for wounds with
low-to-moderate levels of exudate
• Contains alginate
Code
Size
Units
HCPCS*
3146
11⁄2 x 2 1⁄2" (4 x 6 cm)
30
A6234
3110
4 x 4" (10 x 10 cm)
10
A6234
3115
6 x 6" (15 x 15 cm)
5
A6235
3120
8 x 8" (20 x 20 cm)
5
A6236
Exudate Level
54
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 46
55
Triad™ Hydrophilic Wound Dressing
• Butterfly-shaped hydrocolloid dressing for better
conformity and adhesion
• Specifically designed for difficult-to-dress areas
• Contains alginate
• Zinc-oxide-based hydrophilic paste absorbs
moderate levels of wound exudate
• Natural debrider
• Ideal alternative for difficult-to-dress
areas
• Not made with natural rubber latex (sterile)
Code
Size
Units
HCPCS*
3280
24 sq. in. (6 x 8 cm)
5
A6237
3283
42 sq. in. (9 x 11 cm)
5
A6237
Exudate Level
Code
Size
Units
HCPCS*
1964
2.5 oz./71 g tube
12
A6240
1967
6 oz./170 g tube
12
A6240
Exudate Level
Comfeel® Plus Sacral Dressing
• Triangular-shaped hydrocolloid dressing for
maximum absorption and adhesion in the sacral area
• Contains alginate
Code
Size
3285
7 x 8" (18 x 20 cm)
Units
HCPCS*
5
A6235
Exudate Level
Comfeel® Plus Pressure Relief Dressing
• Hydrocolloid dressing with pressure-relieving
foam technology
• Ideal for protecting wounds on the heel or elbow
• Contains alginate
Code
Size
Units
HCPCS*
3350
3" Butterfly (7 cm)
5
A6237
3353
4" Round (10 cm)
5
A6237
3356
6" Round (15 cm)
5
A6238
• Provides a moist wound environment
• Does not contain alginate
• Not made with natural rubber latex (sterile)
3233
Code
Size
Units
HCPCS*
1063
6 fl. oz./178 mL
12
A6260
1061
12 fl. oz./355 mL
12
A6260
Exudate Level
• Rehydrates dry wounds and eschar
• Promotes moist wound environment
and autolytic debridement
• Not made with natural rubber latex
Comfeel® Ulcer Care
Size
• Saline-based solution for cleansing and irrigating
acute and chronic wounds
• No-rinse, isotonic, pH-balanced formula
• Does not interfere with wound healing
• 7.6 psi irrigation pressure
Woun’Dres® Collagen Hydrogel
Exudate Level
Code
Sea-Clens® Wound Cleanser
Hydrophilic Paste / Wound Cleansers / Hydrogels
Hydrocolloid Dressings
Comfeel® Plus Contour Dressing
Units
HCPCS*
1 1⁄2 x 2 1⁄2" (4 x 6 cm)
30
A6234
3213
4 x 4" (10 x 10 cm)
10
A6234
3218
6 x 6" (15 x 15 cm)
5
A6235
Exudate Level
Code
Size
Units
HCPCS*
1166
1 oz./28 g tube
36
A6248
7690
3 oz./84 g tube
12
A6248
Exudate Level
Purilon® Gel
• Sterile hydrogel with hydrating and
absorbing properties for effective
autolytic debridement
• Maintains a moist wound environment
• Contains alginate
• Not made with natural rubber latex (sterile)
Code
Size
Units
HCPCS*
3906
.28 oz./8 g
10
A6248
3900
.5 oz./15 g
10
A6248
3903
.88 oz./25 g
10
A6248
Exudate Level
56
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 46
57
Biatain® Super, Non-Adhesive
• Easy-to-handle and easy to use
• Comfort and protection
• Promotes a moist wound environment1
• For atraumatic dressing removal
• Suitable for highly exuding wounds2
• Promotes an optimal moist wound
environment1-3
• All-in-one simple to use wound dressing1
Code
Size
3910
4 x 4" (10 x 10 cm)
Units
10
HCPCS*
A6206
3912
4 x 8" (10 x 20 cm)
3
A6207
3920
6 x 6" (15 x 15 cm)
10
A6207
3915
6 x 8" (15 x 20 cm)
10
A6207
Exudate Level
Code
Size
46300
4 x 4" (10 x 10 cm)
Units
10
HCPCS*
A6251
46320
5 x 5" (12.5 x 12.5 cm)
10
A6251
46450
5 x 8" (12.5 x 20 cm)
10
A6252
46350
6 x 6" (15 x 15 cm)
10
A6251
46390
8 x 8" (20 x 20 cm)
10
A6252
Exudate Level
Biatain® Super, Adhesive
Code
Size
46100
4 x 4" (10 x 10 cm)
Units
10
HCPCS*
A6203
46120
5 x 5" (12.5 x 12.5 cm)
10
A6203
46250
5 x 8" (12.5 x 20 cm)
10
A6204
46150
6 x 6" (15 x 15 cm)
10
A6203
46200
8 x 8" (20 x 20 cm)
10
A6204
Exudate Level
1. Morris. British Journal of Nursing 2003: 12(10): 630-35
2. Norkus et al. Journal of Wound Care 2005: 14(9):429-32
3. Karlsmark et al. British Journal of Nursing 2004: 13(6): S29-S35
4. Palamand, et al. Wound: A Compendium of Clinical Research and Practise,
1991, 3(4): 149-150
1. Canac. Impact Medicine 2003. Vol. 35 p.10-13
58
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224 | For important safety information see page 46
Super Absorbents
Contact Layer
Physiotulle® Wound Contact Layer
6 x 6" (15 x 15 cm)
6 x 8" (15 x 20 cm)
8 x 8" (20 x 20 cm)
2 x 2¾" (5 x 7 cm)
4 x 4¾" (10 x 12 cm)
9 x 51⁄2" (23 x 14 cm)
8 x 111⁄2" (20 x 29 cm)
11½ x 15¾" (29 x 40 cm)
2" (5 cm) round
3" (8 cm) round
4 x 8" (10 x 20 cm)
9612
3542
www.coloplast.us
3545
3810
3812
3814
3816
3818
3465
3467
3412
Biatain® Foam Dressing
Comfeel® Film
Comfeel® Plus Transparent
Dressing
4 x 4" (10 x 10 cm)
9610
Contreet® Ag Hydrocolloid
Dressing
Size
Code
Convert from
50
10
10
10
10
10
5
5
100
5
5
5
Units
Biatain® Foam Dressing
Comfeel® Plus Transparent
Dressing
Comfeel® Plus Ulcer Dressing
Biatain® Ag Adhesive
Convert to
3533
N/A
N/A
N/A
6105
6105
3416
3120
3530
9635
3120
9632
Code
2 x 2¾" (5 x 7 cm)
2 x 2¾" (5 x 7 cm)
8 x 8" (20 x 20 cm)
4 x 4" (10 x 10 cm)
8 x 8" (20 x 20 cm)
2 x 2¾" (5 x 7 cm)
7 x 7" (18 x 18 cm)
8 x 8" (20 x 20 cm)
5 x 5" (12½ x 12½ cm)
Size
10
10
5
10
5
10
5
5
5
Units
Discontinued Products
60
1.800.533.0464
Product Guide
Skin Care | Effective September 2014
Skin
Inconsistent skin care increases the
risk of complications and cost of
inefficiencies1,2
Important safety information
Inconsistent
Skin Care
IncontinenceAssociated
Dermatitis
(IAD)
Hospital-Acquired
Pressure Ulcer
(HAPU)
$$
$$$
$$$$
Simplifying skin care has been
shown to have an impact on patient
outcomes and reduce supply chain
costs3,4
Skin
InterDry® is a skin protectant for the management of skin
folds and other skin-to-skin contact areas. It reduces
microbial colonization in the fabric. This single-use fabric
provides moisture translocation to keep skin dry while the
antimicrobial in the fabric reduces odor. The safe use of
InterDry fabric during pregnancy, lactation and on children
has not been demonstrated. Although many patients benefit
from the use of this device, results may vary. See the device
labeling for detailed information including the indication,
contraindications, warnings, precautions, and potential
complications/adverse events. For further questions, call
Coloplast Corp. at 1-800-533-0464 and/or consult the
company website at www.coloplast.us.
Care
Improved
clinical compliance
Improved
patient outcomes
Reduced
product waste
Reduced
pharmacy costs
Reduced cost
of complications
Costs
Simplify Care with Coloplast’s
structured skin care regimen
1. Lewis-Byers K, Thayer D, Kahl A. An evaluation of two incontinence skin care protocols
in a long-term care setting. Ostomy Wound Manage. 2002;48(12):44-51.
2. Junkin J, Selekof J. Beyond diaper rash: Incontinence-associated dermatitis, does it
have you seeing red? Nursing. 2008;38(11 Suppl):56hn1-10.
3. Junkin J, Selekof J. Prevalence of incontinence and associated skin injury in the acute
care patient. J Wound Ostomy Continence Nurs. 2007;34(3):260-269.
4. Gray M, Bliss D, Doughty D, Ermer-Seltun J, Kennedy-Evans KL, Palmer M.
Incontinence-associated dermatitis: A consensus. J Wound Ostomy Continence Nurs.
2007;34(1):45-54.
62
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63
Color-coded labels simplify
product selection
Easy product identification:
Symbols & colors represent product function
CLEANSERS
1
Brand Name
A brand name you’ve
come to trust
2
Category
Defines the need
Rinse
No-Rinse
1
2
3
MOISTURIZERS
Moisturize
3
Description
Defines the product
4
4
Indication
SKIN PROTECTANTS
Defines the
product use
5
Barrier
5
Symbol
Graphic representation
of skin care needs
SKIN PROTECTANTS
WITH ANTIFUNGAL
6 Cap Color
Barrier with
Antifungal
Further differentiates
product function
ANTIFUNGALS
Antifungal
SKIN FOLD MANAGEMENT
Textile with Silver
5
INFECTION PREVENTION/
HAND HYGIENE
6
Rinse
64
www.coloplast.us
1.800.533.0464
No-Rinse
www.coloplast.us
65
Bedside-Care® Perineal Wash
No-Rinse, Foaming Body Wash, Shampoo &
Incontinence Cleanser
• All-in-one, deodorizing body wash, shampoo
and incontinence cleanser
• Foam delivery system
•Alcohol-free
•pH-balanced
• CHG compatible
No-Rinse Body Wash, Shampoo & Incontinence Cleanser
• Soothing and deodorizing
• Dye, fragrance and alcohol-free
•pH-balanced
• CHG compatible
Product
Code
Size
Scented
7143
4 fl. oz./118 mL
36
7145
8 fl. oz./237 mL
12
7147
4 fl. oz./118 mL
36
7146
8 fl. oz./237 mL
12
Unscented
Code
Size
1452
4 fl. oz./118 mL
36
1453
8 fl. oz./237 mL
12
1455
1 gal./3.8 L
Units
No-Rinse Body Wash, Shampoo & Incontinence Cleanser
• All-in-one, deodorizing body wash, shampoo
and incontinence cleanser
•Alcohol-free
•pH-balanced
• CHG compatible
Code
Size
1768
4 fl. oz./118 mL
36
1762
8 fl. oz./237 mL
12
1764
1 gal./3.8 L
4
Bedside-Care® EasiCleanse™
Code
Size
7055
30 sheets/pk
30 pks/cs
Units
7056
5 sheets/pk
100 pks/cs
Units
4
Bedside-Care® Sensitive Skin Foam
No-Rinse, Foaming Body Wash, Shampoo &
Incontinence Cleanser
• Tear-free, hypoallergenic
•Neonate1 to geriatric suitable
• Dye, fragrance and alcohol-free
•pH-balanced
• CHG compatible
Gentle Rain® Extra Mild
Sensitive Skin, Moisturizing Body Wash,
Shampoo & Hand Wash
• Mild ingredients and added emollients for use
on fragile, sensitive skin
• Dermatologist tested, hypoallergenic and dye-free
•pH-balanced
Code
7231
Units
7230
Size
5 mL single
application packet
2 fl. oz./59 mL
7229
4 fl. oz./118 mL
36
7235
8 fl. oz./237 mL
36
21 fl. oz./621 mL†
12
12
Code
Size
7300
4 fl. oz./118 mL
36
7233
7301
8 fl. oz./237 mL
12
7234
34 fl. oz./1000 mL†
7236
1 gal./3.8 L
Bedside-Care® Sensitive Skin
Units
300
36
4
Gentle Rain® Antibacterial
No-Rinse Body Wash, Shampoo &
Incontinence Cleanser
• Tear-free, hypoallergenic
•Neonate1 to geriatric suitable
• Dye, fragrance and alcohol-free
•pH-balanced
• CHG compatible
Antibacterial Moisturizing Body Wash,
Shampoo & Hand Wash
• Cleanses, moisturizes and deodorizes skin
• Dermatologist tested, hypoallergenic and dye-free
•pH-balanced
Code
Size
Units
7201
2 fl. oz./59 mL
36
4 fl. oz./118 mL
36
7205
21 fl. oz./621 mL†
12
8 fl. oz./237 mL
12
7207
34 fl. oz./1000 mL†
12
Code
Size
1300
1301
1. Association of Women’s Health, Obstetric and Neonatal Nurses. Neonatal
Skin Care, Third Edition. Evidence-Based Clinical Practice Guideline, 2013.
www.coloplast.us
Units
No-Rinse, Self-Sudsing, Disposable Washcloth
• Non-irritating, non-sensitizing
• Preservative, dye, alcohol and
not made with natural rubber latex
• CHG compatible
• Suitable for neonatal use1
Bedside-Care®
66
Cleansers
Cleansers
Bedside-Care® Foam
1.800.533.0464
†
Units
See dispensers on page 75
www.coloplast.us
67
Atrac-Tain® Cream
Superior Moisturizing Skin Protectant Cream
• Once a day application
• Contains 6% dimethicone
• Fragrance, petrolatum, lanolin and alcohol-free
• CHG compatible
• Suitable for neonatal use1,2
Units
Urea & Alpha Hydroxy Acid (AHA)
• 10% urea and 4% AHA
• Exfoliates and softens severely dry, cracked,
calloused skin
• Fragrance, dye and preservative-free
• CHG compatible
Code
Size
7090
4 g single application packet
300
Code
Size
7091
2 oz./57 g
12
1843
2 g single application packet
7092
5 oz./142 g
12
1802
2 oz./57 g
12
7095
9 oz./255 g
12
1814
5 oz./142 g
12
Units
Moisturizers
Moisturizers
Sween® 24 Cream
300
Sween Cream®
Moisturizing Cream
• Non-occlusive formula
• Will not interfere with tape adhesion
• CHG compatible
• Suitable for neonatal use1
Code
Size
0283
7067
7068
7069
2 g single application packet
3 oz./85 g
6.5 oz./184 g
12 oz./339 g jar
Units
300
12
12
12
Sween® Lotion
Moisturizing Lotion
• Enriched with vitamin E
• Non-occlusive formula
• CHG compatible
• Suitable for neonatal use1
Code
Size
0424
0407
0406
0402
0408
2 mL single application packet
2 fl. oz./59 mL
4 fl. oz./118 mL
8 fl. oz./237 mL
21 fl. oz./621 mL†
†
Units
300
36
36
36
12
See dispensers on page 75.
1. Association of Women’s Health, Obstetric and Neonatal Nurses. Neonatal
Skin Care, Third Edition. Evidence-Based Clinical Practice Guideline, 2013.
2. Mouser, T. Effectiveness of a Non-Petrolatum Emollient Cream Lasting 24
Hours in a NICU and PICU Poster presented at Clinical Symposium on
Advances in Skin & Wound Care. Oct. 2005, Las Vegas, NV.
68
www.coloplast.us
1.800.533.0464
www.coloplast.us
69
Baza Cleanse & Protect® Lotion
Clear Moisture Barrier Ointment
• Clear moisture barrier
• Minimal ingredients
• Adheres to intact and eroded skin
• Easy to apply and remove
• CHG compatible
• Suitable for neonatal use1,2
All-In-One Perineal Lotion
• One step provides mild cleansing,
a breathable barrier and moisturization
• Available with odor control
•pH-balanced
• CHG compatible
Code
Size
7565
7566
7567
4 g single application packet
2.5 oz./71 g
6 oz./170 g
Units
300
12
12
Product
Code
Size
Unscented
7710
Scented
7712
7725
4 g single
application packet
8 fl. oz./237 mL
8 fl. oz./237 mL
Units
300
12
12
Skin Protectants
Skin Protectants
Critic-Aid® Clear
Critic-Aid® Skin Paste
Thick Moisture Barrier Paste
• Minimal ingredients
• Adheres to intact and eroded skin
• Easy to apply and remove
• CHG compatible
• Suitable for neonatal use1
Code
Size
1944
1947
2.5 oz./71 g
6 oz./170 g
Sween® Body Powder
Units
12
12
All-Body Powder
• Absorbs moisture and perspiration
• Non-talcum based formula
• Helps reduce friction and prevent shearing
• Easy to apply
Code
Size
0506
0505
3 oz./85 g
8 oz./227 g
Units
36
36
Baza® Clear
Moisture Barrier Ointment
• Clear, petrolatum-based moisture barrier
• Contains skin conditioners
• CHG compatible
Code
Size
7015
1005
1006
4 g single application packet
1.75 oz./50 g
5 oz./142 g
Units
300
12
12
Baza® Protect
Moisture Barrier Cream
• Zinc oxide and dimethicone-based moisture barrier
• Contains skin conditioners
• CHG compatible
Code
Size
1873
1877
1880
4 g single application packet
2 oz./57 g
5 oz./142 g
Units
300
12
12
1. Association of Women’s Health, Obstetric and Neonatal Nurses. Neonatal Skin
Care, Third Edition. Evidence-Based Clinical Practice Guideline, 2013.
2. Ratliff, C., Dixon, M. Treatment of Incontinence-Associated Dermatitis (Diaper
Rash) in a Neonatal Unit. JWOCN 2007; 34(2):158-162.
70
www.coloplast.us
1.800.533.0464
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71
Clear Moisture Barrier Ointment with Antifungal
• Clear moisture barrier with 2% miconazole nitrate
• Minimal ingredients
• Adheres to intact and eroded skin
• Easy to apply and remove
• CHG compatible
Code
Size
7570
7571
7572
4 g single application packet
2 oz./57 g
5 oz./142 g
For the management of skin-on-skin irritation
Units
300
12
12
Baza® Antifungal
Skin Fold Management
Antifungals
Critic-Aid® Clear AF
Moisture Barrier Antifungal Cream
• Moisture barrier with 2% miconazole nitrate
• Contains skin conditioners
• CHG compatible
Code
Size
1622
1611
1607
4 g single application packet
2 oz./57 g
5 oz./142 g
Units
300
12
12
Micro-Guard® Powder
Antifungal Powder
• Non-talcum based formula with 2% miconazole nitrate
• Treats superficial fungal infections
• Helps reduce friction and shearing
Code
Size
1337
3 oz./85 g
Patented Method of Action
• Moisture-wicking fabric keeps the skin fold dry
• Ionic silver complex in the fabric fights itching
and odor
• Polyurethane coated polyester fibers
reduce friction
By addressing the cause, InterDry effectively manages
complications associated with skin folds.
Units
12
Now available over-the-counter for continuity of care.
Visit inter-dry.com or call 1-855-440-4700
InterDry®
Textile with Antimicrobial Silver Complex
•Manages moisture, friction and bacterial or
fungal organisms in skin folds1
• Manages the symptoms associated with
intertrigo such as erythema, painful rash,
denudement, satellite lesions and odor2
• Wicks and translocates moisture
• Silver within the textile provides effective
antimicrobial action for up to 5 days
Code
Size
7910
7912
10 x 144"
10 x 36"
Units
10 /case
10 pks/box
1. Vorbeck, E. Evaluation of a Skin Fold Management Textile with Antimicrobial
Silver Complex in a Variety of Case Studies
2. Freyberg J, et al. Moisture Management Challenges for the WOC Nurse
presented at the WOCN Society 39th Annual Conference, June 2007
72
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1.800.533.0464
For important safety information see page 62
www.coloplast.us
73
Coloplast® Wall Dispenser
No-Rinse, Instant Hand Sanitizing Gel
• Kills 99.9% of most microorganisms in
less than 15 seconds1
• Effective against H1N1 virus1
• Added moisturizers
• CHG and latex glove compatible
• Holds 27 fl. oz. and 34 fl. oz.
(800 mL and 1000 mL) refill bags
• Completely closed to prevent possible contamination
• Metered 1 mL pump dispenses appropriate amount
• No-drip nozzle leaves facility clean and safe
• Easy-to-operate push pad meets Americans with
Disabilities Act guidelines
• Keyless opening for simple cartridge replacement
• Installs quickly with choice of screws or tape
Code
Size
1644
1645
7041
4 fl. oz./118 mL
21 fl. oz./621 mL†
27 fl. oz./800 mL†
Units
36
12
12
Code
Size
7251
Holds 27 fl. oz. and 34 fl. oz.
(800 mL and 1000 mL)
Drip tray
7262
Accessories
Hand Hygiene
Isagel®
Units
12
60
Embrace™ Bracket
• Holds 21 fl. oz (621 mL) Coloplast containers
securely in place
• Improved tamper- and theft-resistant design
• Optional locking collar conceals cap
• Installs quickly with screws or tape
Code
Size
0089
Holds 21 fl. oz. (621 mL)
Units
12
Hex-On®
Odor Antagonist
• Controls airborne odors
• Non-aerosol spray
• Light, mild scent
†
Code
Size
7583
2 fl. oz./59 mL
Units
12
See dispensers on page 75.
1. References on file at Coloplast Corp.
74
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1.800.533.0464
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75
www.coloplast.us
1.800.533.0464
www.coloplast.us
4 fl. oz.
.5 fl. oz.
3 oz. jar
2 fl. oz.
5 fl. oz.
34 fl. oz.
1 gal.
Size
8 oz. jar
8 oz. jar
4 fl. oz.
Bedside Care
Perineal Wash
2 fl. oz. Baza
Antifungal
2.5 ml
towelette
2 fl. oz.
21 fl. oz.
34 fl. oz.
7203
0222
7066
7662
7664
7011
0403
Code
1806
1002
1246
1673
0809
7021
Gentle Rain® Antibacterial
Sween Cream®
Sween Cream® Fresh Scent
Sween® Lotion
Convert from
Atrac-Tain® Lotion
Baza® Clear
Baza® Antifungal Hospital Pack
Isagel®
Lotion Skin Cleanser
Kind Touch™
2 fl. oz.
4 fl. oz.
16 fl. oz.
21 fl. oz.
34 fl. oz.
1 gal.
1707
1701
1702
1710
7051
1703
Gentle Rain®
7043
Size
Code
Convert from
12
12
36
Sensitive Skin, Moisturizing Body Wash,
Shampoo & Hand Wash
Gentle Rain® Extra Mild™
Isagel®
Baza® Antifungal
12
6 bx/50
Bedside Care®
Atrac-Tain® Cream
Baza® Clear
Convert to
Sween® Lotion
Sween Cream®
Sween Cream®
Gentle Rain® Antibacterial
Gentle Rain® Extra Mild
Convert to
12
12
12
Units
12
4
12
12
12
36
36
36
36
12
12
12
4
Units
7234
7233
1644
1644
1611
1768
1814
1006
Code
0408
0408
7067
7068
7067
0283
7201
7230
7229
7235
7233
7234
7236
Code
34 fl. oz.
21 fl. oz.
4 fl. oz
4 fl. oz
2 fl. oz
4 fl. oz
5 fl. oz
5 fl. oz
Size
21 fl. oz.
21 fl. oz.
3 fl. oz.
6.5 fl. oz.
2 g. single
app. pkt.
3 fl. oz.
2 fl. oz.
2 fl. oz.
4 fl. oz.
8 fl. oz.
21 fl. oz.
34 fl. oz.
1 gal.
Size
12
12
36
36
12
36
12
12
Units
12
12
12
12
12
300
36
36
36
12
12
12
4
Units
Discontinued Products
Conversion sheet: Skin Care
Discontinued Products
76
77
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1.800.533.0464
www.coloplast.us
2 fl. oz.
4 fl. oz.
16 fl. oz.
21 fl. oz.
34 fl. oz.
1 gal.
4 fl. oz.
8 fl. oz.
6 fl. oz.
12 fl. oz.
0821
0849
0822
0830
7031
0824
1410
1400
0904
0901
8 fl. oz.
16 fl. oz.
21 fl. oz.
1 gal.
4 fl. oz.
2 g packet
3 oz.
2 oz.
4 fl. oz.
0102
0101
0119
0107
1805
7666
7065
1318
7581
Sween Cream® Fresh Scent
Sween Cream® Fragrance Free
Micro-Guard Cream
4 fl. oz.
3 cloths/
package
7584
7726
Baza Cleanse & Protect Cloths
®
Hex-On® Fresh Linen
Odor Antagonist
7583
Hex-On® Fresh Linen
Odor Antagonist
Antifungal Cream
®
Moisturizing Cream
Moisturizing Cream
Urea & Alpha Hydroxy Acid (AHA)
Atrac-Tain® Lotion
2 fl. oz.
2 fl. oz.
0117
Sween® Bath Oil
Bath Additive and Skin Conditioner
Size
Code
Convert from
No-Rinse Body Wash, Shampoo and Incontinence
Cleanser
Sproam®
Incontinent Cleanser & Deodorizer
Peri-Wash®
Antimicrobial Lotion Skin Cleanser
Size
Code
Soft Touch™
100
12
12
12
12
300
36
36
12
12
4
36
Units
12
12
12
36
36
12
12
12
4
36
Units
12
67088
7725
Odor Control
7583
1611
7067
0283
1814
Code
7146
7147
1453
1452
7201
7205
7205
7207
7207
7201
Code
Baza Cleanse & Protect® Cloth
N/A
N/A
Moisture Barrier Antifungal Cream
Baza Antifungal
®
Moisturizing Cream
Sween Cream®
Moisturizing Cream
Sween Cream®
Urea & Alpha Hydroxy Acid (AHA)
Atrac-Tain® Cream
N/A
N/A
N/A
N/A
N/A
Convert to
No-Rinse, Foaming Body Wash, Shampoo &
Incontinence Cleanser
Bedside-Care® Foam (Unscented)
No-Rinse, Body Wash & Shampoo Incontinence
Cleanser
Bedside-Care® Perineal Wash
Antibacterial Moisturizing Body Wash,
Shampoo & Hand Wash
Gentle Rain® Antibacterial
Convert to
8 cloths/
pkg
8 fl. oz.
2 fl. oz.
2 oz.
3 oz.
2 g packet
5 fl. oz.
Size
8 fl. oz.
4 fl. oz.
8 fl. oz.
4 fl. oz.
2 fl. oz.
21 fl. oz.
21 fl. oz.
34 fl. oz.
34 fl. oz.
2 fl. oz.
Size
12
24
12
12
12
300
12
Units
12
36
12
36
36
12
12
12
12
36
Units
Discontinued Products
Convert from
Discontinued Products
78
79
80
www.coloplast.us
1.800.533.0464
Product Guide
Ostomy Care | Effective September 2014
Ostomy
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
For all
ostomy types
Accessories
New
SenSura® Mio
Fits Right. Feels Right.
A barrier designed to fit your patients
SenSura® Mio has an elastic barrier that fits your patients’
individual body shapes and follows their contours when bending
and stretching.
SenSura Mio is very discreet. The soft, water-resistant textile
material gives the pouch the feel of a clothing item. Its specially
chosen neutral gray color is designed to stay unnoticed under
all clothing colors.
To learn more visit us at www.sensuramio.us or
call 1-888-726-7872.
83
Innovations to make
everyday life easier
Brava® Ostomy Accessories
Easy-to-use, no-sting products
protect and care for the skin
SenSura® Mio
BodyFit Technology® elastic barrier
fits to real bodies
SenSura® Xpro Extended Wear
Adhesive
All of the skin-friendly benefits of
SenSura in a more erosionresistant barrier
“I used to think
running was out of
the question. Now
my barrier stays in
position.”
Sandra, Brava user and running enthusiast
Disclosure: Sandra is a Brava
user who has received
compensation from Coloplast
to provide this information.
BodyCheck Tool
The BodyCheck tool is the
newest addition to the
Coloplast Care program.
Because we know real
bodies change over time,
we’ve developed a simple
tool to help determine the
most appropriate solution for each unique body type.
Ordering samples of the recommended product(s) is easy
with the just the click of a button. To learn more visit:
bodycheck.coloplast.com
84
www.coloplast.us
1.800.533.0464
Contact Coloplast Consumer Care at
1-888-726-7872
for free evaluation samples today!
Accessories
Improved Multi-Chamber Uro Pouch
Input from nurses inspired a quieter,
lower profile pouch
Think again. Think Brava®
Ostomy Care
Accessories that help reduce leakage and care for your
skin to make you feel secure.
Brava® Elastic Barrier Strips
Skin-friendly strips are used to “picture frame” around
an ostomy barrier, providing extra security.
• Elastic (follows the contours of the body)
• Ensures the position of your barrier and
minimizes roll-up
• Skin-friendly and secure alternative to tape
• Not made with natural rubber latex
Accessories
Think again. Think Brava®
Brava® Elastic Barrier Strips- Curved
For round or oval barrier shapes
Code
Size
120700*
51/2" strips
*2 strips = 1 billable unit of A4362
Units
20 strips
HCPCS*
A4362
Brava® Elastic Barrier Strips- Y shape
Designed for users with varying body shapes,
e.g. hernias or skin folds
Code
Size
120721*
53/4" strips
*3 strips = 1 billable unit of A5121
Units
30 strips
HCPCS*
A5121
Brava® Elastic Barrier Strips- Straight
For square or rectangular barrier shapes
Code
Size
120740*
51/4" strips
*2 strips = 1 billable unit of A4362
Units
20 strips
HCPCS*
A4362
Brava® Moldable Ring
Designed to be durable and secure used to fill in uneven skin surfaces and protect the skin.
• Provides a tight seal around the stoma
• Ideal for ileostomates and urostomates —
absorbs moisture without breaking down
• Easy to handle, mold and apply
• Alcohol-free = sting-free
• Not made with natural rubber latex
Code
120307
120427
Size
2 mm (thin)
4.2 mm (thick)
Units
10
10
HCPCS*
A4385
A4385
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
87
Brava® Skin Barrier Spray
Pectin-based product that protects peristomal skin
• Protects peristomal skin from stoma output
• Used to fill uneven skin surfaces to create a flat
pouching surface
• Alcohol-free = sting-free
• Not made with natural rubber latex
Code
26555
Size
2 oz
• Protect against stoma output and adhesives
• Dry within seconds without building a thick or tacky layer
• Alcohol-free, silicone- based, and sting-free
• Not made with natural rubber latex
Code
120205
Units
10 strips
Size
1.7 oz (50 mL)
Units
1
HCPCS*
A4369
HCPCS*
A4406
Accessories
Accessories
Brava® Strip Paste
Brava® Skin Barrier Wipes
• Protect against stoma output and adhesives
• Dry within seconds without building a thick or tacky layer
• Alcohol-free, silicone- based, and sting-free
• Not made with natural rubber latex
Brava Belt for SenSura Mio
®
®
Neutral gray color was designed to blend in under
clothing; adjustable plastic tab is encased in fabric
to prevent it from digging into your skin. Designed
specifically for use with SenSura® Mio Click barriers.
• Not made with natural rubber latex
Code
4237
4247
Size
40" length
61" length
Code
120215
Units
15
15
HCPCS*
A4367
A4367
Comfortable, adjustable belt offers extra security
for people with a flush or retracted stoma by
supporting a convex barrier and allowing the
stoma to protrude.
• Neutral color won’t show under clothing
• Not made with natural rubber latex
Size
431⁄3" length
49" length
Units
15
15
HCPCS*
A4367
A4367
• Designed to lift the edges of the barrier for ease
in removal
• Dry within seconds without leaving an oily
residue behind
• Alcohol-free, silicone- based, and sting-free
• Not made with natural rubber latex
Size
1.7 oz (50 mL)
Units
1
88
www.coloplast.us
Units
1
HCPCS*
A4406
Units
12
HCPCS*
A4405
Used to fill in uneven skin surfaces to create a
flat pouching surface
• Provides tight sealing around the stoma
• Protects against stoma output
• Minimizes risk of maceration
• Non-pectin
• Not made with natural rubber latex
Size
2 oz
HCPCS*
A4455
Brava® Protective Sheet
• Wipe away adhesive residue
• Dry within seconds without leaving an oily
residue behind
• Alcohol-free, silicone- based, and sting-free
• Not made with natural rubber latex
Size
1 wipe
Size
2 oz
Coloplast® Paste
Code
2650
Brava® Adhesive Remover Wipes
Code
120115
HCPCS*
A5120
Brava® Paste
Code
12050
Brava® Adhesive Remover Spray
Code
120105
Units
30 wipes/box
A sting-free alternative to conventional alcohol-based paste
• Creates a tight, effective seal between peristomal
skin and the ostomy/fistula appliance
• Contains pectin
• Not made with natural rubber latex
Brava® Ostomy Belt
Code
4215
4220
Size
1 wipe
Units
30 wipes/box
HCPCS*
A4456
1.800.533.0464
Hydrocolloid skin barrier that protects
the skin from stoma output
• Offers effective protection for peristomal
skin and “3-way stretch”
• Provides a ready surface for good adhesion
• Adheres to moist skin
• Not made with natural rubber latex
Code
32105
32155
32205
Size
4 x 4" (10 x 10 cm)
6 x 6" (15 x 15 cm)
8 x 8" (20 x 20 cm)
Units
10
5
5
HCPCS*
A4362
A5121
A5122
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
89
PREP™ Protective Skin Barrier
Non-sterile protective powder for moisture absorption.
• May use in conjunction with Brava® Skin Barrier Spray or
PREP™ to “crust”, thereby protecting moist skin
• Not made with natural rubber latex
Clear film forms a breathable barrier
protecting against skin irritants such as
adhesives, urine and feces. No need to
remove between applications.
• Not made with natural rubber latex
Code
19075
Size
1 oz. (25 g)
Units
16
HCPCS*
A4371
Brava® Lubricating Deodorant
A pouch lubricant + deodorizer in one. Powder-fresh
liquid neutralizes odor and allows output to slide to the
bottom of the pouch for easier emptying.
• Not made with natural rubber latex
Code
12060
12061
Size
.25 fl. oz. (7.5 mL)
sachet
8 oz. bottle
Units
20 sachets
HCPCS*
A4394
1
A4394
Curved ostomy scissors.
• Not made with natural rubber latex
Size
One size
Size
54 wipes/pack
Dabber
Code
0925
Size
2 fl. oz. (59 mL)
Units
12 packs/box
HCPCS*
A5120
Units
12
HCPCS*
A4369
Units
50
HCPCS*
A4368
Units
20
HCPCS*
A4363
Pouch Filters (Filtrodor®)
Charcoal-activated, deodorizing filter with
self-sealing foam center; adheres to pouch.
• Not made with natural rubber latex
Code
0509
Ostomy Scissors
Code
95050
Wipes
Code
2041
Units
30/bx
HCPCS*
N/A
Coloplast® Skin Barrier Rings
Drainable Pouch Clamp
Simple closure clamp is easy to manipulate,
even for those with low dexterity.
• Not made with natural rubber latex
Code
9500
Soft and flexible barrier rings provide skin
protection for stomas, fistulas, and draining wounds.
• Non-pectin based
• Not made with natural rubber latex
Accessories
Accessories
Brava® Powder
Post-Op Accessories
Code
2310
2315
2320
2325
2330
2340
2350
90
Size
3⁄8" (10 mm)
3⁄5" (15 mm)
3⁄4" (20 mm)
1" (25 mm)
11⁄8" (30 mm)
13⁄5" (40 mm)
2" (50 mm)
www.coloplast.us
Units
30
30
30
30
30
30
30
HCPCS*
A4404
A4404
A4404
A4404
A4404
A4404
A4404
1.800.533.0464
Window for Assura® post-op pouches (page 160)
• Not made with natural rubber latex
Cut-to-fit
Code
12801
12803
Size
Matches Assura® PostOp 12800 and 12808
Matches Assura® PostOp 12802 and 12810
Units
20
HCPCS*
A4421
15
A4421
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
91
Irrigation Sets
Includes a fixed connector that fits directly to
SenSura® Mio, SenSura® and Assura® urostomy
pouches. The bag holds up to 2 liters and has a
120 cm long flexible tube with anti-reflux valve.
Bag hanger (#5070) not included.
Order separately.
• Not made with natural rubber latex
Code
21365
Units
10
Coloplast® Economy Version
Durable water bag with integrated thermometer, bold print,
large opening. Can be used with 1- or 2-piece ostomy systems.
• Not made with natural rubber latex
HCPCS*
A4357
Code
1500
Units
1
Bed Drainage Bag
Bag tubing specifically designed for fistula
output. Holds up to 2000mL. Long tubing
can be cut easily and allows nurses to find
the right length for bed drainage. Can be
used with fistula / wound management
systems or high-output pouches.
HCPCS*
A4398
A4399
Assura® Hospital Version
Durable water bag with integrated thermometer, bold print, large
opening. Can be used with 1- or 2-piece ostomy systems.
• Not made with natural rubber latex
• Not made with natural rubber latex
Code
14010
Includes
1-Water Bag/Regulator
1-Cone
Accessories
Accessories
Urostomy Night Bag
Units
6
HCPCS*
A4357
Code
1500H
Units
1
Bag Hanger
Includes
1-Water Bag/Regulator
1-Cone
4-Adhesive Irrigation
Sleeves (#1003)
2-Closure Clips
HCPCS*
A4398
A4399
A4397
Reusable, sturdy, plastic drainage bag hanger
secures tubing and ensures bag stability.
• Not made with natural rubber latex
Code
5070
Size
One Size
Units
1
HCPCS*
A4421
Components supplied in a travel bag.
• Not made with natural rubber latex
Code
12830
Extra Drain Port
For use with Fistula Wound Management
Systems (page 162). Drain port can be easily
applied to the lid to allow for catheter
insertion. For catheters ranging from
18FR - 22FR, the drain port is ready for use.
For catheters ranging from 24FR-30FR, pull
off the top of the drain port - DO NOT CUT.
• Not made with natural rubber latex
Code
14015
SenSura® or Assura Deluxe Version
Units
12
HCPCS*
A4421
Units
10
10
10
HCPCS*
A4421
A4421
A4421
Units
1
Includes
1-Water Bag/Regulator
1-Cone
1-Irrigation Faceplate
1-Belt
2-Irrigation Sleeves (#12836)
HCPCS*
A4398
A4399
A4361
A4367
A4397
Coloplast® Transparent Fistula Lids
Replacement lids match the transparent
lid included with each fistula pouch.
• Not made with natural rubber latex
Code
14021
14031
14041
92
Size
Mini (matches 14050)
Midi (matches 14060)
Maxi (matches 14070)
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
93
Accessories
Irrigation Sleeves
Irrigation Sleeves
Disposable irrigation sleeve (adhesive-backed).
• Not made with natural rubber latex
Transparent
Code
1003
Units
10
HCPCS*
A4397
Irrigation sleeves for use with SenSura® or Assura® barriers or
faceplate. Consult chart below to order the correct transparent sleeves.
• Not made with natural rubber latex
Code
Units
HCPCS*
12834
Size
5
A4397
12835
5
A4397
12836
5
A4397
Irrigation Sleeve #
12834
12835
12836
Use with SenSura® Product Code
Units
- 10011, 10012, 10013,
10015-10017, 11011, 11012,
11015, 11016
5
- 10021, 10022, 10023,
10025-10027, 11021-11025
5
- 10031, 10032, 10035,
10036, 11031, 11032, 11035, 11036
5
Irrigation Accessories
SenSura® or Assura® Irrigation Faceplate
For use with ostomy belt.
(Use with #12836 Irrigation Sleeve) Note: not
compatible with Brava® Belt for SenSura® Mio
• Not made with natural rubber latex
Code
12820
Units
1
HCPCS*
A4361
Coloplast Stoma Cone
Soft and flexible stoma cone with tubing.
• Not made with natural rubber latex
Code
1110
Units
1
HCPCS*
A4399
*For important information regarding the use of HCPCS codes listed and code
definitions see page 222
94
www.coloplast.us
1.800.533.0464
SenSura® Mio Click
The new SenSura® Mio is based on our
human-centered approach to innovation; it's
designed with individual bodies in mind.
Elastic barrier to fit
real body shapes.
Flexible coupling for
security.
Neutral gray textile
for discretion.
Two-Piece Click
Full-circle filter to reduce
ballooning.
• Flat
• Belt tabs
• Not made with natural rubber latex
Cut-to-fit
Units: 5
Code
Stoma Size
Color
10502
3/8"-13/8"
(10-35 mm)
A4414
10512
3/8"-1¾"
(10-45 mm)
A4414
10522
3/8"-21/8"
(10-55 mm)
A4414
10531
3/8"-29/16"
(10-65 mm)
HCPCS*
A4415
Pre-cut
Units: 5
Code
Stoma Size
Color
10503
¾" (20 mm)
A4414
10506
7/8"
A4414
10504
1" (25 mm)
A4414
10505
11/8" (28 mm)
A4414
10513
13/16"
A4414
10514
1¼" (32 mm)
A4414
10515
13/8"
(35 mm)
A4414
10516
1½" (38 mm)
A4414
10523
19/16"
A4414
10524
1¾" (45 mm)
A4414
10525
2" (50 mm)
A4414
(22 mm)
(30 mm)
(40 mm)
HCPCS*
2-Piece SenSura® Mio Click
SenSura® Mio Click Standard Wear Barrier
SenSura® Mio Click MAXI
Drainable Pouch
• • • • EasiClose™ WIDE Outlet
Full-circle filter
Neutral gray, water-resistant textile
Opaque pouches feature peek-a-boo inspection
window for easy application
• Not made with natural rubber latex
www.coloplast.us
1.800.533.0464
Transparent 11" (28 cm) / 655 mL
Units: 10
Code
HCPCS*
Color
11463
A4427
11473
A4427
11483
A4427
11487
A4427
Opaque 11" (28 cm) / 655 mL
Units: 10
Code
HCPCS*
Color
11462
A4427
11472
A4427
11482
A4427
11486
A4427
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
97
• • • • • Full-circle filter
• Neutral gray, water-resistant textile
• Opaque pouches feature peek-a-boo inspection
window for easy application
• Not made with natural rubber latex
EasiClose™ WIDE Outlet
Without Filter
Neutral gray, water-resistant textile
Not made with natural rubber latex
Transparent 11" (28 cm) / 655 mL
Units: 10
Code
HCPCS*
Color
11474
A4426
11484
A4426
11488
A4426
SenSura® Mio Click MIDI
Drainable Pouch
Opaque 71⁄4" (18½ cm) / 275 mL
Code
EasiClose™ WIDE Outlet
Full-circle filter
Neutral gray, water-resistant textile
Opaque pouches feature peek-a-boo inspection
window for easy application
• Not made with natural rubber latex
11401
A4423
11412
A4423
11421
A4423
SenSura® Mio Click MAXI
Urostomy Pouch
Opaque 10¼" (26 cm) / 485 mL
Units: 10
Code
HCPCS*
Color
11461
A4427
11471
A4427
• Multi-chambers minimize sloshing
• Wider anti-reflux valves prevent urine from
washing over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Neutral gray, water-resistant textile
• Not made with natural rubber latex
Transparent 10½" (26½ cm) / 480 mL
Code
SenSura® Mio Click MAXI
Closed Pouch
• Full-circle filter
• Neutral gray, water-resistant textile
• Opaque pouches feature peek-a-boo
inspection window for easy application
• Not made with natural rubber latex
Transparent 8 1⁄4" (20½ cm) / 570 mL
Units: 10
Color
HCPCS*
11492
A4433
11498
A4433
Opaque 10½" (26½ cm) / 480 mL
Code
Units: 10
Color
HCPCS*
11491
A4433
11497
A4433
Units: 30
Color
HCPCS*
A4423
11426
Opaque 8 1⁄4" (20½ cm) / 570 mL
Code
HCPCS*
Urostomy
• • • • Code
Units: 30
Color
2-Piece SenSura® Mio Click
2-Piece SenSura® Mio Click
SenSura® Mio Click MIDI
Closed Pouch
SenSura® Mio Click MAXI
Drainable Pouch
Units: 30
Color
Xpro vs. Standard Wear, how do I choose?
Extended wear doesn’t necessarily indicate
longer wear time!
HCPCS*
11402
A4423
11413
A4423
11422
A4423
11425
A4423
S
enSura® Xpro (Extended Wear) is engineered
to offer extra protection for liquid ileostomies
and urostomies. Coloplast’s "extended wear"
products are lighter in color to visually differentiate
adhesive type.
S
enSura® Standard Wear focuses on moisture
absorption and may offer better adhesion for
those in more humid climates.
98
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
99
• Convex Light
• Belt tabs
• Not made with natural rubber latex
• Flat
• Belt tabs
• Not made with natural rubber latex
Cut-to-fit
Code
Units: 5
Stoma Size
Cut-to-fit
Code
Stoma Size
A4414
11011
5/8
HCPCS*
10011
3⁄8
10021
3⁄8
-
(10-45 mm)
A4414
11021
5
10031
3⁄8
- 2 1⁄4" (10-55 mm)
A4414
11031
5
10041
3⁄8
- 2 1⁄2" (10-65 mm)
A4415
11041
5
- 13⁄8" (10-35 mm)
13⁄4"
Pre-cut
Code
Color
Units: 5
HCPCS*
- 7/8" (15-22 mm)
A4373
⁄8 - 15/16" (15-33 mm)
A4373
⁄8 -
111/16"
(15-43 mm)
A4373
⁄8 - 2 1/16" (15-53 mm)
A4373
Units: 5
Stoma Size
Color
(20 mm)
HCPCS*
10012
13⁄16"
A4414
10013
1" (25 mm)
A4414
10022
1 3⁄16" (30 mm)
A4414
10023
13⁄8" (35 mm)
A4414
10032
1 9⁄16" (40 mm)
A4414
SenSura® Click Xpro (Extended Wear) Barrier
• Flat
• Belt tabs
• Not made with natural rubber latex
Cut-to-fit
Code
Stoma Size
10015
3⁄8
10025
3⁄8
10035
3⁄8
10045
3⁄8
Pre-cut
Code
Stoma Size
11012
7/8"
11022
1" (25 mm)
A4373
11023
11/8"
(28 mm)
A4373
11024
11/4" (31 mm)
A4373
11032
13/8"
A4373
Color
(22 mm)
Units: 5
HCPCS*
A4373
(35 mm)
SenSura® Click Xpro (Extended Wear) Barrier
Color
- 13⁄8" (10-35 mm)
Units: 5
HCPCS*
• Convex Light
• Belt tabs
• Not made with natural rubber latex
A4409
-
13⁄4"
(10-45 mm)
A4409
Cut-to-fit
-
21⁄4"
(10-55 mm)
A4409
Code
- 21⁄2" (10-65 mm)
A4410
11015
5/8
- 7/8" (15-22 mm)
A4407
Units: 5
HCPCS*
11025
5/8
- 15/16" (15-33 mm)
A4407
11035
5/8
- 111/16" (15-43 mm)
A4407
11045
5/8
Pre-cut
Code
Stoma Size
10016
13⁄16"
10017
1" (25 mm)
A4409
10026
13⁄16" (30 mm)
A4409
10027
13⁄8"
A4409
Pre-cut
10036
19⁄16" (40 mm)
A4409
Code
(20 mm)
(35 mm)
2-Piece SenSura® Click
2-Piece SenSura® Click
SenSura® Click Standard Wear Barrier
SenSura® Click Standard Wear Barrier
Color
A4409
Units: 5
Stoma Size
-
21/16"
Color
(15-53 mm)
HCPCS*
A4408
Units: 5
Stoma Size
Color
(22 mm)
HCPCS*
11016
7/8"
11026
1" (25 mm)
A4407
11027
11/8"
(28 mm)
A4407
11028
11/4" (31 mm)
A4407
11036
13/8"
A4407
(35 mm)
A4407
For Assura CONVEX barriers, see pages 108-109.
®
Indicates convexity
100
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
101
• • • • SenSura® Click Magnum High Output
Drainable Pouch
EasiClose™ WIDE Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
• • • • Transparent 111⁄2" (29 1⁄2 cm) / 655 mL
Code
Color
Funnel-shaped outlet attaches to a drain bag
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Units: 20
Transparent 121⁄2" (32 cm) / 1160 mL
HCPCS*
Code
11194
A4427
11195
Units: 10
Color
HCPCS*
19050
A4413
A4427
19051
A4413
11196
A4427
19052
A4413
11197
A4427
Opaque 111⁄2" (29 1⁄2 cm) / 655 mL
Code
Units: 20
Color
HCPCS*
11124
A4427
11125
A4427
11126
A4427
11127
A4427
Opaque 121⁄2" (32 cm) / 1160 mL
Code
Units: 10
Color
HCPCS*
19040
A4413
19041
A4413
19042
A4413
2-Piece SenSura® Click
2-Piece SenSura® Click
SenSura® Click MAXI
Drainable Pouch
For Assura® Ileo Night Pouches, see page 112.
Units: 30
®
SenSura Click MAXI
Closed Pouch
SenSura® Click MIDI
Drainable Pouch
• • • • • Filter
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
EasiClose™ WIDE Outlet
Filter
Soft cloth on front and back
Not made with natural rubber latex
Transparent 81⁄2" (21 cm) / 570 mL
Code
Opaque 101⁄2" (26 1⁄2 cm) / 485 mL
Code
Units: 20
Color
HCPCS*
11114
A4427
11115
A4427
SenSura® Click MAXI
Drainable Pouch
• • • • EasiClose WIDE Outlet
Without filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
™
Transparent 111⁄2" (29 1⁄2 cm) / 655 mL
Code
Color
11186
A4426
Opaque 81⁄2" (21 cm) / 570 mL
Code
Color
HCPCS*
10164
A4423
10165
A4423
10166
A4423
10167
A4423
Units: 20
Color
HCPCS*
11135
A4426
11136
A4426
www.coloplast.us
A4423
10187
HCPCS*
A4426
Opaque 111⁄2" (29 1⁄2 cm) / 655 mL
102
HCPCS*
Units: 20
11185
Code
Units: 30
Color
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
103
Opaque 10 3⁄8" (26 cm) / 480 mL
• With filter
• Soft cloth on front and back
• Not made with natural rubber latex
11844
A4433
11845
A4433
11846
A4433
Code
Opaque 7" (18 cm) / 275 mL
Code
Units: 30
Color
HCPCS*
10154
A4423
10155
A4423
10156
A4423
For Assura® stoma caps, see page 114.
Urostomy
Units: 10
Color
SenSura® Click Uro MIDI
Urostomy Pouch
• Multi-chambers minimize sloshing
• Wider anti-reflux valves prevent urine from
washing over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Transparent 91⁄2" (24 cm) / 430 mL
Code
SenSura Uro
Units: 10
Color
Wider anti-reflux valves support varying
ways of managing stents:
Wider anti-reflux
valves
HCPCS*
A4433
11851
®
HCPCS*
2-Piece SenSura® Click
2-Piece SenSura® Click
SenSura® Click MIDI
Closed Pouch
Opaque 91⁄2" (24 cm) / 430 mL
Code
Units: 10
Color
HCPCS*
A4433
11841
• Stents threaded into a pouch
connected to a night drainage bag
For Assura urostomy micro-pouches and minicaps,
see page 114.
• Rolling the stents in the top of the
pouch, making a loop
Urostomy Night Bag and Bag Hanger
®
See Accessories page 92 for more information.
• Stents that have been cut
Welded "multi-chambers"
minimize ballooning
SenSura® Click Uro MAXI Urostomy Pouch
• Multi-chambers minimize sloshing
• Wider anti-reflux valves prevent urine from
washing over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Transparent 10 3⁄8" (26 cm) / 480 mL
Code
104
Units: 10
Color
HCPCS*
11854
A4433
11855
A4433
11856
A4433
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
105
Assura® Standard Wear Barrier
• Flat
• Belt tabs
• Not made with natural rubber latex
• Convex Light
• Belt tabs
• Not made with natural rubber latex
Cut-to-fit
Code
Units: 5
Stoma Size
Color
HCPCS*
2881
3⁄8
- 13⁄8" (10-35 mm)
A4414
2882
3⁄8
- 13⁄4" (10-45 mm)
A4414
2883
3⁄8
- 21⁄4" (10-55 mm)
A4414
Pre-cut
Units: 5
Code
Stoma Size
Color
Cut-to-fit
Units: 5
Code
Stoma Size
14261
5/8
14262
5
14263
5
Color
- 15/16" (15-23 mm)
⁄8 -
15/16"
HCPCS*
A4373
(15-33 mm)
A4373
⁄8 - 111/16" (15-43 mm)
A4373
HCPCS*
12841
13⁄16"
12842
1" (25 mm)
A4414
Pre-cut
Code
Stoma Size
12844
13⁄16" (30 mm)
A4414
14271
3/4"
(18 mm)
A4373
12845
13⁄8" (35 mm)
A4414
14272
7/8"
(22 mm)
A4373
12847
19⁄16" (40 mm)
A4414
14273
1" (25 mm)
A4373
12848
13⁄4"
A4414
14274
11/8"
(28 mm)
A4373
14275
11/4" (31 mm)
A4373
14276
13/8"
(35 mm)
A4373
14277
11/2" (38 mm)
A4373
14278
15/8"
A4373
(20 mm)
A4414
(45 mm)
®
Assura Extended Wear Barrier
• Flat
• Belt tabs
• Not made with natural rubber latex
Cut-to-fit
Code
2-Piece Assura®
2-Piece Assura®
Assura® Standard Wear Barrier
Color
(41 mm)
Units: 5
HCPCS*
Units: 5
Stoma Size
Color
HCPCS*
2831
3⁄8
- 13⁄8" (10-35 mm)
A4409
2832
3⁄8
- 13⁄4" (10-45 mm)
A4409
2833
3⁄8
Pre-cut
Code
Stoma Size
14250
5⁄8"
14251
13⁄16"
-
21⁄4"
(10-55 mm)
(15 mm)
(20 mm)
Color
Units: 5
HCPCS*
Units: 5
Stoma Size
A4409
14281
5/8
- 15/16" (15-23 mm)
A4407
A4409
14282
5/8
- 15/16" (15-33 mm)
A4407
14283
5/8
- 111⁄16" (15-43 mm)
A4407
A4409
14254
13⁄16"
A4409
14255
13⁄8"
14257
19⁄16" (40 mm)
A4409
14258
13⁄4"
A4409
(45 mm)
Cut-to-fit
Code
1" (25 mm)
(35 mm)
• Convex Light
• Belt tabs
• Not made with natural rubber latex
A4409
14252
(30 mm)
Assura® Extended Wear Barrier
Color
HCPCS*
A4409
Indicates convexity
106
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
107
• Convex
• Belt tabs
• Not made with natural rubber latex
Pre-cut
Units: 5
Code
Stoma Size
Color
HCPCS*
14291
3⁄4"
(18 mm)
A4407
14292
7⁄8"
(22 mm)
A4407
14293
1" (25 mm)
A4407
14294
11⁄8" (28 mm)
A4407
14295
11⁄4" (31 mm)
A4407
14296
13⁄8" (35 mm)
A4407
14297
11⁄2" (38 mm)
A4407
14298
15⁄8"
A4407
(41 mm)
Assura® Standard Wear Barrier
• Convex
• Belt tabs
• Not made with natural rubber latex
Cut-to-fit
Units: 5
Code
Stoma Size
Color
12716
5⁄8
- 15⁄16" (15-33 mm)
A4373
12719
5⁄8
- 111⁄16" (15-43 mm)
A4373
Pre-cut
HCPCS*
Units: 5
Code
Stoma Size
12701
5⁄8"
12702
Color
HCPCS*
(15 mm)
A4373
3⁄4"
(18 mm)
A4373
12703
7⁄8"
(22 mm)
A4373
12704
1" (25 mm)
12705
11⁄8"
(28 mm)
Cut-to-fit
Units: 5
Code
Stoma Size
14243
5/8
- 115/16" (15-23 mm)
A4407
14246
5/8
- 15/16" (15-33 mm)
A4407
14249
5/8
-
111/16"
(15-43 mm)
HCPCS*
A4407
Pre-cut
Code
Units: 5
Stoma Size
Color
HCPCS*
14232
3/4"
(18 mm)
A4407
14233
7/8"
(22 mm)
A4407
14234
1" (25 mm)
A4407
14235
11/8" (28 mm)
A4407
14236
11/4"
(31 mm)
A4407
14237
13/8" (35 mm)
A4407
14238
1 1/2"
(38 mm)
A4407
14239
15/8" (41 mm)
A4407
Assura® MAXI
Drainable Pouch
• • • • EasiClose™ WIDE Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
A4373
Transparent 111⁄2" (29 1⁄2 cm) / 655 mL
A4373
Code
Units: 10
A4427
Color
HCPCS*
12706
11⁄4" (31 mm)
A4373
15974
12707
13⁄8" (35 mm)
A4373
15975
A4427
A4427
12708
11⁄2" (38 mm)
A4373
15976
12709
15⁄8" (41 mm)
A4373
Opaque 111⁄2" (29 1⁄2 cm) / 655 mL
Code
www.coloplast.us
Units: 10
Color
HCPCS*
15984
A4427
15985
A4427
15986
A4427
Indicates convexity
Indicates convexity
108
Color
2-Piece Assura®
2-Piece Assura®
Assura® Extended Wear Barrier
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
109
• • • • • • • • • EasiClose™ WIDE Outlet
Without filter
Soft cloth on front and back
Not made with natural rubber latex
Opaque 111⁄2" (29 1⁄2 cm) / 655 mL
Code
Units: 10
Color
HCPCS*
15982
A4426
15983
A4426
EasiClose™ Outlet
Filter
Soft cloth on front and back
Graphic pattern
Not made with natural rubber latex
Opaque 101⁄2" (26 1⁄2 cm) / 485 mL
Code
Units: 10
Color
HCPCS*
13964
A4427
13965
A4427
13966
A4427
2-Piece Assura®
2-Piece Assura®
Assura® MIDI
Drainable Pouch
Assura® MAXI
Drainable Pouch
Assura® MIDI
Drainable Pouch
• • • • EasiClose™ WIDE Outlet
Filter
Soft cloth on front and back
Not made with natural rubber latex
Assura® MINI
Drainable Pouch
Opaque 101⁄2" (26 1⁄2 cm) / 485 mL
Code
Units: 10
Color
HCPCS*
15954
A4427
15955
A4427
15956
A4427
Code
Units: 10
Color
Units: 10
Color
HCPCS*
13974
A4427
13975
A4427
13976
A4427
Opaque 111⁄2" (29 1⁄2 cm) / 655 mL
A4427
13925
A4427
Clamp closure
Without filter
Soft cloth on front and back
Not made with natural rubber latex
Units: 10
Color
HCPCS*
13984
A4427
13985
A4427
13986
A4427
Code
Units: 10
Color
A4426
12578
A4426
12579
A4426
Assura® MIDI
Drainable Pouch
• • • • Clamp closure
Without filter
Soft cloth on front and back
Not made with natural rubber latex
Code
www.coloplast.us
1.800.533.0464
HCPCS*
12577
Opaque 93⁄4" (241⁄2 cm) / 400 mL
110
HCPCS*
13924
Opaque 111⁄4" (281⁄2 cm) / 760 mL
Transparent 111⁄2" (29 1⁄2 cm) / 655 mL
Code
Opaque 91⁄4" (231⁄2 cm) / 280 mL
• • • • EasiClose™ Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Code
EasiClose™ Outlet
Filter
Soft cloth on front and back
Not made with natural rubber latex
Assura® MAXI
Drainable Pouch
Assura® MAXI
Drainable Pouch
• • • • • • • • Units: 10
Color
HCPCS*
12527
A4426
12528
A4426
12529
A4426
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
111
Assura® MIDI
Closed Pouch
• • • • • Filter
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Soft outlet attaches to drain bag #14010
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 7" (18 cm) / 275 mL
Transparent 12 1⁄2" (32 cm) / 750 mL
Code
Units: 10
Color
HCPCS*
8114
A4413
8115
A4413
8116
A4413
Code
Code
Color
HCPCS*
12344
A4423
12345
A4423
12346
A4423
Opaque 7" (18 cm) / 275 mL
Code
Opaque 12 1⁄2" (32 cm) / 750 mL
Units: 30
Units: 30
Color
HCPCS*
Units: 10
12354
A4423
HCPCS*
12355
A4423
12356
A4423
Color
2846
A4413
2847
A4413
2-Piece Assura®
2-Piece Assura®
Assura® High Output
Drainable Pouch
For bed drainage bag and bag hanger, see page 92.
Ileostomy / Colostomy
Assura® High Output
Drainable Pouch
• Clamp closure
• Filter
• Not made with natural rubber latex
Assura® Stoma Cap
Opaque 2 L
Code
Units: 5
Color
HCPCS*
2836
A4413
2837
A4413
Assura® MAXI
Closed Pouch
• Filter
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Transparent 8 1⁄2" (21 cm) / 570 mL
Code
12375
A4423
12376
A4423
Color
HCPCS*
2801
A5055
2802
A5055
2803
A5055
Units: 30
Color
HCPCS*
12384
A4423
12385
A4423
12386
A4423
www.coloplast.us
Code
Units: 30
HCPCS*
A4423
Opaque 8 1⁄2" (21 cm) / 570 mL
112
Opaque
Units: 30
Color
12374
Code
• Filter
• Soft cloth on front
• Small size is optimal for intimate moments or
colostomates who irrigate
• Not made with natural rubber latex
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
113
• Multi-chambers minimize sloshing
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Assura® Urostomy Micro-Pouch
• Miniature size prevents twisting
• Soft outlet can be connected to a drain bag for
nighttime use, or a leg bag for patients in a
wheelchair
• Soft cloth on front
• Not made with natural rubber latex
Transparent 6" (15 cm)
Code
Color
Transparent 101⁄2" (261⁄2 cm) / 488 mL
Code
A4433
Units: 10
14228
A4433
HCPCS*
14229
A4433
A4433
14205
A4433
14206
A4433
Try a leg bag for discreet day wear — available on page 25-26.
For nighttime, use a urostomy night bag found on page 92.
Assura® Urostomy Minicap
Opaque 101⁄2" (261⁄2 cm) / 488 mL
Code
Units: 10
Color
Opaque 100 mL
A4433
14225
A4433
14226
A4433
Units: 10
Color
HCPCS*
• S
oft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Transparent 10 3⁄4" (271⁄4 cm) / 375 mL
Units: 10
2807
A5055
Code
Color
2808
A5055
1757
A4433
1758
A4433
1759
A4433
Opaque 10 3⁄4" (271⁄4 cm) / 375 mL
Code
114
HCPCS*
14224
Assura® MAXI
Urostomy Pouch
Ultra-absorbent material inside
Small size is optimal for intimate use
Soft cloth on front
Not made with natural rubber latex
Code
HCPCS*
14227
14204
• • • • Units: 10
Color
www.coloplast.us
2-Piece Assura®
2-Piece Assura®
Assura® MAXI
Urostomy Pouch
Urostomy
1.800.533.0464
HCPCS*
Units: 10
Color
HCPCS*
1754
A4433
1755
A4433
1756
A4433
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
115
Single Use Kits
• S
oft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back
• Not made with natural rubber latex
SenSura® Click Standard Wear Barrier
+ Drainable Pouch
Transparent 91⁄2" (24 cm) / 150 mL
Code
Units: 10
Color
HCPCS*
1751
A4433
1752
A4433
• Barrier #10031 Flat with belt tabs
• Pouch #11196 MAXI / EasiClose™
WIDE Outlet
• Instructions for use
• Stoma measuring guide
• Not made with natural rubber latex
Cut-to-fit / Transparent
Urostomy Night Bag and Bag Hanger
Code
Stoma Size
See Accessories page 92 for more information.
11009
3/8
Units: 5
Color
HCPCS*
2-Piece Single Use Kits
2-Piece Assura®
Assura® MIDI
Urostomy Pouch
A4414
A4427
- 21/4" (10-55 mm)
SenSura® Click Standard Wear Barrier
+ Drainable Pouch
• Barrier #11031 Convex Light with belt tabs
• Pouch #11196 MAXI / EasiClose™
WIDE Outlet
• Instructions for use
• Stoma measuring guide
• Not made with natural rubber latex
Cut-to-fit / Transparent
Code
Stoma Size
11010
5/8
Units: 5
Color
HCPCS*
A4373
A4427
- 111/16" (15-43 mm)
SenSura® Click Standard Wear Barrier
+ Assura® Urostomy Pouch
• • • • • • Barrier #10031 Flat with belt tabs
Pouch #1759 MAXI / soft outlet
Urostomy adapter
Instructions for use
Stoma measuring guide
Not made with natural rubber latex
Cut-to-fit / Transparent
Code
11004
Stoma Size
3/8
Units: 5
Color
HCPCS*
- 21/4" (10-55 mm)
A4414
A4433
See previous page for night drainage bag and hanger,
sold separately.
116
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
117
2-Piece Single Use Kits
Assura® Standard Wear Barrier
+ Drainable Pouch
• Barrier #2883 Flat with belt tabs
• Pouch #15976 MAXI / EasiClose™
WIDE Outlet
• Instructions for use
• Stoma measuring guide
• Not made with natural rubber latex
Cut-to-fit / Transparent
Code
11002
Stoma Size
3⁄8
Units: 5
Color
HCPCS*
A4414
A4427
- 21⁄4" (10-55 mm)
Assura® Standard Wear Barrier
+ Drainable Pouch
• Barrier #14263 Convex Light with belt tabs
• Pouch #15976 MAXI / EasiClose™
WIDE Outlet
• Instructions for use
• Stoma measuring guide
• Not made with natural rubber latex
Cut-to-fit / Transparent
Code
11001
Stoma Size
5⁄8
- 111⁄16" (15-43 mm)
Units: 5
Color
HCPCS*
A4373
A4427
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
118
www.coloplast.us
1.800.533.0464
SenSura® Mio Flex
This flexible adhesive coupling
fits to individual body contours
and maintains a secure seal over
uneven abdomens caused by
scarring, skin folds, hernias, and
other pouching challenges.
Elastic barrier to fit
real body shapes.
Full-circle filter to reduce
ballooning.
Neutral gray textile
for discretion.
Two-Piece Flex
Ostomy Care
• Flat
• Not made with natural rubber latex
Cut-to-fit
Units: 5
Code
Stoma Size
10551
3/8"-15/16"
10561
3/8"-17/ 8"
10571
3/8"-211/16"
Color
(10-33 mm)
HCPCS*
A4414
(10-48 mm)
A4414
(10-68 mm)
A4414
Pre-cut
Units: 5
Code
Stoma Size
10562
1" (25 mm)
Color
A4414
10566
11/8"
A4414
10563
13/16" (30 mm)
A4414
10567
1¼" (32 mm)
A4414
10564
13/8" (35 mm)
A4414
10568
1½" (38 mm)
A4414
10565
19/16" (40 mm)
A4414
10572
1¾" (45 mm)
A4415
10573
2" (50 mm)
A4415
(28 mm)
HCPCS*
2-Piece SenSura® Mio Flex
SenSura® Mio Flex Standard Wear Barrier
SenSura® Mio Flex MAXI
Drainable Pouch
• • • • EasiClose™ WIDE Outlet
Full-circle filter
Neutral gray, water-resistant textile
Opaque pouches feature peek-a-boo inspection
window for easy application
• Not made with natural rubber latex
Transparent 11" (28 cm) / 655 mL
Code
Color
Units: 10
HCPCS*
12273
A4425
12283
Opaque 11" (28 cm) / 655 mL
A4425
Code
Color
HCPCS*
12262
A4425
12272
A4425
12282
A4425
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
121
• • • • • Flat
• Not made with natural rubber latex
EasiClose™ WIDE Outlet
Without Filter
Neutral gray, water-resistant textile
Not made with natural rubber latex
Cut-to-fit
Code
Transparent 11" (28 cm) / 655 mL
Units: 10
Code
HCPCS*
Color
Units: 10 (**Units for 10108: 5)
Stoma Size
-
10102
3/8
- 17/8" (10-48 mm)
-
(10-68 mm)
A4414
- 31/2" (10-88 mm)
A4415
A5063
10103
3/8
12284
A5063
10108**
3/8
A4414
A4414
SenSura® Flex Xpro (Extended Wear) Barrier
SenSura® Mio Flex MIDI
Drainable Pouch
• • • • • 2 3/4"
(10-33 mm)
HCPCS*
10101
12274
15/16"
Color
3/8
• Flat
• Not made with natural rubber latex
EasiClose™ WIDE Outlet
Full-circle filter
Neutral gray, water-resistant textile
Peek-a-boo inspection window for easy application
Not made with natural rubber latex
Cut-to-fit
Opaque 10 1⁄4" (26 cm) / 485 mL
Units: 10
Code
HCPCS*
Color
A4425
12281
Units: 10
Code
Stoma Size
10104
3/8
Color
10105
3/8
-
(10-48 mm)
A4409
10106
3/8
- 23/4" (10-68 mm)
A4410
- 15/16" (10-33 mm)
17/8"
HCPCS*
A4409
SenSura® Flex Standard Wear Barrier
SenSura® Mio Flex MAXI
Closed Pouch
• Convex Light
• Belt tabs
• Not made with natural rubber latex
• Full-circle filter
• Neutral gray, water-resistant textile
• Opaque pouches feature peek-a-boo inspection
window for easy application
• Not made with natural rubber latex
Transparent 8 1⁄4" (20½ cm) / 570 mL
Cut-to-fit
Units: 5
Units: 30
Code
Stoma Size
HCPCS*
11301
5/8
- 15/16" (15-23 mm)
A4373
12203
A4419
11302
5/8
- 15/16" (15-33 mm)
A4373
12216
A4419
11303
5/8
-
12223
A4419
11307
5/8
- 2" (15-53 mm)
Code
Color
Opaque 8 1⁄4" (20½ cm) / 570 mL
Code
2-Piece SenSura® Flex
2-Piece SenSura® Mio Flex
SenSura® Flex Standard Wear Barrier
SenSura® Mio Flex MAXI
Drainable Pouch
111/16"
Color
(15-43 mm)
HCPCS*
A4373
A4373
Units: 30
Color
HCPCS*
12202
A4419
Pre-cut
12213
A4419
Code
Stoma Size
12222
A4419
11312
7/8"
11313
1" (25 mm)
A4373
11314
11/8"
(28 mm)
A4373
11315
11/4" (31 mm)
A4373
Units: 5
(22 mm)
Color
HCPCS*
A4373
Indicates convexity
122
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1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
123
SenSura® Flex MAXI
Closed Pouch
• Convex Light
• Belt tabs
• Not made with natural rubber latex
• Flter
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Cut-to-fit
Units: 5
Code
Stoma Size
Color
HCPCS*
11304
5/8
- 15/16" (15-23 mm)
A4407
11305
5/8
- 15/16" (15-33 mm)
A4407
11306
5/8
- 111⁄16" (15-43 mm)
A4407
11308
5/8
- 2" (15-53 mm)
A4408
Transparent 81⁄2" (21 cm) / 570 mL
Code
Color
• • • • EasiClose™ WIDE Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
A4419
10912
A4419
10917
A4419
Opaque 81⁄2" (21 cm) / 570 mL
Units: 30
Color
HCPCS*
A4425
11517
A4425
11590
A4425
Opaque 111⁄2" (29 1⁄2 cm) / 655 mL
Units: 20
Color
HCPCS*
A4425
11514
11515
A4425
11518
A4425
11591
A4425
10915
A4419
10918
A4419
Assura® AC Standard Wear Barrier
• Flat
• Not made with natural rubber latex
Units: 10 (**Units for 14309: 5)
Cut-to-fit
Code
Stoma Size
Color
- 15/16" (10-33 mm)
HCPCS*
14301
3/8
14302
3/8 -
(10-48 mm)
A4414
14303
3/8
- 23/4" (10-68 mm)
A4414
14309**
3/8
- 31/2" (10-88 mm)
A4415
17/8"
A4414
• Flat
• Not made with natural rubber latex
EasiClose WIDE Outlet
Without filter
Soft cloth on back
Not made with natural rubber latex
™
Cut-to-fit
Code
Transparent 111⁄2" (291⁄2 cm) / 655 mL
Code
A4419
Assura® AC Extended Wear Barrier
SenSura® Flex MAXI
Drainable Pouch
• • • • HCPCS*
10914
Units: 20
11512
Code
Color
For Assura® AC urostomy pouches see page 129. For XL
closed pouch, see page 128.
Transparent 111⁄2" (29 1⁄2 cm) / 655 mL
Code
HCPCS*
10911
Code
SenSura® Flex MAXI
Drainable Pouch
Units: 30
2-Piece SenSura® Flex
2-Piece SenSura® Flex
SenSura® Flex Xpro (Extended Wear) Barrier
Units: 20
Color
HCPCS*
11612
A5063
11690
A5063
Units: 5
Stoma Size
- 15/16" (10-33 mm)
Color
HCPCS*
14304
3/8
14305
3/8
-
(10-48 mm)
A4409
14306
3/8
- 23/4" (10-68 mm)
A4410
17/8"
A4409
Indicates convexity
124
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1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
125
Assura® AC XL
Drainable Pouch
• Convex Light
• Belt tabs
• Not made with natural rubber latex
• • • • Cut-to-fit
Code
Units: 5
Stoma Size
Color
HCPCS*
14401
5/8
- 15/16" (10-23 mm)
A4373
14403
5/8
- 111/16" (15-43 mm)
A4373
14406
5/8
- 2 3⁄8" (15-61 mm)
EasiClose™ Outlet
Without filter
Soft cloth on back
Not made with natural rubber latex
Transparent 12 1⁄2" (32 cm) / 750 mL
Code
Units: 20
Color
HCPCS*
A5063
14527
A4373
Pre-cut
Units: 5
Color
Code
Stoma Size
14642
7/8"
14643
1" (25 mm)
A4373
• • • • 14644
11/8" (28 mm)
A4373
Transparent 11 1⁄4" (28 1⁄2 cm) / 600 mL
14645
11/4"
(31 mm)
A4373
Code
14646
13/8" (35 mm)
A4373
14356
A4425
14357
A4425
14359
A4425
(22 mm)
HCPCS*
Assura® AC MAXI
Drainable Pouch
A4373
®
Assura AC Extended Wear Barrier
• Convex Light
• Belt tabs
• Not made with natural rubber latex
Units: 5
Stoma Size
Color
HCPCS*
14601
5/8
- 15/16" (15-23 mm)
A4407
14602
5/8
- 15/16" (15-33 mm)
A4407
14603
5/8
- 111/16" (15-43 mm)
A4407
14408
5/8
- 23/8" (15-61 mm)
A4408
Assura® AC XL
Drainable Pouch
• • • • Opaque 12 1⁄2" (32 cm) / 750 mL
Units: 20
Color
HCPCS*
A4425
14379
Units: 20
Color
HCPCS*
• • • • EasiClose™ Outlet
Filter
Soft cloth on front and back
Not made with natural rubber latex
Opaque 11 1⁄4" (28 1⁄2 cm) / 600 mL
Code
Units: 20
Color
HCPCS*
14361
A4425
14362
A4425
14364
A4425
Assura® AC MIDI
Drainable Pouch
EasiClose™ Outlet
Filter
Soft cloth on front and back
Not made with natural rubber latex
Code
EasiClose™ Outlet
Filter
Soft cloth on back
Not made with natural rubber latex
Assura® AC MAXI
Drainable Pouch
Cut-to-fit
Code
2-Piece Assura® AC
2-Piece Assura® AC
Assura® AC Standard Wear Barrier
• • • • EasiClose™ Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 10 1⁄4" (26 cm) / 470 mL
Code
Units: 20
Color
HCPCS*
14342**
A4425
14344
A4425
**Custom Peel. Includes perforated rings providing the option of an exact
fit around the stoma. Rings are simply removed for the best fit.
Indicates convexity
126
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1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
127
Opaque 81⁄2" (21 cm) / 500 mL
Units: 30
Units: 20
Code
HCPCS*
14331
A4419
14346
A4425
14332
A4419
14347
A4425
14333**
A4419
14349
A4425
14334
A4419
Code
Color
Color
HCPCS*
**Custom Peel. Includes perforated rings providing the option of an exact
fit around the stoma. Rings are simply removed for the best fit.
Assura® AC MIDI
Closed Pouch
Assura® AC MAXI
Drainable Pouch
• • • • • Filter
• Soft cloth on front and back
• Not made with natural rubber latex
EasiClose™ Outlet
Without filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Opaque 7" (18 cm) / 250 mL
Transparent 11 1⁄4" (28½ cm) / 600 mL
Code
Color
Opaque 11 1⁄4" (28½ cm) / 600 mL
Code
Code
HCPCS*
14316
A4419
14317
A4419
14319
A4419
Units: 20
Color
Units: 30
Units: 20
A5063
14521
2-Piece Assura® AC
2-Piece Assura® AC
Opaque 10 ⁄4" (26 cm) / 470 mL
1
Color
HCPCS*
HCPCS*
A5063
14525
Urostomy
Assura® AC XL
Closed Pouch
Assura® AC MAXI
Urostomy Pouch
• Filter
• Soft cloth on front and back
• Not made with natural rubber latex
Opaque 101⁄2" (26 1⁄2 cm) / 850 mL
Code
Units: 30
Color
HCPCS*
A4419
14355
Assura® AC MAXI
Closed Pouch
• Filter
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Transparent 101⁄2" (26½ cm) / 475 mL
Code
Units: 20
Color
A5073
14554
A5073
Opaque 101⁄2" (26½ cm) / 475 mL
Units: 30
Color
HCPCS*
14326
A4419
14327
A4419
14328**
A4419
14329
A4419
HCPCS*
14552
Code
Transparent 81⁄2" (21 cm) / 500 mL
Code
• Multi-chambers minimize sloshing
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Units: 20
Color
HCPCS*
14553
A5073
14555
A5073
Urostomy Night Bag and Bag Hanger
See Accessories page 92 for more information.
** Custom Peel. Includes perforated rings providing the option of an
extact fit around the stoma. Rings are simply removed for the best fit.
128
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
129
• • • • • SenSura® Flex Standard Wear Barrier
+ MAXI Drainable Pouch
Barrier #14302 Flat
Pouch #14521 EasiClose™ Outlet / without filter
Instructions for use
Stoma measuring guide
Not made with natural rubber latex
• Instructions for use
• Stoma measuring guide
• Not made with natural rubber latex
Cut-to-fit / Transparent
• Barrier #10102 Flat
• Pouch #11512 EasiClose™ WIDE Outlet / filter
11006
Code
Cut-to-fit / Transparent
Code
11011K
Stoma Size
3/8
Units: 5
Color
HCPCS*
A4414
A4425
- 17/8" (10-48 mm)
Cut-to-fit / Transparent
21001
Stoma Size
3/8
Units: 5
Color
- 23/4" (10-68 mm)
11003
21002
-
Units: 5
Color
HCPCS*
A4409
A4425
(10-48 mm)
Stoma Size
3/8
Units: 5
Color
HCPCS*
A4415
A4425
- 2 3/4" (10-68 mm)
SenSura® Mio Standard Wear + Assura® AC
MAXI Urostomy Pouch*
• • • • Cut-to-fit / Transparent
17/8"
Cut-to-fit / Transparent
A4415
A4425
• Barrier #10105 Flat
• Pouch #11512 EasiClose™ WIDE Outlet / filter
3/8
A4414
A5063
- 17/8" (10-48 mm)
• Instructions for use
• Stoma measuring guide
• Not made with natural rubber latex
HCPCS*
• Instructions for use
• Stoma measuring guide
• Not made with natural rubber latex
Stoma Size
HCPCS*
Assura® AC Standard Wear Barrier
+ MAXI Drainable Pouch
Code
SenSura® Flex Xpro (Extended Wear) Barrier
+ MAXI Drainable Pouch
Code
3/8
Units: 5
Color
• Barrier #14303 Flat
• Pouch #14344 EasiClose™ Outlet / filter
• Barrier #10103 Flat
• Pouch #11517 EasiClose™ WIDE Outlet / filter
Code
Stoma Size
2-Piece Single Use Kits
2-Piece Single Use Kits
Assura® AC Standard Wear Barrier
+ MAXI Drainable Pouch
Single Use Kits
Urostomy adapter
Instructions for use
Stoma measuring guide
Not made with natural rubber latex
• Barrier #10561 Flat
• Pouch #14554 Soft outlet / multi-chamber
Cut-to-fit / Transparent
Code
11007
Stoma Size
3/8
- 17/8" (10-48 mm)
Units: 5
Color
HCPCS*
A4414
A5073
• Barrier #10106 Flat
• Pouch #11517 EasiClose™ WIDE Outlet / filter
Cut-to-fit / Transparent
Code
21003
130
Stoma Size
3/8
- 2 3/4" (10-68 mm)
www.coloplast.us
Units: 5
Color
HCPCS*
Urostomy Night Bag and Bag Hanger
See Accessories page 92 for more information.
A4410
A4425
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
131
132
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1.800.533.0464
SenSura® Mio 1-piece
Pouching System
The standard in ostomy care
Full-circle filter to reduce
ballooning.
Neutral gray textile
for discretion.
1-piece
Elastic barrier to fit
real body shapes.
Ostomy Care
• • • • • EasiClose™ WIDE Outlet
Flat
Full-circle filter
Neutral gray, water-resistant textile
Opaque pouches feature peek-a-boo inspection
window for easy application
• Not made with natural rubber latex
Transparent 11" (28 cm) / 655 mL
Units: 10
Code
Cut
Stoma Size
10481
Cut-to-fit
3/8"-2 1/8"
10482
Pre-cut
1" (25 mm)
A4424
10488
Pre-cut
11/8" (28 mm)
A4424
10483
Pre-cut
13/16"
A4424
10490
Pre-cut
1¼" (32 mm)
A4424
10484
Pre-cut
13/8"
(35 mm)
A4424
10491
Pre-cut
1½" (38 mm)
A4424
10487
Pre-cut
19/16"
A4424
10485
Pre-cut
1¾" (45 mm)
A4424
10486
Pre-cut
2" (50 mm)
A4424
(10-55 mm)
(30 mm)
(40 mm)
Opaque 11" (28 cm) / 655 mL
HCPCS*
A4424
1-Piece SenSura® Mio
SenSura® Mio Standard Wear MAXI
Drainable Pouch
Units: 10
Code
Cut
Stoma Size
10471
Cut-to-fit
3/8"-21/8"
10472
Pre-cut
1" (25 mm)
A4424
10473
Pre-cut
11/8" (28 mm)
A4424
10474
Pre-cut
13/16"
A4424
10475
Pre-cut
1¼" (32 mm)
A4424
10476
Pre-cut
13/8"
(35 mm)
A4424
10480
Pre-cut
1½" (38 mm)
A4424
10479
Pre-cut
19/16"
A4424
10477
Pre-cut
1¾" (45 mm)
A4424
10478
Pre-cut
2" (50 mm)
A4424
(10-55 mm)
(30 mm)
(40 mm)
HCPCS*
A4424
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
135
SenSura® Mio Standard Wear MIDI
Closed Pouch
• • • • Flat
EasiClose™ WIDE Outlet
Full-circle filter
Peek-a-boo inspection window allows
easy application
• Neutral gray, water-resistant textile
• Not made with natural rubber latex
• • • • Flat
Full-circle filter
Neutral gray, water-resistant textile
Peek-a-boo inspection window allows
easy application
• Not made with natural rubber latex
Opaque 10¼" (26 cm) / 485 mL
Units: 10
Code
Cut
Stoma Size
10461
Cut-to-fit
3/8"-1¾"
HCPCS*
(10-55 mm)
A4424
Opaque 7 1⁄4" (19 cm) / 340 mL
Cut
Stoma Size
10871
Cut-to-fit
5/8"-1¾"
10872
Pre-cut
1" (25 mm)
A4416
10873
Pre-cut
13/16" (30 mm)
A4416
Pre-cut
13/8"
A4416
10874
SenSura® Mio Standard Wear MAXI
Drainable Pouch
• • • • • Units: 30
Code
(15-45 mm)
(35 mm)
HCPCS*
A4416
1-Piece SenSura® Mio
1-Piece SenSura® Mio
SenSura® Mio Standard Wear MIDI
Drainable Pouch
SenSura® Mio Standard Wear MINI
Closed Pouch
Flat
EasiClose™ WIDE Outlet
Without filter
Neutral gray, water-resistant textile
Not made with natural rubber latex
Transparent 11" (28 cm) / 655 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
10489
Cut-to-fit
3/8"-21/8"
10492
Pre-cut
1" (25 mm)
A5061
10493
Pre-cut
11/8" (28 mm)
A5061
10494
Pre-cut
1¼" (32 mm)
A5061
10495
Pre-cut
13/8" (35 mm)
A5061
10496
Pre-cut
1½" (38 mm)
A5061
(10-55 mm)
A5061
SenSura® Mio Standard Wear MAXI
Closed Pouch
• • • • Flat
Full-circle filter
Neutral gray, water-resistant textile
Peek-a-boo inspection window allows
easy application
• Not made with natural rubber latex
• Full-circle filter
• Neutral gray, water-resistant textile
• Peek-a-boo inspection window allows
easy application
• Comfortable and discreet stoma cap alternative
• Not made with natural rubber latex
Opaque 51⁄4" (13 cm) / 110 mL
Code
10870
Units: 30
Cut
Stoma Size
Cut-to-fit
5/8"-1¾"
(15-45 mm)
SenSura® Mio Original Standard Wear MAXI
Code
Units: 30
Code
Cut
Stoma Size
HCPCS*
10881
Cut-to-fit
5/8"-1¾"
10885**
Cut-to-fit
19/16"-21/8" (40-55 mm)
A4416
10883
Pre-cut
13/16" (30 mm)
A4416
10884
Pre-cut
13/8" (35 mm)
A4416
10885**
Pre-cut
19/16" (40 mm)
A4416
(15-45 mm)
A4416
A4416
• Closed Pouch
• • Flat
• • Filter
• • Soft cloth on front and back
• • Peek-a-boo inspection window allows easy
• application
• • Not made with natural rubber latex
Opaque 8 1⁄2" (21 cm) / 550 mL
Opaque 8 1⁄4" (21 cm) / 550 mL
HCPCS*
Units: 30
Cut
Stoma Size
10831
Cut-to-fit
5/8 -13/4"
10835**
Cut-to-fit
19⁄16 - 21⁄4" (40-55 mm)
A4416
10833
Pre-cut
13⁄16"
A4416
10834
Pre-cut
13/8" (35 mm)
A4416
Pre-cut
19⁄16"
A4416
10835*
(15-45 mm)
(30 mm)
(40 mm)
HCPCS*
A4416
**Because of its larger starter hole, 10835 functions as both a pre-cut
and cut-to-fit solution
**Because of its larger starter hole, 10885 functions as both a pre-cut
and cut-to-fit solution
136
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1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
137
• • • • • • • • • Flat
Filter
Soft cloth on front and back
Peek-a-boo inspection window allows
easy application
• Not made with natural rubber latex
Transparent 11 1⁄2" (29 1⁄2 cm) / 655 mL
Opaque 7" (18 cm) / 340 mL
Units: 30
Code
Cut
Stoma Size
10821
Cut-to-fit
5/8
Flat
EasiClose™ WIDE Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Code
Units: 20
Cut
Stoma Size
HCPCS*
15521
Cut-to-fit
A4416
15522
Pre-cut
1" (25 mm)
A4424
A4424
- 13/4" (15-45 mm)
- 3" (10-76 mm)
10822
Pre-cut
1" (25 mm)
A4416
15523
Pre-cut
13/16"
10823
Pre-cut
13⁄16" (30 mm)
A4416
15524
Pre-cut
13/8" (35 mm)
Pre-cut
13/8"
A4416
10824
(35 mm)
SenSura® Mio Original Standard Wear MINI
Closed Pouch
• • • • Flat
Filter
Soft cloth on front and back
Peek-a-boo inspection window allows
easy application
• Not made with natural rubber latex
Opaque 5 1⁄2" (14 cm) / 110 mL
Units: 30
Code
Cut
Stoma Size
10811
Cut-to-fit
5/8
HCPCS*
3/8
HCPCS*
- 13/4" (15-45 mm)
A4416
(30 mm)
Opaque 111⁄2" (29 1⁄2 cm) / 655 mL
SenSura® Mio Standard Wear MAXI
Urostomy Pouch
A4424
Units: 20
Code
Cut
Stoma Size
15531
Cut-to-fit
3/8
15532
Pre-cut
1" (25 mm)
A4424
15533
Pre-cut
13/16"
A4424
15534
Pre-cut
13/8" (35 mm)
- 3" (10-76 mm)
(30 mm)
HCPCS*
A4424
A4424
SenSura® Standard Wear MAXI
Drainable Pouch
• • • • • Flat
EasiClose™ WIDE Outlet
Without filter
Soft cloth on back
Not made with natural rubber latex
Transparent 11 1⁄2" (29 1⁄2 cm) / 655 mL
Urostomy
A4424
1-Piece SenSura®
1-Piece SenSura® Mio
SenSura® Standard Wear MAXI
Drainable Pouch
SenSura® Mio Original Standard Wear MIDI
Closed Pouch
Units: 20
Code
Cut
Stoma Size
15821
Cut-to-fit
3/8
- 3" (10-76 mm)
HCPCS*
A5061
• • • • Neutral gray, water-resistant textile on back
Flat
Multi-chambers minimize sloshing
Anti-reflux valves prevent urine from washing
over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Not made with natural rubber latex
Transparent 10 1⁄2" (27 cm) / 400 mL
138
Units: 10
Code
Cut
Stoma Size
10586
Cut-to-fit
3/8"-1¾"
www.coloplast.us
HCPCS*
(10-45 mm)
A5071
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
139
SenSura® Xpro (Extended Wear) MAXI
Drainable Pouch
• • • • • • • • • • • Flat
EasiClose™ WIDE Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 11 1⁄2" (29 1⁄2 cm) / 655 mL
Code
15981
Units: 10
Cut
Stoma Size
Cut-to-fit
3/8
Code
Cut
HCPCS*
- 3" (10-76 mm)
Opaque 11 1⁄2" (29 1⁄2 cm) / 655 mL
A5056
Units: 10
Stoma Size
Units: 10
Code
HCPCS*
Cut
Stoma Size
-
- 111/16" (15-43 mm)
HCPCS*
15695
Cut-to-fit
15696
Cut-to-fit
5/8
Pre-cut
1" (25 mm)
A5056
15992
Pre-cut
13/16" (30 mm)
A5056
15993
Pre-cut
11/4"
(32 mm)
A5056
15994
Pre-cut
11/2" (38 mm)
A5056
®
SenSura Standard Wear MAXI
Drainable Pouch
Convex Light
EasiClose™ WIDE Outlet
Filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 11 1⁄2" (29 1⁄2 cm) / 655 mL
Transparent 11 1⁄2" (29 1⁄2 cm) / 655 mL
5/8
15991
• • • • • • Convex Light
EasiClose™ WIDE Outlet
Filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
15/16"
(15-33 mm)
Opaque 11 1⁄2" (29 1⁄2 cm) / 655 mL
A5057
A5057
Units: 10
Code
Cut
Stoma Size
15697
Pre-cut
7/8"
15698
Pre-cut
1" (25 mm)
(22 mm)
HCPCS*
A5057
A5057
SenSura® Standard Wear MAXI
Drainable Pouch
Units: 10
HCPCS*
• Flat
• Soft outlet for liquid stool ­— can connect to
a drain bag (e.g. #14010) at night
• Filter
• Soft cloth on front and back
• Peek-a-boo inspection window allows
easy application
• Not made with natural rubber latex
Code
Cut
Stoma Size
15606
Cut-to-fit
5/8
15623
Pre-cut
1" (25 mm)
A4389
Opaque 12 1⁄2" (32 cm) / 630 mL
15624
Pre-cut
1 1⁄8" (28 mm)
A4389
Code
Cut
Stoma Size
19004
Cut-to-fit
3/8
- 111/16" (15-43 mm)
1-Piece SenSura®
1-Piece SenSura®
SenSura® Xpro (Extended Wear) MAXI
Drainable Pouch
A4389
Units: 30
- 3" (10-76 mm)
HCPCS*
A4424
For bed drainage bag, see page 92.
Opaque 11 1⁄2" (29 1⁄2 cm) / 655 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
15608
Cut-to-fit
5/8
15633
Pre-cut
1" (25 mm)
A4389
15634
Pre-cut
11/8" (28 mm)
A4389
- 111/16" (15-43 mm)
A4389
SenSura® Standard Wear MAXI
Closed Pouch
• Flat
• Filter
• Soft cloth on front and back
• Not made with natural rubber latex
Opaque 8 1⁄2" (21 cm) / 550 mL
Units: 30
Code
Cut
Stoma Size
15480
Cut-to-fit
3/8
Pre-cut
13/8"
15484
- 3" (10-76 mm)
(35 mm)
HCPCS*
A4416
A4416
Indicates convexity
140
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
141
1-Piece SenSura®
1-Piece SenSura®
Urostomy
SenSura® Standard Wear MAXI
Urostomy Pouch
• Convex Light
• Multi-chambers minimize sloshing
• Anti-reflux valves prevent urine from washing
over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Belt tabs
• Soft cloth on back
• Not made with natural rubber latex
SenSura® Standard Wear MAXI
Urostomy Pouch
• Flat
• Multi-chambers minimize sloshing
• Anti-reflux valves prevent urine from washing
over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back
• Not made with natural rubber latex
Transparent 10 3⁄8" (26 cm) / 400 mL
Code
Cut
Stoma Size
11804
Cut-to-fit
3/8
- 3" (10-76 mm)
Units: 10
Transparent 103⁄8" (26 cm) / 400 mL
Units: 10
HCPCS*
Code
Cut
Stoma Size
HCPCS*
A5071
11814
Cut-to-fit
5/8
- 15/16" (15-33 mm)
A4392
SenSura® Xpro (Extended Wear) MAXI
Urostomy Pouch
SenSura® Standard Wear MIDI
Urostomy Pouch
• Convex Light
• Multi-chambers minimize sloshing
• Anti-reflux valves prevent urine from washing
over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
• Flat
• Multi-chambers minimize sloshing
• Anti-reflux valves prevent urine from washing
over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back
• Not made with natural rubber latex
Transparent 9 1⁄2" (24 cm) / 330 mL
Units: 10
Code
Cut
Stoma Size
11803
Cut-to-fit
3/8
HCPCS*
- 21/2" (10-66 mm)
A5071
Transparent 10 3⁄8" (26 cm) / 400 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
11819
Cut-to-fit
5/8
- 15/16" (15-33 mm)
A4393
®
SenSura Xpro (Extended Wear) MAXI
Urostomy Pouch
Opaque 10 3⁄8" (26 cm) / 400 mL
• Flat
• Multi-chambers minimize sloshing
• Anti-reflux valves prevent urine from washing
over the stoma
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
142
Units: 10
Code
Cut
Stoma Size
HCPCS*
11809
Cut-to-fit
3/8
Units: 10
Code
HCPCS*
Cut
Stoma Size
11805
Pre-cut
7/8"
11806
Pre-cut
1" (25 mm)
A4391
11807
Pre-cut
13/16"
A4391
11808
Pre-cut
11/4" (32 mm)
www.coloplast.us
(30 mm)
Stoma Size
11816
Pre-cut
7/8"
11817
Pre-cut
1" (25 mm)
A4393
11818
Pre-cut
11/4" (32 mm)
A4393
(22 mm)
HCPCS*
A4393
See Accessories page 92 for more information.
A4391
Opaque 10 3⁄8" (26 cm) / 400 mL
(22 mm)
Cut
Urostomy Night Bag and Bag Hanger
Transparent 10 3⁄8" (26 cm) / 400 mL
- 3" (10-76 mm)
Units: 10
Code
A4391
A4391
1.800.533.0464
Indicates convexity
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
143
Assura® Standard Wear MAXI
Drainable Pouch
• • • • • Flat
EasiClose™ WIDE Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Assura® Standard Wear MAXI
Drainable Pouch
• • • • • • Convex Light
EasiClose™ WIDE Outlet
Filter
Belt tabs
Soft cloth on back
Not made with natural rubber latex
Transparent 111⁄2" (29 cm) / 530 mL
Code
Stoma Size
- 1 ⁄16" (15-33 mm)
A4389
- 111⁄16" (15-43 mm)
A4389
Units: 10
14511
Cut-to-fit
5/8
Code
Cut
Stoma Size
HCPCS*
14512
Pre-cut
5/8
15860
Cut-to-fit
3/8
Opaque 111⁄2" (29 cm) / 530 mL
Code
Cut
Stoma Size
15870
Cut-to-fit
3/8
15874
Pre-cut
1" (25 mm)
A4424
15875
Pre-cut
1 ⁄16" (30 mm)
A4424
15876
Pre-cut
13⁄8" (35 mm)
A4424
3
HCPCS*
A4424
Assura® Standard Wear MAXI
Drainable Pouch
• • • • • Flat
EasiClose™ WIDE Outlet
Without filter
Soft cloth on front and back
Not made with natural rubber latex
Opaque 111⁄2" (29 cm) / 530 mL
Units: 10
Code
Cut
Stoma Size
15871
Cut-to-fit
3/8
- 3" (10-75 mm)
5
HCPCS*
A4424
Units: 10
- 3" (10-75 mm)
Units: 10
Cut
Transparent 111⁄2" (29 cm) / 530 mL
- 3" (10-75 mm)
1-Piece Assura®
1-Piece Assura®
EasiClose™ WIDE outlets offer a 1/2" wider integrated
closure for easy, fast emptying on the go.
HCPCS*
Assura® Standard Wear MAXI
Drainable Pouch
• • • • • Flat
EasiClose™ Outlet
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
13860
Cut-to-fit
3/8
- 3" (10-75 mm)
A4424
Opaque 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
13870
Cut-to-fit
3/8
13874
Pre-cut
1" (25 mm)
A4424
13875
Pre-cut
13/16" (30 mm)
A4424
Pre-cut
13/8"
A4424
13876
- 3" (10-75 mm)
(35 mm)
A4424
A5061
Assura® Standard Wear MIDI
Drainable Pouch
• • • • • Assura® Extended Wear MAXI
Drainable Pouch
• • • • • 144
Flat
EasiClose™ WIDE Outlet
Without filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Flat
EasiClose™ Outlet
Filter
Soft cloth on front and back
Not made with natural rubber latex
Opaque 101⁄4" (26 cm) / 390 mL
Code
Units: 10
Cut
Stoma Size
HCPCS*
Transparent 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
13840
Cut-to-fit
3/8
Code
Cut
Stoma Size
HCPCS*
13844
Pre-cut
1" (25 mm)
A4424
15869
Cut-to-fit
3/8
13845
Pre-cut
13/16"
A4424
13846
Pre-cut
13/8" (35 mm)
- 3" (10-75 mm)
A4388
Opaque 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
15879
Cut-to-fit
3/8
www.coloplast.us
- 3" (10-75 mm)
A4388
1.800.533.0464
-
21/2"
(15-65 mm)
(30 mm)
A4424
A4424
Indicates convexity
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
145
Assura® Standard Wear MAXI
Drainable Pouch
• • • • • • • • • • • • Convex Light
EasiClose™ Outlet
Filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Transparent 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
HCPCS*
Code
HCPCS*
Cut
Stoma Size
14411
Cut-to-fit
5/8
- 15/16"
14412
Cut-to-fit
5/8
- 111/16" (15-43 mm)
(15-33 mm)
Cut
Stoma Size
A4389
14103
Cut-to-fit
5/8
- 111/16"
A4389
14163
Pre-cut
7/8"
(15-43 mm)
14164
Pre-cut
1" (25 mm)
A4389
14165
Pre-cut
11/8" (28 mm)
A4389
Pre-cut
11/4"
A4389
(22 mm)
(31 mm)
A4389
A4389
Opaque 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
14166
Code
Cut
Stoma Size
HCPCS*
Opaque 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
14414
Cut-to-fit
5/8
- 1 5⁄16" (15-33 mm)
A4389
Code
HCPCS*
14415
Cut-to-fit
5/8
- 1 ⁄16" (15-43 mm)
A4389
14421
Pre-cut
7/8"
(22 mm)
A4389
14422
Pre-cut
1" (25 mm)
14423
Pre-cut
11/8" (28 mm)
Pre-cut
11/4"
A4389
14424
11
(31 mm)
Cut
Stoma Size
14106
Cut-to-fit
5/8
14173
Pre-cut
7/8"
A4389
14174
Pre-cut
1" (25 mm)
A4389
A4389
14175
Pre-cut
11/8" (28 mm)
A4389
Pre-cut
11/4"
A4389
Assura® Standard Wear MIDI
Drainable Pouch
(15-43 mm)
(22 mm)
(31 mm)
Convex Light
EasiClose™ Outlet
Filter
Belt tabs
Soft cloth on front and back
Not made with natural rubber latex
• • • • • • A4389
Convex
EasiClose™ Outlet
Filter
Belt tabs
Soft cloth on front and back
Not made with natural rubber latex
Opaque
10 1⁄4" (26 cm) / 390 mL
Units: 10
Opaque 101⁄4" (26 cm) / 390 mL
Code
Cut
Stoma Size
HCPCS*
Code
Cut
Stoma Size
14404
Cut-to-fit
5/8
- 1 5⁄16" (15-33 mm)
A4389
14196
Cut-to-fit
5/8
14405
Cut-to-fit
5/8
- 111/16" (15-43 mm)
A4389
www.coloplast.us
A4389
1-Piece
1-Piece
• • • • • • 14176
- 111/16"
Assura® Standard Wear MIDI
Drainable Pouch
Indicates convexity
146
Convex
EasiClose™ Outlet
Filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
1-Piece Assura®
1-Piece Assura®
Assura® Standard Wear MAXI
Drainable Pouch
Units: 10
- 111/16" (15-43 mm)
HCPCS*
A4389
Indicates convexity
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
147
• • • • • • • • • • • • Convex
EasiClose™ Outlet
Without filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
14413
Cut-to-fit
5/8
- 15⁄16" (15-33 mm)
14416
Cut-to-fit
5/8
- 111/16" (15-43 mm)
A4390
Units: 10
Code
Cut
Stoma Size
HCPCS*
14419
Cut-to-fit
5/8
A4390
Assura® Standard Wear MAXI
Drainable Pouch
• • • • • Transparent 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
HCPCS*
12660
Stoma Size
Cut-to-fit
3/8
- 2 ⁄4" (10-70 mm)
3
A5061
Cut
Stoma Size
HCPCS*
13706
Cut-to-fit
5/8
- 111/16" (15-43 mm)
A4389
Opaque 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
12533
Cut-to-fit
5/8
- 111/16" (15-43 mm)
A4389
Units: 10
Code
Cut
Stoma Size
HCPCS*
12670
Cut-to-fit
3/8
• • • • • • Convex
Clamp closure
Without filter
Belt tabs
Soft cloth on back
Not made with natural rubber latex
Transparent 9 3⁄4" (24 1⁄2 cm) / 230 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
13703
Cut-to-fit
5/8
- 111/16" (15-43 mm)
A4389
A5061
1-Piece
1-Piece
Opaque 111⁄4" (28 1⁄2 cm) / 530 mL
- 2 3⁄4" (10-70 mm)
Units: 10
Code
Assura® Standard Wear MINI
Drainable Pouch
Flat
Clamp closure
Without filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Cut
Transparent 111⁄4" (28 1⁄2 cm) / 530 mL
A4390
Opaque 111⁄4" (28 1⁄2 cm) / 530 mL
- 111/16" (15-43 mm)
Convex
Clamp closure
Without filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
1-Piece Assura®
1-Piece Assura®
Assura® Standard Wear MAXI
Drainable Pouch
Assura® Extended Wear MAXI
Drainable Pouch
Assura® Standard Wear MINI
Drainable Pouch
• • • • • Flat
Clamp closure
Without filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 9 3⁄4" (24 1⁄2 cm) / 230 mL
Units: 10
Code
HCPCS*
12630
Cut
Stoma Size
Cut-to-fit
3/8
-- 2 ⁄4" (10-55 mm)
1
Opaque 9 3⁄4" (24 1⁄2 cm) / 230 mL
A5061
Units: 10
Code
Cut
Stoma Size
12620
Cut-to-fit
3/8
- 2 1⁄4" (10-55 mm)
HCPCS*
A5061
Indicates convexity
Indicates convexity
148
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
149
• • • • • • Opaque 7" (18 cm) / 350 mL
Convex
Clamp closure
Without filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
12416
Cut-to-fit
5/8
- 111⁄16" (15-43 mm)
A4390
Opaque 111⁄4" (28 1⁄2 cm) / 530 mL
Units: 10
Code
Cut
Stoma Size
12419
Cut-to-fit
5/8
HCPCS*
- 111⁄16" (15-43 mm)
A4390
Cut
Stoma Size
• • • • 12140
Cut-to-fit
12144
Pre-cut
1" (25 mm)
12145
Pre-cut
1 ⁄16" (30 mm)
A4416
12146
Pre-cut
1 3⁄8" (35 mm)
A4416
12147
Pre-cut
1 9⁄16" (40 mm)
A4416
12149
Pre-cut
2" (50 mm)
A4416
1
3
A4416
A4416
Assura® Standard Wear MINI
Closed Pouch
• • • • Flat
Filter
Soft cloth on front and back
Not made with natural rubber latex
Opaque 5" (12 cm) / 170 mL
12110
Flat
Filter
Soft cloth on front and back
Not made with natural rubber latex
⁄16 - 2 ⁄2" (20-65 mm)
HCPCS*
13
Code
Assura® Standard Wear MAXI
Closed Pouch
Units: 30
Code
1-Piece Assura®
1-Piece Assura®
Assura® Extended Wear MAXI
Drainable Pouch
Units: 30
Cut
Stoma Size
Cut-to-fit
13/16
- 2 ⁄2" (20-65 mm)
1
HCPCS*
A4416
Assura® Standard Wear MAXI
Closed Pouch
Opaque 81⁄2" (22 cm) / 530 mL
Units: 30
HCPCS*
• • • • • Convex Light
Filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Code
Cut
Stoma Size
12170
Cut-to-fit
13/16
12174
Pre-cut
1" (25 mm)
A4416
12175
Pre-cut
13/16" (30 mm)
A4416
Transparent 8 1⁄2" (22 cm) / 560 mL
12176
Pre-cut
13/8"
A4416
Code
Cut
Stoma Size
12177
Pre-cut
19/16" (40 mm)
A4416
14441
Cut-to-fit
5/8
- 15/16" (15-33 mm)
A4417
Cut-to-fit
5/8
- 111/16"
A4417
Cut
Stoma Size
14444
Cut-to-fit
5/8
- 15/16"
14445
Cut-to-fit
5/8
- 111/16" (15-43 mm)
- 3" (20-75 mm)
A4416
(35 mm)
14442
Units: 10
(15-43 mm)
HCPCS*
®
Assura Standard Wear MIDI
Closed Pouch
• • • • Opaque
Flat
Filter
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Code
Transparent 7" (18 cm) / 350 mL
Cut
Stoma Size
12130
Cut-to-fit
13/16
12134
Pre-cut
1" (25 mm)
A4416
12135
Pre-cut
13/16" (30 mm)
A4416
Pre-cut
13/8"
A4416
www.coloplast.us
A4417
A4417
HCPCS*
- 21⁄2" (20-65 mm)
(35 mm)
A4416
Indicates convexity
150
(15-33 mm)
HCPCS*
Units: 30
Code
12136
Units: 10
Indicates convexity
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
151
• • • • • Urostomy
Convex Light
Filter
Belt tabs
Soft cloth on back (and front of opaque)
Not made with natural rubber latex
Transparent 7" (18 cm) / 350 mL
Assura® Standard Wear MAXI
Urostomy Pouch
Units: 10
Code
Cut
Stoma Size
14431
Cut-to-fit
5/8
- 15⁄16" (15-33 mm)
A4417
Cut-to-fit
5/8
- 1 ⁄16" (15-43 mm)
A4417
14432
11
Opaque 7" (18 cm) / 350 mL
HCPCS*
• Flat
• Multi-chambers minimize sloshing
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back
• Not made with natural rubber latex
Transparent 10 3⁄4" (27 1⁄2 cm) / 470 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
14222
Cut-to-fit
3/8
- 2 1⁄4" (10-55 mm)
Cut
Stoma Size
14434
Cut-to-fit
5/8
- 15⁄16" (15-33 mm)
A4417
14435
Cut-to-fit
5/8
- 111⁄16" (15-43 mm)
A4417
14451
Pre-cut
7/8"
(22 mm)
A4417
14452
Pre-cut
1" (25 mm)
A4417
14453
Pre-cut
1 1⁄8" (28 mm)
A4417
14454
Pre-cut
1 ⁄4" (31 mm)
A4417
1
HCPCS*
Assura® Standard Wear Stoma Cap
Flat
Filter
Belt tabs
Soft cloth on back
Small pouch size for discreet moments
Not made with natural rubber latex
Opaque
Units: 30
Code
Cut
Stoma Size
2501
Cut-to-fit
13/16
- 2 1⁄4" (20-55 mm)
HCPCS*
A5055
Assura® Standard Wear MAXI
Urostomy Pouch
• Convex Light
• Multi-chambers minimize sloshing
• Soft outlet can be connected to urostomy
night bag #21365
• Belt tabs
• Soft cloth on back
• Not made with natural rubber latex
Transparent 10 3⁄4" (27 1⁄2 cm) / 470 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
14717
Cut-to-fit
5/8
- 1 11⁄16" (15-43 mm)
• Flat
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Transparent 10 3⁄4" (27 cm) / 465 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
5585
Cut-to-fit
3/8
Code
5580
Indicates convexity
www.coloplast.us
A4392
Assura® Standard Wear MAXI
Urostomy Pouch
- 2 1⁄4" (10-55 mm)
Opaque 10 3⁄4" (27 cm) / 465 mL
152
A5071
Units: 10
Code
• • • • • • 1-Piece Assura®
1-Piece Assura®
Assura® Standard Wear MIDI
Closed Pouch
A5071
Units: 10
Cut
Stoma Size
Cut-to-fit
3/8
- 2 ⁄4" (10-55 mm)
1
HCPCS*
A5071
Indicates convexity
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
153
Assura® Standard Wear MAXI
Urostomy Pouch
• Flat
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
• Convex
• Soft outlet can be connected to urostomy
night bag #21365
• Belt tabs
• Soft cloth on back
• Not made with natural rubber latex
Transparent 7" (18 cm) / 265 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
5575
Cut-to-fit
3/8
- 21/4" (10-55 mm)
Opaque 7" (18 cm) / 265 mL
A5071
Units: 10
Code
Cut
Stoma Size
5570
Cut-to-fit
3/8
- 2 1⁄4" (10-55 mm)
HCPCS*
A5071
Assura® Extended Wear MAXI
Urostomy Pouch
• Flat
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back
• Not made with natural rubber latex
Transparent 9 ⁄2" (24 cm) / 375 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
12474
Cut-to-fit
3/8
1
- 2 1⁄4" (10-55 mm)
A4391
Assura® Extended Wear MIDI
Urostomy Pouch
• Flat
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back (and front of opaque)
• Not made with natural rubber latex
Transparent 9 1⁄2" (24 cm) / 265 mL
Code
Cut
Stoma Size
Cut-to-fit
3/8
Code
Cut
Stoma Size
12471
Cut-to-fit
3/8
12472
- 2 1⁄4" (10-55 mm)
Opaque
154
1-Piece Assura®
1-Piece Assura®
Assura® Standard Wear MIDI
Urostomy Pouch
10 3⁄4" (27 cm) / 465 mL
Transparent
Units: 10
Code
Cut
Stoma Size
12595
Cut-to-fit
5/8
- 15/16" (15-33 mm)
HCPCS*
A4392
12596
Cut-to-fit
5/8
- 111/16" (15-43 mm)
A4392
12991
Pre-cut
5/8 "
(15 mm)
A4392
12992
Pre-cut
3/4 "
(18 mm)
A4392
12993
Pre-cut
7/8 "
(22 mm)
A4392
12994
Pre-cut
1" (25 mm)
A4392
12995
Pre-cut
11/8" (28 mm)
A4392
12996
Pre-cut
11/4"
(31 mm)
A4392
12997
Pre-cut
13/8" (35 mm)
A4392
Assura® Extended Wear MAXI
Urostomy Pouch
• Convex
• Soft outlet can be connected to
urostomy night bag #21365
• Belt tabs
• Soft cloth on back
• Not made with natural rubber latex
10 3⁄4" (27 cm) / 465 mL
Transparent
Units: 10
HCPCS*
A4391
Code
Units: 10
Cut
Stoma Size
12432
Cut-to-fit
5/8
- 1 ⁄16" (15-33 mm)
A4393
12433
Cut-to-fit
5/8
- 111⁄16" (15-43 mm)
A4393
5
HCPCS*
Units: 10
www.coloplast.us
- 2 1⁄4" (10-55 mm)
HCPCS*
A4391
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
155
1-Piece Single Use Kits
Single Use Kits
SenSura® 1-piece Single Use Kit
• • • • Pouch #15521 MAXI / EasiClose™ WIDE Outlet
Instructions for use
Stoma measuring guide
Not made with natural rubber latex
Transparent
Units: 5
Code
Cut
Stoma Size
11008
Cut-to-fit
3/8
- 3" (10-76 mm)
HCPCS*
A4424
Assura® 1-piece Single Use Kit
• • • • Pouch #15860 MAXI / EasiClose™ WIDE Outlet
Instructions for use
Stoma measuring guide
Not made with natural rubber latex
Transparent
Units: 5
Code
Cut
Stoma Size
11005
Cut-to-fit
3/8
- 3" (10-76 mm)
HCPCS*
A4424
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
156
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1.800.533.0464
SenSura® Post-op
pouches. Security.
Right from the start.
Your patients deserve all the
benefits of SenSura® from day
one following their operation.
The post-operative phase is critical for you and
your patients. You need appliances that allow you
to provide the right care, and your patients need
appliances that give them comfort and peace of mind
following their operation.
For optimal discretion in the transition from the
hospital to the community, consider the SenSura®
1-piece Drainable pouch on page 141.
For extra high capacity, consider the SenSura® Click
Magnum high output pouch on page 103.
Post-op
Our new range of SenSura® Post-Op pouches
provides ease of use and optimal security with our
unique double-layer adhesive.
Ostomy Care
• Flat
• Soft outlet can connect to bed drain bag #14010
• Easy-to-open and -close access window
attached to pouch
• Soft cloth on back
• Not made with natural rubber latex
Transparent 13" (33 cm) / 830 mL
Units: 5
Code
Cut
Stoma Size
HCPCS*
19020
Cut-to-fit
3/8
- 3" (10-76 mm)
A6154
19021
Cut-to-fit
3/8
- 41/2" (10-115 mm)
A6154
SenSura® Standard Wear 1-piece STERILE
Post-Op Pouch w/ Window
• Flat
• Soft outlet can connect to bed drain bag #14010
• Easy-to-open and -close access window
attached to pouch
• Soft cloth on back
• Not made with natural rubber latex
Transparent 13" (33 cm) / 830 mL
1-Piece Post-Op / Wound Pouches
SenSura® Standard Wear 1-piece
Post-Op Pouch w/ Window
Units: 5
Code
Cut
Stoma Size
19010
Cut-to-fit
3/8
- 3" (10-76 mm)
HCPCS*
A6154
19011
Cut-to-fit
3/8
- 41/2" (10-115 mm)
A6154
SenSura® Standard Wear 1-piece
Post-Op Pouch
• • • • • Flat
Soft outlet can connect to bed drain bag #14010
Effective pouching solution for small fistulas
Soft cloth on back
Not made with natural rubber latex
Transparent 12 1⁄4" (31 cm) / 690 mL
Code
Cut
Stoma Size
19030
Cut-to-fit
3/8
- 3" (10-76 mm)
Units: 5
HCPCS*
A6154
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
159
Post-Op Accessories
• Replacement window for Assura® post-op pouches
• Not made with natural rubber latex
• • • • Flat
Soft outlet can connect to bed drain bag #14010
Soft cloth on front and back
Peek-a-boo inspection window ensures easy placement and visualization of the stoma
• Not made with natural rubber latex
Opaque 12 1⁄4" (31 cm) / 690 mL
Code
19001
Cut-to-fit
Code
Size
Units
12801
Matches 1/2 - 23/4"
(12800, 12808)
20
A4421
12803
Matches 1/2 - 37/8"
(12802, 12810)
15
A4421
Units: 5
Cut
Stoma Size
Cut-to-fit
3/8
HCPCS*
- 3" (10-76 mm)
A6154
For a non-sterile version, see page 141. For SenSura
Magnum high output pouches, and a non-sterile version,
see page 103.
HCPCS*
®
Assura® Standard Wear 1-piece
Post-Op Pouch w/ Window
• • • • • Code
Units: 5
Cut
Stoma Size
12800
Cut-to-fit
1/2
-
12802
Cut-to-fit
1/2
- 4" (13-100 mm)
23/4"
(13-70 mm)
• • • • Flat
Soft outlet can connect to bed drain bag #14010
Soft cloth on back
Not made with natural rubber latex
Transparent 12 1⁄4" (31 cm) / 690 mL
Flat
Soft outlet can connect to bed drain bag #14010
Easy-to-open and -close access window
Soft cloth on back
Not made with natural rubber latex
Transparent 13" (33 cm) / 830 mL
Assura® Standard Wear 1-piece
Post-Op Pouch
HCPCS*
A6154
A6154
Code
Cut
Stoma Size
12805
Cut-to-fit
1/2
- 23/4" (13-70 mm)
• • • • • • • • Flat
Soft outlet can connect to bed drain bag #14010
Soft cloth on back
Not made with natural rubber latex
Cut
Stoma Size
12818
Cut-to-fit
1/2
- 23/4" (13-70 mm)
HCPCS*
A6154
Units: 5
Code
Cut
Stoma Size
12808
Cut-to-fit
1/2
- 23/4" (13-70 mm)
A6154
Cut-to-fit
1/2
- 4" (13-100 mm)
A6154
12810
Code
Units: 5
For Assura® high output pouches and ileo night pouches,
see page 112.
oft outlet can connect to bed drain bag #14010
S
Easy-to-open and -close access window
Soft cloth on back
Not made with natural rubber latex
Transparent 13" (33 cm) / 830 mL
A6154
Assura® Standard Wear 1-piece STERILE
Post-Op Pouch
Transparent 12 1⁄4" (31 cm) / 690 mL
Assura® Standard Wear 1-piece STERILE
Post-Op Pouch w/ Window
• Flat
Units: 5
HCPCS*
1-Piece Post-Op / Wound Pouches
1-Piece Post-Op / Wound Pouches
SenSura® Standard Wear 1-piece STERILE
Post-Op Pouch
HCPCS*
For extra Assura post-op windows (sold separately), see
next page.
®
160
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
161
Inflatable Ring
• Provides stability when applying the lid
• Prevents leakage
Fistula / Wound Pouch Accessories
Flexible Lid
• Easy to apply and
remove
• Allows access to
dress the wound
Double-layer
adhesive
• Flexible and long-lasting
• Protects skin from
drainage
Coloplast® Fistula Drain Port
Can be easily applied to the lid to allow for
catheter insertion. For catheters ranging from
18FR - 22FR, the drain port is ready for use.
For catheters ranging from 24FR - 30FR, pull
off the top of the drain port - DO NOT CUT.
• Not made with natural rubber latex
Tracing Guide
• Provides accuracy in
cutting fistula or wound
patterns
Fistula Accessories
Fistula / Wound Management
Pump
• Easy to inflate the ring
Outlets
• Spigots make draining
fistulas/wounds easy
Units: 12
Code
Size
14015
One size
HCPCS*
A4421
Coloplast® Bed Drainage Bag
Bag tubing specifically designed for fistula
output. Holds up to 2000ml. Long tubing can
be cut easily, allowing nurses to find the right
length for bed drainage.
• Not made with natural rubber latex
Drain Port
• Allows for catheter
insertion
Coloplast® Fistula and Wound Management System
Each system includes:
• 1 pouch and tracing guide
• 1 drain port (extras sold separately on next page)
• 1 lid (extras sold separately on next page)
• 1 clear drape
• 1 clamp
• Not made with natural rubber latex
Each box includes one pump.
Units: 6
Code
Size
14010
2000 mL
HCPCS*
A4357
For matching bag hanger, see page 92.
Coloplast® Transparent Fistula Lids
Replacement lids match the transparent
lid included with each fistula pouch.
• Not made with natural rubber latex
14050
Mini
14060 Midi
14070 Maxi
Units: 3
Units for 14050: 6
Code
Cut
Stoma Size
14050
Mini
41/8 x 61/4" (104-159 mm)
HCPCS*
A6154
14060
Midi
61/8 x 9" (156-228 mm)
A6154
14070
Maxi
81/8 x 113/4" (208-297 mm)
A6154
Units: 10
Code
Size
14021
Mini (matches 14050)
A4421
14031
Midi (matches 14060)
A4421
14041
Maxi (matches 14070)
A4421
Coloplast® Pouch Clamp
Simple closure clamp is easy to manipulate,
even for those with low dexterity.
• Not made with natural rubber latex
162
www.coloplast.us
1.800.533.0464
HCPCS*
Units: 20
Code
Size
9500
One size
HCPCS*
A4363
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
163
• Absorb moisture (e.g. very liquid output)
without breaking down
• Easy to handle, mold, and apply
• Alcohol-free = sting-free
• Not made with natural rubber latex
Brava® Elastic Barrier Strips
Skin-friendly strips are used to “picture
frame” around an ostomy barrier, providing
extra security.
• Elastic (follows the contours of the body)
• Ensures the position of your barrier and
minimizes roll-up
• Skin-friendly and secure alternative to tape
• Not made with natural rubber latex
Units
20 strips
HCPCS*
A4362
Units
30 strips
Units
HCPCS*
120427
2 mm (thin)
10
A4385
4.2 mm (thick)
10
A4385
A sting-free alternative to conventional alcohol-based paste
• Creates a tight, effective seal between the skin and the
fistula appliance
• Contains pectin
• Not made with natural rubber latex
Units
20 strips
Size
2 oz
Units
1
HCPCS*
A5121
Coloplast® Paste
HCPCS*
A4362
Used to fill in uneven skin surfaces to
create a flat pouching surface
• Provides tight sealing around the stoma
• Protects against stoma output
• Minimizes risk of maceration
• Non-pectin
• Not made with natural rubber latex
Brava® Elastic Barrier Strips- Straight
For square or rectangular barrier shapes
Code
Size
120740*
51/4" strips
*2 strips = 1 billable unit of A4362
120307
Code
12050
Brava® Elastic Barrier Strips- Y shape
Designed for users with varying body
shapes, e.g. hernias or skin folds
Code
Size
120721*
53/4" strips
*3 strips = 1 billable unit of A5121
Size
Brava® Paste
Brava® Elastic Barrier Strips- Curved
For round or oval barrier shapes
Code
Size
120700*
51/2" strips
*2 strips = 1 billable unit of A4362
Code
HCPCS*
A4406
Code
Size
Units
HCPCS*
2650
2 oz
12
A4405
Fistula Accessories: Extra Protection
Fistula Accessories: Extra Protection
Brava® Moldable Rings
Extra Protection
Brava® Strip Paste
• Pectin-based product protects skin
from effluent
• Used to create a tight seal between the
fistula or wound manager and healthy skin
• Alcohol-free = sting-free
• Not made with natural rubber latex
Brava® Powder
Code
Size
Units
HCPCS*
Code
Size
HCPCS*
26555
2 oz package (.2 oz / strip)
10 strips
A4406
19075
1 oz
A4371
• Provides effective moisture absorption and
protection
• Not made with natural rubber latex
Units: 16
Brava® Adhesive Remover Spray
• Designed to lift the edges of the barrier for ease
in removal
• Dry within seconds without leaving an oily
residue behind
• Alcohol-free, silicone- based, and sting-free
• Not made with natural rubber latex
Code
120105
164
www.coloplast.us
1.800.533.0464
Size
1.7 oz (50 mL)
Units
1
HCPCS*
A4455
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
165
Fistula Accessories: Extra Protection
Brava® Adhesive Remover Wipes
• Wipe away adhesive residue
• Dry within seconds without leaving an oily
residue behind
• Alcohol-free, silicone- based, and sting-free
• Not made with natural rubber latex
Code
120115
Size
1 wipe
Units
30 wipes/box
HCPCS*
A4456
Brava® Skin Barrier Spray
• Protect against stoma output and adhesives
• Dry within seconds without building a thick or tacky layer
• Alcohol-free, silicone- based, and sting-free
• Not made with natural rubber latex
Code
120205
Size
1.7 oz (50 mL)
Units
1
HCPCS*
A4369
Brava® Skin Barrier Wipes
• Protect against stoma output and adhesives
• Dry within seconds without building a thick or tacky layer
• Alcohol-free, silicone- based, and sting-free
• Not made with natural rubber latex
Code
120215
Size
1 wipe
Units
30 wipes/box
HCPCS*
A5120
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
166
www.coloplast.us
1.800.533.0464
Coloplast Pediatric
Pouching Systems
Coloplast offers pediatric pouches in many different styles
and sizes to accomodate the different stages in a child’s life.
Coloplast offers one-piece and two-piece ostomy pouching
systems, as well as, drainable, closed-end (non-drainable),
and spout (urostomy) pouches.
Pediatric
Assura® AC (Adhesive Coupling) Pediatric
A simple, soft, secure system for neonates! This
ostomy pouching system is based on adhesives that
make it easy to apply the pouch to the barrier. The
pouching system is easy to clean, soft and comfortable,
safe and simple to handle with the EasiCloseTM standard
integrated outlet.
Assura® AC Pediatric Standard Wear Barrier
• Flat
• No starter hole
• Not made with natural rubber latex
Cut-to-fit
Code
Units: 10
Stoma Size
Color
HCPCS*
14307
0 - 5⁄8" (0-17 mm)
A4414
14308
0 - 1" (0-27 mm)
A4414
Assura® AC Pediatric Drainable Pouch
• • • •
EasiClose™ Outlet
Filter
Soft cloth on back
Not made with natural rubber latex
Transparent 5 1⁄2" (14 cm)
Units: 10
Code
Length
14681
5½" (14 cm)
A4425
14682
6½" (16 cm)
A4425
Color
HCPCS*
EasiClose™ Outlet
Filter
Soft cloth on front and back
Not made with natural rubber latex
Opaque (Teddy Bear) 5 1⁄2" (14 cm)
Units: 10
Code
Length
14691
5½" (14 cm)
Color
A4425
14692
6½" (16 cm)
A4425
Pediatric
Assura® AC Pediatric Drainable Pouch
• • • •
2-Piece AC Pediatric Pouches / Barriers
For younger children
HCPCS*
Ask us about our pediatric education!
• Pregnancy with an Ostomy
• Pediatric FAQ
• My Child Has An Ostomy:
A Resource Sheet for Caregivers
• Life After Your Child’s Ostomy
• When I Met Tipster: A coloring
book for children with ostomies
Life After Your Child’s Ostomy
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
169
*SenSura® Mio Flex, SenSura® Flex and Assura AC can
be used interchangeably as long as the coupling size/
color (e.g. green) match.
SenSura® Mio Flex Standard Wear Barrier
• Flat
• Not made with natural rubber latex
For younger children/smaller pouch sizes
Units: 10
Cut-to-fit
Code
Stoma Size
3⁄8
10551
Color
- 15⁄16" (10-33 mm)
HCPCS*
A4414
SenSura® Flex Standard Wear Barrier
• Flat
• Not made with natural rubber latex
Units: 10
Stoma Size
3⁄8
10101
-
15⁄16"
Specifically developed adhesive and a smaller barrier size are
ideal for pediatrics, while a mix-and-match "green" flange size
offers versatility. The SenSura® and Assura® pouches and barrier
may be used interchangeably with "green"-sized adult SenSura®
or Assura products for a broad array of pouching options.
Assura® Pediatric Standard Wear Barrier
Cut-to-fit
Code
Assura® 2-piece Pediatric Pouching Systems
Color
(10-33 mm)
HCPCS*
A4414
• Flat
• Not made with natural rubber latex
Cut-to-fit
Units: 5
Code
2182
Color
3⁄8
- 13⁄8" (10-35 mm)
HCPCS*
A4414
®
Assura AC* MIDI Drainable Pouch
• • • •
EasiClose™ Outlet
Filter
Soft cloth on front and back
Not made with natural rubber latex
Assura® Pediatric Drainable Pouch
Opaque 101⁄4" (26 cm) / 470 mL
Code
Units: 20
Color
HCPCS*
A4425
14346
Color
14316
HCPCS*
A4426
2156
Units: 30
Opaque 53⁄4" (14 1⁄2 cm)
HCPCS*
Code
A4419
2161
Units: 30
Color
HCPCS*
A4423
Assura® Stoma Cap
Assura® AC* MAXI Urostomy Pouch
• With filter
• Soft cloth on front
• Small size is optimal for intimate moments
or colostomates who irrigate
• Not made with natural rubber latex
• Multi-chambers minimize sloshing
• Soft outlet can be connected to urostomy
night bag #21365
• Soft cloth on back
• Not made with natural rubber latex
Transparent 101⁄2" (26 1⁄2 cm) / 475 mL
14552
Units: 20
Color
• Soft cloth on front and back
• Not made with natural rubber latex
Opaque 7" (18 cm) / 250 mL
Code
Code
Assura® Pediatric Closed Pouch
• With filter
• Soft cloth on front and back
• Not made with natural rubber latex
Code
Transparent 81⁄2" (21 cm) / 150 mL
Pediatric
Pediatric
Assura® AC* MIDI Closed Pouch
• Clamp closure
• Soft cloth on back
• Not made with natural rubber latex
2-Piece Click Pediatric / Pouches / Barriers
2-Piece AC Pediatric / Teen Pouches / Barriers
For older children and/or larger stomas
Color
Units: 20
Opaque
HCPCS*
Code
A5073
2801
Units: 30
Color
HCPCS*
A5055
*For important information regarding the use of HCPCS codes listed and code
definitions see page 222
170
www.coloplast.us
1.800.533.0464
171
SenSura® Mio Click MIDI
Drainable Pouch
• S
oft outlet can be connected to a drain bag for
nighttime use, or a leg bag for people in a
wheelchair - see page 92 for options
• Can be connected to a drain bag for nighttime
use, or a leg bag during the day
• Soft cloth on back
• Not made with natural rubber latex
Transparent 81⁄2" (21 cm) / 150 mL
Code
• • • • •
Units: 10
Color
HCPCS*
A4433
1789
EasiClose™ WIDE Outlet
Filter
Neutral gray, water-resistant textile
Peek-a-boo inspection window for easy placement
Not made with natural rubber latex
Opaque 101⁄4" (26 cm) / 485 mL
Code
Units: 20
Color
A4427
11461
SenSura® Mio Click MIDI
Closed Pouch
Assura® Urostomy Micro-Pouch
• Miniature size prevents twisting
• Soft outlet can be connected to a drain bag for
nighttime use, or a leg bag for people in a
wheelchair - see page 92 for options
• Soft cloth on front
• Not made with natural rubber latex
• • • •
Filter
Neutral gray, water-resistant textile
Peek-a-boo inspection window for easy placement
Not made with natural rubber latex
Opaque 71⁄4" (18½ cm) / 275 mL
Transparent 6" (15 cm)
Code
Units: 10
Color
HCPCS*
Code
Units: 30
Color
HCPCS*
A4423
11401
A4433
14204
SenSura® Mio Click Uro MIDI
Urostomy Pouch
Assura® Urostomy Minicap
• • • •
HCPCS*
Ultra-absorbent material inside
Small size is optimal for intimate use
Soft cloth on front
Not made with natural rubber latex
Opaque 100 mL
Code
Units: 10
Color
HCPCS*
A5055
2807
• Multi-chambers minimize sloshing
• Wider anti-reflux valves prevent urine from
washing over the stoma
• Soft outlet can be connected to a drain bag for
nighttime use, or a leg bag for people in a
wheelchair - see page 92 for options
• Neutral gray, water-resistant textile
• Peek-a-boo inspection window for easy placement
• Not made with natural rubber latex
Opaque 101⁄2" (261⁄2 cm) / 480 mL
For older children and/or larger pouch sizes
Note: SenSura® Mio Click products cannot be used
together with SenSura® Click or Assura 2-piece
products
Code
11491
2-Piece Pediatric / Teen Urostomy Pouches
2-Piece Pediatric Pouches / Barriers
Assura® Pediatric Urostomy Pouch
Units: 10
Color
HCPCS*
A4433
For additional pouching options, consider SenSura Click adult
pouches and barriers.
Urostomy Night Bag and Bag Hanger
See Accessories page 92 for more information.
SenSura® Mio Click
Standard Wear Barrier
• Flat
• Belt tabs
• Not made with natural rubber latex
Cut-to-fit
Code
10502
172
Units: 5
Stoma Size
3⁄8
- 13⁄8" (10-35 mm)
www.coloplast.us
Color
HCPCS*
A4414
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
173
ColoKids™ 1-piece Pediatric Pouching Systems
Specially developed Assura "swiss roll" technology provides
moisture absorption and balance while offering consistent tack
and adhesion to the skin. Smaller pouch sizes provide a pediatricfriendly pouching option.
ColoKids™ (Standard Wear) 1-piece
Drainable Pouch
• • • •
10461
Units: 10
Cut
Stoma Size
Cut-to-fit
3⁄8
HCPCS*
- 13⁄8" (10-35 mm)
A5061
ColoKids™ (Standard Wear) 1-piece
Closed Pouch
Units: 10
Cut
Stoma Size
Cut-to-fit
3⁄8
-
13⁄4"
(10-45 mm)
Flat
Filter
Neutral gray, water-resistant textile
Peek-a-boo inspection window for easy
placement
• Not made with natural rubber latex
Code
Cut
Stoma Size
Transparent
Units: 30
10871
Cut-to-fit
5⁄8
HCPCS*
SenSura® Mio Standard Wear MINI
Closed Pouch
Cut
Stoma Size
2125
Cut-to-fit
3⁄8
- 13⁄8" (10-35 mm)
A4416
8009
Cut-to-fit
5⁄8
- 13⁄8" (15-35 mm)
HCPCS*
A5071
For pediatric-friendly leg bag drainage options
(sold separately), see page 176.
www.coloplast.us
HCPCS*
A4416
1.800.533.0464
Units: 30
Code
Cut
Stoma Size
10870
Cut-to-fit
5⁄8
- 13⁄4" (15-45 mm)
HCPCS*
Pediatric
Pediatric
Opaque 51⁄4" (13 cm) / 110 mL
Units: 10
Stoma Size
- 13⁄4" (15-45 mm)
Flat
Filter
Neutral gray, water-resistant textile
Peek-a-boo inspection window for easy
placement
• Comfortable and discreet stoma cap alternative
• Not made with natural rubber latex
• Flat
• Soft outlet can be connected to a drain bag for nighttime use, or a leg bag for people in a wheelchair
- see page 92 for options
• Soft cloth on back
• Not made with natural rubber latex
Cut
Units: 30
• • • • ColoKids™ (Standard Wear) 1-piece
Urostomy Pouch
Code
A4424
• • • • Opaque 71⁄4" (19 cm) / 340 mL
Code
HCPCS*
SenSura® Mio Standard Wear MIDI
Closed Pouch
• Flat
• Soft cloth on back
• Not made with natural rubber latex
Transparent
174
Flat
EasiClose™ WIDE Outlet
Filter
Neutral gray, water-resistant textile
Peek-a-boo inspection window for easy placement
Not made with natural rubber latex
Code
Transparent
2115
• • • • • •
Opaque 10 1⁄4" (26 cm) / 485 mL
Flat
Clamp closure
Soft cloth on back
Not made with natural rubber latex
Code
SenSura® Mio Standard Wear MIDI
Drainable Pouch
1-Piece Pediatric / Teen Pouches
1-Piece Pediatric Pouching Systems
For older children/larger pouch sizes
For younger children/smaller pouch sizes
A4416
SenSura® Standard Wear MAXI
Urostomy Pouch
• Flat
• Multi-chambers minimize sloshing
• Anti-reflux valves prevent urine from
washing over the stoma
• Soft outlet can be connected to a drain bag for
nighttime use, or a leg bag for people in a wheelchair
- see page 92 for options
• Neutral gray, water-resistant textile
• Not made with natural rubber latex
Transparent 101⁄2" (27 cm) / 400 mL
Units: 10
Code
Cut
Stoma Size
HCPCS*
10586
Cut-to-fit
3⁄8
- 13⁄4" (10-45 mm)
A5071
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
175
Bathing
Conveen® Active Leg Bag
Bedside-Care® EasiCleanse™ (page 67)
The Conveen Active Leg bag provides a reliable and
discreet solution for patients. It wraps around the thigh
with the bag facing inward for minimal visibility. The bag’s
fabric fastening system enables hassle-free fitting and
keeps the bag in place.
• Not made with natural rubber latex
Code
Size
25502
8.5 oz. (250 mL)
Units
30
Description
Non-sterile
Moisturizers
HCPCS*
A4358
Sween Cream® (page 68)
Sween® 24 Cream (page 68)
Sween® Lotion (page 68)
Security+ Contoured Leg Bag with
Non-Latex Fabric Leg Bag Straps
Deluxe leg bag with pre-attached, adjustable,
anti-kink tubing. Secure, user-friendly closure,
soft cloth backing, anti-reflux valve, and
chambered panels for discretion and low
profile. Not made with natural rubber latex.
Code
Size
5170
21 oz. (600 mL)
Skin Protectants
Units
Description
HCPCS*
10
Medium with
18" tubing
A4358
1-Piece Pediatric / Teen Pouches
1-Piece Pediatric / Teen Pouches
Leg Bags
Critic-Aid® Clear (page 70)
Critic-Aid® Skin Paste (page 70)
Wound Dressings
Night Drainage Bags
Triad™ Hydrophilic Wound Dressing (page 57)
Urostomy Night Bag and Bag Hanger
See Accessories page 92 for more information.
Product recommendations based on:
Association of Women’s Health, Obstetric and Neonatal Nurses.
Neonatal Skin Care, Third Edition. Evidence-Based Clinical
Practice Guideline, 2013.
176
www.coloplast.us
1.800.533.0464
*For important information regarding the use of HCPCS codes listed and code
definitions see page 224
177
Pediatric
178
www.coloplast.us
1.800.533.0464
Cut-to-fit
5
⁄8 - 1 11⁄16"
Cut-to-fit
13
⁄16 - 2 1⁄4"
Pre-cut 19⁄16"
14514
Curagard® 1-Piece Drainable Pouch,
Opaque, w/o Filter
Cut-to-fit
5
⁄8 - 1 9⁄16"
Pre-cut 1"
Pre-cut 13⁄16"
Pre-cut 1 3⁄8"
5800
5825
5830
5835
12137
12100
Cut-to-fit
5
⁄8 - 1 5⁄16"
14513
Assura® 1-Piece Closed Pouch,
Transparent
Cut-to-fit
3
⁄8 - 2 3⁄4"
15861
Assura® 1-Piece Drainable Pouch,
EasiClose™ WIDE Outlet, Transparent,
w/o Filter
Assura® 1-Piece Drainable Pouch,
EasiClose WIDE Outlet, Convex Light,
Opaque
Size
Code
Convert from
Conversion sheet: Ostomy 1-Piece Pouching Systems
10
10
10
10
30
30
10
10
10
Units
SenSura® 1-Piece Drainable Pouch,
EasiClose™ WIDE Outlet, Transparent,
w/o Filter
SenSura® 1-Piece Closed Pouch,
Opaque
SenSura® 1-Piece Drainable Pouch,
EasiClose™ WIDE Outlet, Transparent,
w/o Filter
SenSura® 1-Piece Drainable Pouch,
EasiClose™ WIDE Outlet, Convex Light,
Opaque
Convert to
15821
15821
15821
15821
15480
15480
15608
15608
15821
Code
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit
5
⁄8 - 1 11⁄16"
Cut-to-fit
3
⁄8 - 3"
Cut-to-fit
3
⁄8 - 3"
Cut-to-fit
3
⁄8 - 3"
Cut-to-fit
5
⁄8 - 1 11⁄16"
Cut-to-fit
3
⁄8 - 3"
Size
20
20
20
20
30
30
10
10
20
Units
Discontinued Products
1.800.533.0464
Coloplast
179
www.coloplast.us
1.800.533.0464
1.800.533.0464
Coloplast® 1-Piece Closed Pouch, Cutto-fit, Transparent
Coloplast® 1-Piece Closed Pouch, Cutto-fit, Opaque
Coloplast® 1-Piece Stoma Cap,
Opaque, Pre-cut
Convert from
Pre-cut 1"
Pre-cut 13⁄16"
Pre-cut 13⁄8"
Pre-cut 19⁄16"
Pre-cut 13⁄4"
Pre-cut 2"
Pre-cut 23⁄8"
Cut-to-fit
5
⁄8 - 2 3⁄8"
Cut-to-fit
5
⁄8 - 2 3⁄8"
Pre-cut 19⁄16"
Pre-cut 2 3⁄8"
6325
6330
6335
6340
6345
6350
6360
5600
5560
5540
5700
Size
Code
Conversion sheet: Ostomy 1-Piece Pouching Systems
Curagard® / SecureLife 1-Piece
Drainable Pouch, Opaque, w/o filter
Cut-to-fit
5
⁄8 - 2 3⁄8"
Pre-cut 13⁄16"
Pre-cut 1"
Pre-cut 13⁄16"
Pre-cut 13⁄8"
Pre-cut 19⁄16"
Pre-cut 13⁄4"
Pre-cut 2"
Pre-cut 2 3⁄8"
Cut-to-fit
5
⁄8 - 2 3⁄8"
5901
5920
5925
5930
5935
5940
5945
5950
5960
6300
Cut-to-fit
5
⁄8 - 2 3⁄8"
5900
Curagard® / SecureLife 1-Piece
Drainable Pouch, Transparent, w/o filter
Cut-to-fit
5
⁄8 - 19⁄16"
5810
Curagard® 1-Piece Drainable Pouch,
Transparent, w/o Filter
Size
Code
Convert from
30
30
30
10
10
10
10
10
10
10
30
Units
10
10
10
10
10
10
10
10
10
10
10
10
Units
SenSura® 1-Piece Closed Pouch,
Cut-to-fit, Opaque
SenSura® 1-Piece Closed Pouch,
Cut-to-fit, Opaque
Assura® 1-Piece Stoma Cap, Opaque,
Cut-to-fit
Convert to
SenSura® 1-Piece Drainable Pouch,
EasiClose™ WIDE Outlet, Transparent,
w/o Filter
SenSura® 1-Piece Drainable Pouch,
EasiClose WIDE Outlet, Transparent,
w/o Filter
SenSura® 1-Piece Drainable Pouch,
EasiClose™ WIDE Outlet, Transparent,
w/o Filter
Convert to
2501
2501
15480
15821
15821
15821
15821
15821
15821
15821
15480
Code
15821
15821
15821
15821
15821
15821
15821
15821
15821
15821
15821
15821
Code
Cut-to-fit
13
⁄16 - 2 1⁄8"
Cut-to-fit
13
⁄16 - 2 1⁄8"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Size
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Size
30
30
30
20
20
20
20
20
20
20
30
Units
20
20
20
20
20
20
20
20
20
20
20
20
Units
Discontinued Products
Conversion sheet: Ostomy 1-Piece Pouching Systems
Discontinued Products
180
Coloplast
181
www.coloplast.us
1.800.533.0464
1.800.533.0464
Coloplast
Green
Red
Blue
5
⁄8"
12568
12569
12840
Red
Blue
Green
6551
6561
6542
Coloplast® 2-Piece Drainable Pouch,
Opaque, w/o filter
6552
6541
Yellow
Red
(Custom Peel)
Green
14314
14318
Coloplast® 2-Piece Drainable Pouch,
Transparent, w/o filter
Red
14312
Assura® AC 2-Piece Closed Pouch
Red
Red
(Custom Peel)
14363
Assura® AC 2-Piece Drainable Pouch,
EasiClose™ Closure, Opaque
Size
Code
Convert from
Conversion sheet: Ostomy 2-Piece Pouching Systems
Assura® 2-Piece Standard Wear Barrier,
Flat, Pre-Cut
Assura® 2-Piece Drainable Pouch with
Clamp Closure, Transparent, w/o Filter
12567
Blue
Blue
15973
13926
Assura® 2-Piece Drainable Pouch,
EasiClose Closure, Opaque
Red
15972
Assura® 2-Piece Drainable Pouch,
EasiClose WIDE Outlet, Transparent,
w/o Filter
Size
Code
Convert from
10
10
10
10
10
30
30
30
20
Units
10
10
5
10
10
10
10
Units
SenSura® Click 2-Piece Drainable
Pouch, EasiClose™ WIDE Outlet,
Opaque (Use with SenSura Click
Barrier)
SenSura® Click 2-Piece Drainable
Pouch, EasiClose™ WIDE Outlet,
Transparent (Use with SenSura Click
Barrier)
SenSura® Flex 2-Piece Drainable
Pouch, EasiClose™ WIDE Outlet,
Opaque (Use with SenSura Click
Barrier)
SenSura® Flex 2-Piece Closed Pouch
(Use with SenSura Flex Barrier)
Convert to
SenSura® Click 2-Piece Standard Wear
Barrier, Flat (Use with SenSura Click
Pouch)
SenSura® Click 2-Piece Drainable
Pouch with EasiClose™ WIDE Outlet,
Opaque, w/ Filter (Use with SenSura
Click Barrier)
SenSura® Click 2-Piece Drainable
Pouch with EasiClose™ WIDE Outlet,
Transparent (Use with SenSura Click
Barrier)
SenSura® Click 2-Piece Drainable
Pouch with EasiClose™ WIDE Outlet,
Transparent, w/o Filter (Use with
SenSura Click Barrier)
Convert to
11135
11185
11186
11124
11194
10917
10915
10912
11515
Code
11185
11186
10011
11194
11186
11126
11185
Code
Red
Red
Blue
Green
Green
Yellow
Red
Red
Red
Size
Red
Blue
3
⁄8 - 1 3⁄8"
Green
Blue
Blue
Red
Size
20
20
20
20
20
30
30
30
20
Units
20
20
5
20
20
20
20
Units
Discontinued Products
Conversion sheet: Ostomy 2-Piece Pouching Systems
Discontinued Products
182
183
www.coloplast.us
1.800.533.0464
1.800.533.0464
Size
Blue
Green
Red
Blue
Green
Red
Blue
Green
Red
Blue
Green
Code
6562
6641
6651
6661
6642
6652
6662
6644
6654
6664
4241
Cut-to-fit
5
⁄8 - 2"
Cut-to-fit
5
⁄8 - 2 3⁄8"
4550
4560
Red
Blue
Cut-to-fit
5
⁄8 - 19⁄16"
4250
4260
4540
Coloplast® 2-Piece Standard Wear
Barrier with Tape Border, Flat
Green
4240
Coloplast® 2-Piece Urostomy Pouch,
Transparent, Maxi
Size
Code
Convert from
Conversion sheet: Ostomy 2-Piece Pouching Systems
Coloplast® 2-Piece Urostomy Pouch,
Transparent, Midi
Coloplast® 2-Piece Stoma Cap,
Transparent
Coloplast® 2-Piece Closed Pouch,
Opaque
Coloplast® 2-Piece Closed Pouch,
Transparent
Convert from
10
10
10
10
10
10
Units
30
30
10
30
30
30
30
30
30
10
30
Units
SenSura® Click 2-Piece Standard Wear
Barrier, Flat (Use with SenSura Click
Pouch)
SenSura® Click Uro, 2-Piece Urostomy
Pouch, Transparent, Maxi (Use with
SenSura Click Barrier)
Convert to
SenSura® Click Uro, 2-Piece Urostomy
Pouch, Transparent (Use with SenSura
Click Barrier)
Assura® 2-Piece Stoma Cap, Opaque
(Use with Assura Barrier)
SenSura® Click 2-Piece Closed Pouch,
Opaque (Use with SenSura Click
Barrier)
SenSura® Click 2-Piece Closed Pouch,
Opaque (Use with SenSura Click
Barrier)
Convert to
10031
10021
11855
11856
10011
11854
Code
2802
2803
11851
10165
10166
2801
10165
10166
10164
11136
10164
Code
Cut-to-fit 3⁄8 - 2 1⁄4"
Cut-to-fit 3⁄8 - 1 3⁄4"
Red
Blue
Cut-to-fit 3⁄8 - 1 3⁄8"
Green
Size
Red
Blue
Green
Red
Blue
Green
Red
Blue
Green
Blue
Green
Size
5
5
10
10
5
10
Units
30
30
10
30
30
30
30
30
30
20
30
Units
Discontinued Products
Conversion sheet: Ostomy 2-Piece Pouching Systems
Discontinued Products
184
Coloplast
185
www.coloplast.us
1.800.533.0464
1.800.533.0464
Coloplast
43 1/3"
8 fl. oz.
(237 mL)
4 fl. oz.
(118 mL)
2 fl. oz.
(59 mL)
1 oz. (25 g)
2 oz. package
(.2 oz / strip)
4 x 4"
(10 x 10 cm)
6 x 6"
(15 x 15 cm)
8 x 8"
(20 x 20 cm)
2 oz (60 mL)
0420
0421
1525
Skin Barrier Cream
3210
Protective Sheet
12000
3220
3215
1907
2655
Ostomy Powder
Ostomy Strip Paste
7680
1527
43 1/3"
Code
Size
Cut-to-fit
1
⁄2 - 3 7⁄8"
Cut-to-fit
1
⁄2 - 2 3⁄4"
Cut-to-fit
1
⁄2 - 3 7⁄8"
Adjustable Ostomy Belt (compatible with
MC/PC Coloplast-brand products)
Adjustable Ostomy Belt (compatible with
Assura® and SenSura® products)
O.A.D.® Liquid Ostomy Appliance
Deodorant
6830
6828
6820
6818
Cut-to-fit
3
⁄8 - 3 1⁄8"
Cut-to-fit
3
⁄8 - 3 1⁄8"
Cut-to-fit
1
⁄2 - 2 3⁄4"
Size
Convert from
Conversion sheet: Accessories
Coloplast® / SecureLife 2-Piece PostOp Barrier w/ Tape Border, Cut-to-fit
Coloplast® 2-Piece Post-Op Pouch,
Transparent, No Filter
6100
Coloplast® 1-Piece Post-Op Pouch
6101
Code
Convert from
6
5
5
16
80
strips
10
24
12
12
10
1
Units
5
5
10
10
5
5
Units
Sween Cream
Brava® Protective Sheet
Brava® Protective Sheet
Brava® Protective Sheet
Brava® Powder
Brava® Strip Paste
Brava® Lubricating Deodorant
Brava® Lubricating Deodorant
Brava® Lubricating Deodorant
Brava® Belt
Brava® Belt
Convert to
SenSura® Flex 2-Piece Standard Wear
Barrier (Use with SenSura Flex Pouch)
SenSura® Flex 2-Piece Drainable Pouch
with EasiClose WIDE Outlet,
Transparent (Use with SenSura Flex
Barrier)
SenSura® Post-Op, 1-Piece Drainable
Pouch, w/o Access Window
Convert to
7067
32205
32155
32105
19075
26555
12060
12061
12061
4215
4215
Code
10108
10103
11690
11517
19030
19030
Code
8 fl. oz.
(237 mL)
8 fl. oz.
(237 mL)
.25 fl. oz.
(7.5 mL) sachet
1 oz. (25 g)
2 oz. package
(.2 oz / strip)
4 x 4"
(10 x 10 cm)
6 x 6"
(15 x 15 cm)
8 x 8"
(20 x 20 cm)
3 oz. (85 g)
43 1/3"
43 1/3"
Size
Cut-to-fit 3⁄8 - 3 1⁄2"
Cut-to-fit 3⁄8 - 2 3⁄4"
Gray
Yellow
Cut-to-fit 3⁄8 - 3"
Cut-to-fit 3⁄8 - 3"
Size
12
5
5
16
10
strips
10
20
16
16
15
15
Units
5
10
20
20
6
6
Units
Discontinued Products
Conversion sheet: Ostomy Post-Op / Fistula Wound Management
Discontinued Products
186
187
Code
12010
12011
12020
12021
12030
12042
2651
Convert from
Adhesive Remover Spray
Adhesive Remover Wipes
Skin Barrier Spray
Skin Barrier Wipes
Moldable Ring
Moldable Ring
Protective Paste with Pectin
Conversion sheet: Accessories
1.7 oz (50 mL)
1 wipe
1.7 oz (50 mL)
1 wipe
3.0 mm thick
4.2 mm thick
2 oz
Size
6
30
6
30
30
30
12
Units
Brava® Adhesive Remover Spray
Brava® Adhesive Remover Wipes
Brava® Skin Barrier Spray
Brava® Skin Barrier Wipes
Brava® Moldable Rings
Brava® Moldable Rings
Brava® Paste
Convert to
120105
120115
120205
120215
120307
120427
12050
Code
1.7 oz (50 mL)
1 wipe
1.7 oz (50 mL)
1 wipe
2.0 mm thick
4.2 mm thick
2 oz
Size
1
30
1
30
10
10
1
Units
Discontinued Products
188
www.coloplast.us
1.800.533.0464
Reference tools | Effective September 2014
Reference Tools
Product Guide
Reference Tools
A nurse-driven program providing support to patients throughout
the care continuum. The program provides patients with product
samples, educational resources, and consumer care support.
Please visit coloplastcare.com or contact your local Consumer Care
Advisor for further information: 1-866-226-6362.
DVDs
Coloplast Consumer Care assists patients with
their intimate healthcare needs. They are
available Monday through Friday from 7 a.m.
to 7 p.m. (CST).
Intermittent Self-Catheterization
• Intermittent Self-Catheterization, Adult Female, English/Spanish
• Intermittent Self-Catheterization, Adult Male, English/Spanish
• Intermittent Self-Catheterization, Pediatric Female, English
• Intermittent Self-Catheterization, Pediatric Male, English
• Intermittent Self-Catheterization, Pediatric Female, Spanish
• Intermittent Self-Catheterization, Pediatric Male, Spanish
•SpeediCath® Instructional DVD, Animated, English/Spanish
Measuring Guides
•Conveen® Optima Male External Catheter Selection and Fitting Guide
•Freedom Male External Catheter Selection and Fitting Guide
Continence Care Education
Coloplast® Care Program
About the Team
The Coloplast Consumer Care Team can make life easier
for both clinicians and their patients. The team offers oneon-one assistance, as well as:
Provide Product Samples
Consumer Care Advisors are trained support staff, offering
free samples from the complete Coloplast ostomy and
continence product lines. Call the toll free hotline at
1-888-726-7872 or email [email protected] to have
trial products shipped today.
Answer Questions
Our team can answer questions regarding product lines
and educational materials, as well as insurance and
reimbursement issues. Coloplast Consumer Care will
provide the information you and your patients need.
Find The Right Product Solution
Coloplast Consumer Care can help locate a medical
supplies dealer in their local area to ensure that they
have access to the correct products.
1-888-726-7872
1.800.533.0464
Coloplast
191
Patient Educational Video & DVD
A nurse-driven program providing support to patients throughout
the care continuum. The program provides patients with product
samples, educational resources, and consumer care support.
Please visit coloplastcare.com or contact your local Consumer
Care Advisor for further information: 1-877-858-2656.
• In Control: Life After Your Ostomy Surgery
On-Site Education
•SenSura® 1-piece Pouching System
•SenSura® Click 2-piece Pouching System
•SenSura® Flex 2-piece Pouching System
• Product in-services on appropriate use of Coloplast® products
• Customized clinical education programs conducted by certified
wound, ostomy, continence (WOC) nurses
Ostomy Tools
Evidence-based nursing tools provide a standardized language to
assess peristomal skin conditions and quality of life
• Stoma QoL (Quality of Life) Questionnaire
• Ostomy Skin Tool
• DET score
Nurse Educational Video & DVD
• Instructional DVD: 1-piece, 2-piece, Urostomy –
Application & Removal
• Fistula and Wound Management System – Instructional DVD
Educational Guides
• Life After: Ileostomy
• Life After: Colostomy
• Life After: Urostomy
• Life After: Your Child’s Ostomy Surgery
• When I Met Tipster: A coloring book for children with ostomies
• Ostomy Educational Table/Pocket Guide – a diagram for staff
nurses covering types of ostomies, pouching selection, and
peristomal and parastomal challenges.
Wellness Education
www.coloplast.us
Product Instructions for Use (Pictorial)
•SenSura® Mio 1-piece Pouching System
•SenSura® Mio Click 2-piece Pouching System
•SenSura® Mio Flex 2-piece Pouching System
• Fistula Wound Management System
•Assura® 1-piece Pouching System
•Assura® 2-piece Pouching System
•Assura® AC (Adhesive Coupling)
Spanish Educational Tools
Educational Guides
• La Vida Después de la Colostomía
Life After: Colostomy
• La Vida Después de la Ileostomía
Life After: Ileostomy
• La Vida Después de la Urostomía
Life After: Urostomy
Educational Sheets
• Cómo Cuidar Su Nueva Ostomía
Caring for your New Ostomy
• Directriz Alimenticio de Colostomía
Colostomy Dietary Guidelines
• Directriz Alimenticio de lleostomía
Ileostomy Dietary Guidelines
• Directriz Alimenticio de Urostomía
Urostomy Dietary Guidelines
• Colostomy: Self-Care and Dietary Guidelines
• Urosotomy: Self-Care and Dietary Guidelines
• Ileostomy: Self-Care and Dietary Guidelines
• Ostomy Pouching Systems
• BodyCheck Tool
• What to Wear
•Socializing
• Keeping Your Skin Healthy
•Intimacy
• Ostomy Accessory Products
• Getting into Exercise
• Tips for Dining Out
• Tips for Traveling
• Reach Out and Get Connected
• General Medicare Guidelines Related to Ostomy
• Pregnancy with an Ostomy
• My Child has an Ostomy
• Pediatric FAQ
192
Ostomy Care Education
Ostomy Care Education
Coloplast® Care Program
Patient Educational Video & DVD
• En Control: La Vida Después de su Cirugía de Ostomía
In Control: Life After Your Ostomy Surgery Video & DVD
Other Resources
CE-Accredited Education Modules
www.education.woundcarestrategies.com
For additional educational resources, visit www.coloplast.us
1.800.533.0464
1.800.533.0464
Coloplast
193
Coloplast offers education programs to help support your wound and
skin care protocol and educate your staff on best practices in care.
Links Partnership Program: Wound Care
Inconsistent wound care management can lead
to costly complications. The Coloplast Links
Wound Care Partnership is designed to assist
with appropriate dressing selection to reduce
wound complications and associated costs.
Every Nurse is a Skin Care Nurse
Every Nurse is a Skin Care Nurse is a 20 page
booklet discussing the importance of skin
care and managing risk for skin breakdown
with patients. The booklet provides guidance
on preventative skin care measures and care
for common types of skin conditions. At the
end of the booklet, a quiz is offered to test
your knowledge of the information.
Clinical Implememtation Tools CD
The Clinical Implementation Tools CD includes
assessment, intervention, and documentation
tools to help your facility successfully implement
a structured skin care regimen.
Links Partnership Program: Skin Care
The Coloplast Links Skin Care Partnership is a
comprehensive clinical practice quality initiative
designed to improve compliance, provide highquality care, and reduce supply chain costs.
Skin Care Partnership
Sales Training and Implementation
www.coloplast.us
M1226N
On-Site Education
• Product in-services on appropriate use of Coloplast products
• Customized clinical educational programs for contact hours
conducted by certified wound, ostomy, continence nurses
(WOCN)
Moisture-Associated Skin Damage (MASD)
Education Series
An expert panel of clinicians in the areas MASD
discuss risk factors, diagnosis and treatment
of the four common types of MASD. This
education portal offers information in the form
of general information on MASD, downloadable
articles, videos and product selection by
condition.
Wound & Skin Care Education
Wound & Skin Care Education
Coloplast® Academy
Customized Implementation Materials
•Wound Care product guide posters
•Skin Care product guide posters
• NPUAP revised staging guidelines
• Nurse badges
Rinse
No-Rinse
Moisturize
Barrier
Barrier/
Antifungal
Antifungal
Chronic Wound Assessment Parameters
Hand
Hygiene
Textile
Skin Care Cascade
All Patients
Moisturize
Bathe
Intact,
clear skin
Moderate to
severely dry skin
(including xerosis
and fissures)
Incontinence
Associated
Dermatitis
Fungal
Denuded or
moist skin
Exudate Level
Neonate
Category/
Stage I
Low
Category/
Stage II
Category/
Stage III
Category/
Stage IV
1. Location
a. Below the knee (usually arterial, venous, diabetic or
pressure ulcer)
b. Bony prominences (usually pressure related)
c. Moist areas (usually due to moisture-associated skin damage,
incontinence-associated dermatitis or symptoms associated
with intertrigo1).
3. Dimensions (length x width x depth in cm)
2. Extent of tissue injury (assess after wound debridement)
a. Stage/Category: A pressure ulcer is localized to the skin and/or
Foot
Ulcers
Skintissue
Tears
Donor
Sites over a bony prominence, as a result of
underlying
usually
pressure, or pressure in combination with shear and/or friction.
4. Wound base characteristics (color, texture, tissue type, percent
of each tissue type)
Size
Depth
Leg Ulcers
Moderate
1
References on file at Coloplast Corp.
• Mild ingredients and added emollients for use
on fragile, sensitive skin
• Dermatologist tested, hypoallergenic and dye-free
• pH-balanced
•
•
•
•
Photos of wound stages from the NPUAP Slide Set #1 courtesy of National Pressure Ulcer Advisory Panel.
The use of these photos does not indicate endorsement of these products or product
technologiesDeep
by the NPUAP.
Suspected
Tissue
Intact Skin
•
Exudate Level
Risk Factors
Dry Skin
Immobility
Incontinence
Bedside-Care® Foam*
Cleansers
• All-in-one, deodorizing body wash, shampoo
and incontinent cleanser
• Foam delivery system
• Dye and alcohol-free
• pH-balanced
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Protect Skin
Cleanse
Bedside-Care*
• Soothing and deodorizing
• Dye and alcohol-free
• pH-balanced
STAGES AND DEFINITIONS
High
Gentle Rain® Extra Mild Cleanser
Cleansers/Hydrogels
The Amazing Race Education Series
The Amazing Race is an effort to prevent
pressure ulcers by presenting seven challenges
that integrate the Braden Scale. At the end of
each challenge, a post quiz is offered to test
your knowledge of the information.
* CHG Compatible
Sea-Clens® Wound Cleanser
Woun’Dres® Collagen Hydrogel
Comfeel Plus Clear Dressing (Thin)
Intact Skin
Comfeel Plus Ulcer Dressing
• Once-a-day application
• Contains 6% dimethicone
• Fragrance, petrolatum, lanolin and alcohol-free
•
•
Infection
y
Antifungal
•
•
•
•
•
•
•
•
•
Skin Breakdown
Moisturizers
Alginate Dressings
Intact Skin
•
•
•
•
Critic-Aid Skin Paste*
Skin Protectants
• Petrolatum and zinc-oxide based moisture barrier
• Minimal ingredients
• Adheres to intact and denuded skin
• Easy to apply and remove
•
•
•
•
Cleansers
•
Size
5 mL single
application packet
2 fl. oz./59 mL
8 fl. oz./237 mL
21 fl. oz./621 mL
34 fl. oz./1000 mL
1 gal./3.8 L
•
•
300
36
36
12
12
4
Antifungals
•
1768
1762
1764
36
12
36
12
4 fl. oz./118 mL
8 fl. oz./237 mL
1 gal./3.8 L
36
12
4
Bedside-Care Perineal Wash
1452
1453
1455
4 fl. oz./118 mL
8 fl. oz./237 mL
1 gal./3.8 L
7055
Micro-Guard® Powder
•
• 2% miconazole nitrate
• Treats superficial fungal infections
• Helps reduce friction and shearing
30 sheets/pk
Skin Fold Management
•
•
30 pks/cs
Moisturizers
Sween® 24 Cream
Product Code
7090
7091
7092
7095
InterDry® Ag Textile
36
12
4
Bedside-Care EasiCleanse™ Bath
•
Size
4 g single application packet
2 oz./57 g
5 oz./142 g
9 oz./255 g
Units
300
12
12
12
Product Code
0283
0222
7066
7067
7068
7069
Size
2 g single application packet
0.5 oz./14 g
3 oz./85 g jar
3 oz./85 g
6.5 oz./184 g
12 oz./339 g jar
Baza Protect
Units
300
36
12
12
12
12
Sween Lotion
0424
0407
0406
0402
0408
7011
0403
2 mL single application packet
2 fl. oz./59 mL
4 fl. oz./118 mL
8 fl. oz./237 mL
21 fl. oz./621 mL
34 fl. oz./1000 mL
1 gal./3.8 L
300
36
36
36
12
12
12
Atrac-Tain® Cream
1843
1802
1814
2 g single application packet
2 oz./57 g
5 oz./142 g
300
12
12
Product Code Size
1873
4 g single application packet
1877
2 oz./57 g
1880
5 oz./142 g
•
•
Product Code
7565
7566
7567
Size
4 g single application packet
2.5 oz./71 g
6 oz./170 g
2.5 oz./71 g
6 oz./170 g
Units
300
12
12
12
12
1337
300
12
12
12
3 oz./85 g
Skin Fold Management
InterDry® Ag Textile
Product Code Size
7910
10 x 144”
7912
10 x 36”
Units
10 /case
10 pks/box
Baza® Clear
7015
1005
1006
1002
4 g single application packet
1.75 oz./50 g
5 oz./142 g
8 oz./227 g jar
Biatain Adhesive Foam Dressing
Biatain Heel Foam Dressing
300
12
12
12
•
•
•
•
•*
•*
•*
•* brown •or*black) in the wound bed.
•
•
•
•
•*
•*
•
•*
•*
•
•
•
•
•
•
•
Category/Stage II: Partial thickness loss of dermis presenting as a shallow open
ulcer with a red pink wound bed, without slough. May also present as an intact or
open/ruptured serum filled blister.
Category/Stage III: Full thickness tissue loss. Subcutaneous fat may be visible
but bone, tendon or muscle are not exposed. Slough may be present but does
not obscure the depth of tissue loss. May include undermining and tunneling.
•
•
•
•*
•
•
Category/Unstageable: Full thickness tissue loss in which the base of the ulcer
is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan,
b. Partial-thickness vs. full-thickness: Used to describe the extent
of injury for all wounds except pressure ulcers.
• Partial-thickness: Does not penetrate below the dermis. May
involve the epidermis.
• Full-thickness: Tissue loss extends below the dermis into the
subcutaneous tissue and fascia, possibly exposing bone.
•*
•
•
•
•
•
•
•
•
•
•
Contreet/Biatain Ag Non-Adhesive
Foam Dressing
Contreet/Biatain Ag Adhesive Foam Dressing
Contreet/Biatain Ag Heel Foam Dressing
•
•
•
•
•
•
•*
•*
•Product
•
•
•
•*
•*
*
•Sea-Clens
•* Wound Cleanser
•*
•*
•*
•*
Contreet/Biatain Ag Sacral Foam Dressing
•
•
•
•
SeaSorb Soft Ag Alginate Dressing
with Silver
SeaSorb Soft Ag Alginate Filler with Silver
1
Sinus Tract/Tunneling
Erythema
Fitzpatrick’s Dermatology in General Medicine. Fifth Edition Volume II, 2362-2363.
Photos used with permission. © Copyright 2000 AAWC & 2008 SER WOCN.
Comfeel Ulcer Care
®
•*
3906
3900
3903
1166
7690
•
•
•
•
Size
6 fl. oz./178 mL
12 fl. oz./355 mL
Units
12
12
.28 oz./8 g
.5 oz./15 g
.88 oz./25 g
•
1 oz./28 g tube
3 oz./84 g tube
10
10
10
•
36
12
HCPCS
A6260
A6260
A6248
A6248
A6248
A6248
A6248
Hydrocolloid Dressings
•
•
•
•
•
Size
2 x 23⁄4" (5 x 7 cm)
4 x 4" (10 x 10 cm)
31⁄2 x 51⁄2" (9 x 14 cm)
6 x 6" (15 x 15 cm)
6 x 8" (15 x 20 cm)
8 x 8" (20 x 20 cm)
3280
3283
•
11⁄2 x 21⁄2" (4 x 6 cm)
4 x 4" (10 x 10 cm)
6 x 6" (15 x 15 cm)
8 x 8" (20 x 20 cm)
•
24 sq. in. (6 x 8 cm)
42 sq. in. (9 x 11 cm)
HCPCS
A6234
A6234
A6235
A6235
A6235
A6236
30
5
5
5
A6234
A6234
A6235
A6236
5
5
A6235
A6235
•
•
•
•
•
•Comfeel Plus
• Pressure Relief Dressing
Comfeel Plus Triangle Dressing
3285
7 x 8" (18 x 20 cm)
5
A6239
3350
3353
3356
3" Butterfly (7 cm)
4" Round (10 cm)
6" Round (15 cm)
5
5
5
A6237
A6237
A6238
•
•
Size
11⁄2 x 21⁄2" (4 x 6 cm)
4 x 4" (10 x 10 cm)
6 x 6" (15 x 15 cm)
8 x 8" (20 x 20 cm)
Biatain Heel Foam Dressing
Units
30
5
5
5
HCPCS
A6234
A6234
A6235
A6236
Units
12
12
HCPCS
A6240
A6240
Product Code
9610
9613
Units
30
10
10
HCPCS
A6196
A6196
A6197
Product Code
3705
3710
3715
Size
2.5 oz./71 g
6 oz./170 g
Size
2 x 2" (5 x 5 cm)
4 x 4" (10 x 10 cm)
6 x 6" (15 x 15 cm)
1 x 171⁄2" rope (44 cm)
Contreet/Biatain Ag Adhesive Foam Dressing
9622
9625
9643
4 x 4" (10 x 10 cm)
5 x 5" (121⁄2 x 121⁄2 cm)
7 x 7" (18 x 18 cm)
Size
71⁄2" x 8" (19 x 20 cm)
9 x 9" (23 x 23 cm)
Units
5
HCPCS
A6212
5
Size
4 x 4" (10 x 10 cm)
6 x 6" (15 x 15 cm)
A6213
Units
5
5
4 x 4" (10 x 10 cm)
6 x 6" (15 x 15 cm)
HCPCS
A6234
A6235
5
5
5 x 5" (121⁄2 x 121⁄2 cm)
7 x 7" (18 x 18 cm)
A6209
A6210
5
5
A6212
A6213
5
9 x 9" (23 x 23 cm)
A6212
5
A6213
Contreet/Biatain Ag Foam Cavity Filler
HCPCS
A6209
A6210
A6210
A6211
A6209
A6209
9628
2 x 3" (5 x 8 cm)
5
A6209
SeaSorb Soft Ag Alginate Dressings with Silver
3755
3760
3765
2 x 2" (5 x 5 cm)
4 x 4" (10 x 10 cm)
6 x 6" (15 x 15 cm)
30
10
10
A6196
A6196
A6197
SeaSorb Soft Ag Alginate Filler with Silver
3780
10
10
5
71⁄2 x 73⁄4" (19 x 20 cm)
Contreet/Biatain Ag Sacral Foam Dressing
9641
Units
10
5
5
5
10
10
Biatain Adhesive Foam Dressing
3430
3420
3423
9632
9635
Contreet/Biatain Ag Heel Foam Dressing
A6199
Foam Dressings
Size
4 x 4" (10 x 10 cm)
4 x 8" (10 x 20 cm)
6 x 6" (15 x 15 cm)
8 x 8" (20 x 20 cm)
2" (5 cm) round
3" (8 cm) round
3485
Contreet/Biatain Ag Non-Adhesive Foam Dressing
6
Biatain® Non-Adhesive Foam Dressing
Product Code
3410
3412
3413
3416
3465
3467
Product Code
3488
Contreet®/Comfeel® Ag Hydrocolloid Dressing
SeaSorb Soft Alginate Filler
3740
Biatain Sacral Foam Dressing
Dressings with Antimicrobial Silver
Hydrophilic Paste
Triad™ Hydrophillic Wound Dressing
Product Code
1964
1967
SeaSorb® Soft Alginate Dressings
Units
10
10
10
5
5
5
Comfeel Plus Ulcer Dressing
3146
3110*
3115*
3120
Product Code
3233
3213
3218
3223
Alginate Dressings
Comfeel® Plus Clear Dressing (Thin)
Product Code
3530
3533
3536
3539
3542
3545
Comfeel Plus Contour Dressing
•
Infection
Undermining
Ordering
Information
•
Purilon® Gel
•
•
•
Critical Colonization/Local
Infection
Wound Cleansers/Hydrogels
•
•
•
•
•
Attached
9. Additional wound assessment parameters (odor, wound pain,
procedures performed)
Full-thickness
•
Product Code
1063
1061
•
•
•
•
Contreet/Biatain Ag Foam Cavity Filler
Contaminated/Colonization
8. Periwound (maceration, discoloration, rashes)
Maceration
•
•
Yellow Purlent Drainage
•
Partial-thickness
•
Black Eschar
Slough Yellow
Pink Cloudy Serous
6. Bioburden (bacteria level in the wound)
7. Wound edges
For more information contact NPUAP 2007 or npuap.org © NPUAP 2007
•*
•
•
Granular Red
5. Exudate (type, color, amount, odor)
Category/Stage IV: Full thickness tissue loss with exposed bone, tendon or
muscle. Slough or eschar may be present on some parts of the wound bed.
Often include undermining and tunneling.
Wound’Dres® Collagen Hydrogel
Contreet®/Comfeel® Hydrocolloid Dressing
4 g single application packet
2 oz./57 g
5 oz./142 g
•
•
Category/Stage I: Intact skin with non-blanchable redness of a localized area
usually over a bony prominence. Darkly pigmented skin may not have visible
blanching; its color may differ from the surrounding area.
•
•
SeaSorb® Soft Alginate Dressing
Biatain Sacral Foam Dressing
300
12
12
100
Units
300
12
12
Baza Antifungal
1 x 171⁄2" rope (44 cm)
10
A6199
A6212
A6212
A6213
* For deep cavity wounds; use in conjunction with a filler.
Wound Care
Skin Care
Coloplast develops products and services that make life easier for people with very personal and private medical conditions.
Working closely with the people who use our products, we create solutions that are sensitive to their special needs.
We call this intimate healthcare. Our business includes ostomy care, urology and continence care and wound and skin care.
We operate globally and employ more than 7,000 people.
The Coloplast logo is a registered trademark of Coloplast A/S. © 2010-05.
All rights reserved Coloplast Corp., Minneapolis, MN USA
Skin Is In Education Program
The Skin Is In Education Program is a series
of six video modules (6 – 8 minutes in length)
which discuss current prevention and treatment
guidelines for skin care.
•
•
•
SeaSorb Soft Alginate Filler
Critic-Aid Clear Antifungal
1622
1611
1607
Critic-Aid Skin Paste
12
4 g single application packet
8 fl. oz./237 mL
8 fl. oz./237 mL (Odor control)
3 cloth wipes/package
Antifungals
Product Code Size
7570
4 g single application packet
7571
2 oz./57 g
7572
5 oz./142 g
Micro-Guard® Power
1944
1947
Units
300
12
Baza Cleanse & Protect® Lotion and Cloth
7710
7712
7725
7726
Skin Protectants
Critic-Aid® Clear
Dressings with Antimicrobial Silver
4 fl. oz./118 mL
4 fl. oz./118 mL (Unscented)
8 fl. oz./237 mL
8 fl. oz./237 mL (Unscented)
Bedside-Care
•
Baza Antifungal Cream*
• 2% miconazole nitrate
• Contains skin conditioners
Triad™ Hydrophilic Wound Dressing
Biatain® Non-Adhesive Foam Dressing
Sween Cream®
Units
Bedside-Care® Foam
7143
7147
7145
7146
Critic-Aid Clear Antifungal Ointment*
• Clear moisture barrier with
2% miconazole nitrate
• Minimal ingredients
• Adheres to intact and denuded skin
• Easy to apply and remove
• First effective solution for managing
moisture and reducing friction in skin-to-skin
contact areas
• Helps manage erythema, maceration,
denudement, pain, itching, burning, and
satellite lesions associated with skin folds
• Wicks and translocates moisture
• Silver within the textile provides effective
antimicrobial action for up to 5 days
•
Gentle Rain® Extra Mild
7230
7235
7233
7234
7236
Baza Cleanse & Protect® Lotion and Cloth*
• One step provides mild cleansing, a breathable
barrier and moisturization
• pH-balanced
• Available as a spray or cloth
• Available with odor control
Product Code
7231
Baza® Protect Cream*
• Zinc oxide and dimethicone-based
moisture barrier
• Contains skin conditioners
•
Product Ordering Information
Foam Dressings
•
Comfeel Plus Pressure Relief Dressing
Comfeel Ulcer Care
Wound Care
Skin Repair
Critic-Aid® Clear Ointment*
• Clear moisture barrier
• Minimal ingredients
• Adheres to intact and denuded skin
• Easy to apply and remove
Comfeel Plus Contour Dressing
Wounds
Wound Cleanse
Atrac-Tain® Cream*
• 10% urea and 4% AHA
• Exfoliates and softens severely dry, cracked,
calloused skin
• Fragrance, dye and preservative-free
• Clinically proven to help prevent skin dryness
which can lead to an increased risk of foot ulcers1
Comfeel Plus Triangle Dressing
Skin Fold
Sween Lotion*
Paste
•
•
Sween Cream®*
• Natural vitamin E
• Non-occlusive formula
Hydrocolloid Dressings
Risk Factors
Bedside-Care EasiCleanse™ Bath*
• Non-irritating, non-sensitizing
• Preservative, dye, alcohol and latex-free
• pH-balanced
Sween® 24 Cream*
• Natural vitamins A & D
• Non-occlusive formula
• Will not interfere with tape adhesion
•
•
•
®
Bedside-Care Perineal Wash*
• Soothing and deodorizing
• Dye, fragrance and alcohol-free
• pH-balanced
•
Purilon® Gel
Injury: Purple or maroon localized area of discolored
intact skin or blood-filled blister due to damage of underlying soft tissue from
pressure and/or shear. The area may be preceded by tissue that is painful, firm,
mushy, boggy, warmer or cooler as compared to adjacent tissue.
Coloplast Corp.
Minneapolis, MN 55411
800.533.0464
www.us.coloplast.com
M0405N 05.10
Coloplast develops products and services that make life easier for people with very personal and private medical conditions.
Working closely with the people who use our products, we create solutions that are sensitive to their special needs.
We call this intimate healthcare. Our business includes ostomy care, urology and continence care and wound and skin care.
We operate globally and employ more than 7,000 people.
The Coloplast logo is a registered trademark of Coloplast A/S. © 2010-04.
All rights reserved Coloplast Corp., Minneapolis, MN USA
Coloplast Corp.
Minneapolis, MN 55411
800.533.0464
www.us.coloplast.com
M0510N 04.10
To learn more about the education programs offered by Coloplast,
contact Customer Service at 1-800-533-0464 to find a Territory
Manager in your area.
Skin Fold Management Program
The Skin Fold Management Program is a
30-minute program that focuses on moisture
and how it affects skin fold management.
The program highlights InterDry® Textile and
how it can help effectively manage skin fold
complications.
194
www.coloplast.us
1.800.533.0464
1.800.533.0464
Coloplast
195
1.800.533.0464
1.800.533.0464
Coloplast
SpeediCath®
Folysil 100% Silicone Catheters
Security+ Drainage Bag
Conveen Optima MEC
LoFric® Primo™
LoFric® Hydro-Kit™ II
LoFric®
®
Bardex All-Silicone Foley Catheters
Drainage Bags
Touchless® IC
Clean-Cath®
Util-Cath
InterGlide® Vinyl Catheter w/ Hydrogel Coating
Dover™ 100% Silicone Foleys
Drainage Bags
Uri-Drain Male External Catheter w/ 2-sided Adhesive
Astra Tech
Astra Tech
Astra Tech
Bard
Bard
Bard
Bard
Bard
Bard
Covidien / Kendall
Covidien / Kendall
Covidien / Kendall
Self-Cath® Closed System
Self-Cath Closed System
Curity™ Urine Leg Bag
Dover Leg Bags
Dover ROB-NEL Urethral Catheter
Robinson Vinyl Urethral Catheter
Straight Caths
Straight Hydrophilic Caths
Sterile Closed Systems
Apogee IC
Apogee Closed System
Advance Plus IC
Covidien / Kendall
Covidien / Kendall
Covidien / Kendall
Covidien / Kendall
Cure Twist
Cure Twist
Cure Twist
Hollister®
Hollister®
Note: ® or ™ indicate trademarks of Coviden/Kendall, Cure, or Hollister.
InView® MEC Standard
InView® MEC Special
Hollister®
Hollister®
Advance Hydro Soft Hydrophilic Cath
Hollister®
®
Hollister
Freedom Twist Leg Bag
Uri-Drain™ Reusable / Deluxe Leg Bags
Covidien / Kendall
™
Freedom® Twist Leg Bag
Uri-Drain™ Male External Catheter w/ Foam Strap
®
Conveen® Optima MEC
Conveen® Optima Sport Length MEC
SpeediCath®
®
Self-Cath®
Self-Cath® Closed System
SpeediCath
Self-Cath®
Self-Cath®
Self-Cath®
®
Security+ Contoured Leg Bag
Gizmo™ MEC
Competitive Product Line
Covidien / Kendall
Coloplast Product
®
Brand
Note: ® or ™ indicate trademarks of Astra Tech, Bard, or Coviden/Kendall.
™
Folysil® 100% Silicone Catheters
SpeediCath®
16
16
7, 10, 12
14-15
14-15
8-9
14-15
7, 10, 12
8-9
8-9
8-9
22
22
20
18
Page Number
16
20
24-25
7, 10, 12
8-9
Self-Cath
®
8-9
14-15
20
24-25
7, 10, 12
13
7, 10, 12
7, 10, 12
Self-Cath®
Self-Cath® Closed System
Security+ Drainage Bag
®
SureCath® Set
SpeediCath®
Page Number
Continence Care Cross Reference
www.coloplast.us
™
SpeediCath
LoFric Plus
Astra Tech
®
Coloplast Product
®
Competitive Product Line
Brand
Continence Care Cross Reference
196
197
®
Freedom Clear LS MEC
InView MEC Extra
1.800.533.0464
1.800.533.0464
Coloplast
Self-Cath Closed System
Advance Plus IC
SpeediCath
SureCath Set
Hydrophilic Personal Catheter Closed System
Rochester
Freedom Clear MEC
Pop-On® Silicone MEC
The Natural Silicone MEC
Rochester®
100% Silicone Foley
Pocket Pac i.c.™
Easy Cath
FloCath® Hydrophilic IC
Red Rubber Catheters
Rusch
Rusch
Rusch
Rusch
Rusch
PVC Catheters
Note: ® or ™ indicate trademarks of Rochester or Rusch.
Rusch
External Catheter, Latex Self-Adhesive
Rusch
™
Gizmo MEC
Golden Drain Sure Seal MEC w/ Double-Sided Strap
Rusch
™
Gizmo™ MEC
Deluxe Golden Drain™ MEC w/ Single-Sided Tape
Rusch
Self-Cath®
Self-Cath® Soft
SpeediCath®
8-9
9
7, 10, 12
8-9
Self-Cath
®
14-15
24-25
17-18
18
18
18
20
17-18
16
17-18
16
Page Number
13
7, 10, 12
8-9
13
7, 10, 12
8-9
24-25
24-25
14-15
21-22
Self-Cath® Closed System
Folysil® 100% Silicone Catheters
Freedom® Cath MEC
™
Gizmo™ MEC
Condom Catheter
Rusch
Security+ Leg Bag
Urinary Leg Bag
®
Freedom® Clear LS MEC
Rochester®
®
Rochester
WIDE Band® Silicone MEC
Rochester®
®
Conveen® Optima Sport Length MEC
UltraFlex® Silicone MEC
Conveen® Optima MEC
Competitive Product Line
Rochester®
Coloplast Product
®
Brand
Note: ® or ™ indicate trademarks of Hollister or Rochester.
®
®
SpeediCath®
Hydrophilic Personal Catheter®
Rochester®
Self-Cath®
Personal Catheter®
Rochester®
SureCath® Set
Magic3® Hydrophilic Closed System
®
Rochester®
Hydrophilic Catheter
Magic
Rochester
®
3®
Self-Cath®
Magic3® All-Silicone Catheter
Rochester®
Folysil® 100% Silicone Catheters
All-Silicone Foley
Rochester®
Folysil® 100% Silicone Catheters
Strata SI™ Silicone Foleys
®
Rochester®
®
17-18
17-18
17-18
Page Number
Continence Care Cross Reference
www.coloplast.us
Hollister
Freedom® Fas-Tap® Leg Bags
Not Made With Natural Rubber Latex Urinary Leg Bags
Hollister®
Freedom® Cath MEC
Everyday MEC
Hollister®
Freedom ®Clear MEC
Extended Wear MEC
®
Coloplast Product
®
Competitive Product Line
Hollister®
Hollister
Brand
Continence Care Cross Reference
198
199
1.800.533.0464
1.800.533.0464
Coloplast
Security+ Leg Bag
Security+ Leg Bag
FloCath® Quick™ Catheter Kit
MMG H2o™ Hydrophilic Closed System
Drainable Bag
Easy-Tap Leg Bag
Button Bags®
Reusable Latex Leg Bag
Vinyl Leg Bag with Thumb Clamp
Vinyl Leg Bag with Twist Drain
Rusch
Rusch
Rusch
Rusch
Rusch
Urocare®
Urocare®
Gizmo MEC
Uro-Cath Latex MEC with Urofoam-2
SenSura Click Xpro 2-pc Barrier
ActiveLife® 1-pc Urostomy Pouch
ActiveLife® 1-pc Convex Urostomy Pouch
ActiveLife® 1-pc Closed-End Pouch
SUR-FIT Natura® Moldable Skin Barrier
SUR-FIT® Natura 2-pc Durahesive® w/ CONVEX-IT®
SUR-FIT 2-pc Durahesive Skin Barrier
ConvaTec®
ConvaTec®
ConvaTec®
ConvaTec®
ConvaTec®
SenSura Flex 2-pc Barrier
Esteem synergy AC Stomahesive Barrier
ConvaTec
Esteem synergy® AC Closed-End Pouch
Esteem synergy® AC Drainable Pouch
ConvaTec®
ConvaTec®
Note: ® or ™ indicate trademarks of ConvaTec.
Esteem synergy® AC Convex Moldable Durahesive Barrier
ConvaTec®
®
®
SenSura® Click Xpro 2-pc Barrier
SUR-FIT® AutoLock® 2-pc Durahesive Barrier
ConvaTec®
SenSura® Flex EasiClose™ WIDE Drainable Pouch
SenSura® Flex 2-pc Closed Pouch
SenSura® Flex Xpro 2-pc Convex Light Barrier
®
SenSura® Click 2-pc Barrier
SUR-FIT® AutoLock® 2-pc Stomahesive Barrier
ConvaTec®
SenSura® Click 2-pc Barrier
SUR-FIT® 2-pc Stomahesive® Skin Barrier
®
SenSura® Click 2-pc Barrier
SenSura® Mio 1-pc Closed Pouch
109
110
108
107
84
83
83
84
85
83
122-123
125
SenSura Uro 1-pc Convex Light Urostomy Pouch or
Assura® 1-pc Convex Urostomy pouch
®
124
119-122
119-122
Page #
18
18
18
18
20
20
23
20
20
21
13
13
14-15
SenSura® Uro 1-pc Urostomy Pouch
SenSura® 1-pc Drainable Pouch
ConvaTec®
®
ConvaTec
Esteem® 1-pc Drainable Pouch w/ InvisiClose®
ConvaTec®
®
SenSura® Click Xpro 2-pc Convex Light Barrier
ActiveLife® 1-pc Drainable Pouch
SenSura® 1-pc Drainable Pouch
Competitive Product Line
ConvaTec®
Coloplast Product
™
Brand
Note: ® or ™ indicate trademarks of Rusch or Urocare.
Urocare
®
®
Gizmo™ MEC
Uro-Cath® Latex MEC with Urofoam-1
Urocare®
Gizmo™ MEC
Uro-Con® Texas-Style MEC with Urofoam-2
Urocare®
Gizmo™ MEC
Uro-Con® Texas-Style MEC with Urofoam-1
Urocare®
®
Alpine® Reusable Leg Bag
Security+ Leg Bag
Security+ Leg Bag
Moveen® Drain Bag
SureCath® Set
SureCath® Set
Page Number
Ostomy Care Cross Reference
www.coloplast.us
Urocare
Self-Cath Closed System
MMG Catheter
Rusch
®
Coloplast Product
™
Competitive Product Line
Brand
Continence Care Cross Reference
200
201
®
Assura AC 2-pc Urostomy Pouch
Esteem synergy AC Urostomy Pouch
1.800.533.0464
1.800.533.0464
75
Brava Ostomy Care Moldable Ring 4.2 mm / 2.0 mm
Eakin Seal / SLIMS
ConvaTec
77
75
Brava Ostomy Strip Paste
Stomahesive Strips
155
ColoKids 1-pc Pediatric Drainable Pouch
Little Ones 1-pc Drainable Pouch
Little Ones® 1-pc Urostomy Pouch
Little Ones® 2-pc AC Barrier
ConvaTec®
ConvaTec®
SenSura Click 2-pc Convex Light Barrier or
Assura® 2-pc Convex Barrier
New Image FlexWear Convex Barrier with Floating Flange
SenSura Click 2-pc Closed Pouch
SenSura Xpro 1-pc Flat Drainable Pouch
Premier 1-pc Drainable Pouch w/ Flat Flextend Barrier
Premier® 1-pc Drainable Pouch w/ Convex Flextend® Barrier
Note: ® or ™ indicate trademarks of ConvaTec or Hollister.
Hollister®
Hollister
®
®
®
SenSura® 1-pc Flat Drainable Pouch
Premier® 1-pc Drainable Pouch w/ Flat SoftFlex® Barrier
Hollister®
SenSura® Xpro 1-pc Convex Light Drainable Pouch
®
SenSura® Click Magnum 2-pc High-Output Pouch
New Image® 2-pc High Output Pouch
Hollister®
SenSura® Click Uro 2-pc Urostomy Pouch
New Image® 2-pc Urostomy Pouch
Hollister®
®
New Image 2-pc Closed Pouch
Hollister
®
®
SenSura® Click 2-pc Drainable Pouch with EasiClose™ WIDE
New Image® 2-pc Drainable Pouch
Hollister®
SenSura® Click Xpro 2-pc Convex Light Barrier or
Assura® Extended Wear 2-pc Convex Barrier
New Image® Flextend® Convex Barrier with Floating Flange
®
SenSura® Click 2-pc Flat Barrier
Hollister®
®
Hollister
New Image® Flextend® Flat Barrier with Floating Flange
Hollister®
®
New Image® FlexWear® Flat Barrier with Floating Flange
Hollister®
®
SenSura® Click Xpro 2-pc Flat Barrier
Little Ones® 2-pc AC Drainable Pouch w/ InvisiClose®
Assura® AC 2-pc Pediatric EasiClose Pouch
Competitive Product Line
ConvaTec®
Coloplast Product
Assura® AC 2-pc Pediatric Barrier
ColoKids™ 1-pc Pediatric Urostomy Pouch
™
Brand
Note: ® or ™ indicate trademarks of ConvaTec.
ConvaTec
144
®
®
121
120
119
88
90-91
89
86-87
85, 95
84-85, 94-95
84
83
149-150
Page #
149
155
75
Coloplast® Fistula & Wound Management System
Eakin® Fistula & Wound Pouches
78
ConvaTec®
Brava© Belt (Adjustable)
Ostomy Appliance Belt (Adjustable)
ConvaTec®
Drainable Pouch Clamp
ConvaTec® Tail Closure
©
ConvaTec®
ConvaTec
76
®
®
77
Ostomy Paste
Stomahesive® Paste
77
ConvaTec®
Brava© Ostomy Care Protective Sheet
Stomahesive® Skin Barrier
ConvaTec®
Brava© Ostomy Care Protective Sheet
Eakin® Cohesive Barrier
©
ConvaTec®
®
Ostomy Care Cross Reference
www.coloplast.us
®
76
Brava© Ostomy Powder
Stomahesive® Protective Powder
78
ConvaTec®
Brava© Adhesive Remover Wipes (No-Sting)
AllKare® Adhesive Remover Wipes
116
ConvaTec®
Coloplast® Prep™ Protective Skin Barrier Wipes
Page #
AllKare® Protective Barrier Wipes
®
Coloplast Product
®
Competitive Product Line
ConvaTec®
ConvaTec
Brand
Ostomy Care Cross Reference
202
Coloplast
203
®
SenSura 1-pc Drainable Pouch with Soft Outlet
Premier 1-pc High Output Pouch
1.800.533.0464
1.800.533.0464
SenSura Xpro 1-pc Convex Light Urostomy Pouch
155
ColoKids 1-pc Pediatric Urostomy Pouch
Pouchkins 1-pc Urostomy Pouch w/ Flat SoftFlex Barrier
Assura 2-pc Pediatric Urostomy Pouch
Adapt® Barrier Rings
77
Brava Lubricating Deodorant
Adapt Lubricating Deodorant
76
Brava Adhesive Remover Wipes (No-Sting)
Adhesive Remover Wipes
Hollister
78
Irrigation Supplies
Irrigation Products
Karaya Powder
Hollister®
Note: ® or ™ indicate trademarks of Hollister.
Karaya Paste
Hollister®
®
Hollister
Drainable Pouch Clamp
Drainable Pouch Clamp
Hollister®
Coloplast® Ostomy Powder
Ostomy Paste
Brava© Lubricating Deodorant
m9® Odor Eliminator Drops
Hollister®
Brava© Adhesive Remover Spray (No-Sting)
Medical Adhesive Remover
©
Hollister®
®
77
76
80-81
78
77
76
77
Coloplast® Prep™ Protective Skin Barrier Wipes
Skin Gel Protective Dressing Wipes
75
Hollister®
Brava© Protective Sheet
Solid Skin Barrier
Hollister®
Brava© Belt (Adjustable)
76
Ostomy Belt
©
Ostomy Paste
Hollister®
®
Hollister
77
Adapt® Stoma Powder
Hollister®
®
Brava© Powder
Adapt® Paste
Hollister®
75
Adapt® Barrier Strips
Brava© Strip Paste
Competitive Product Line
Page #
75
153
Hollister®
Coloplast Product
Brava© Moldable Rings, 4.2 mm
152
Brand
Note: ® or ™ indicate trademarks of Hollister.
Hollister®
®
Pouchkins 2-pc Urostomy Pouch
Hollister
®
®
Pouchkins® 2-pc Closed Pouch
149-150, 152
Assura® 2-pc Pediatric Closed Pouch
Pouchkins® 2-pc Drainable Pouch w/ Lock ‘n Roll® Closure
Hollister®
Assura® AC 2-pc Pediatric EasiClose™ Pouch or
Assura® 2-pc Pediatric Drainable Pouch
Hollister®
149, 152
Assura® AC 2-pc Pediatric Barrier or Assura® 2-pc Pediatric Barrier
Pouchkins® SoftFlex® Flat Barrier
™
Hollister®
Hollister
®
155
®
ColoKids™ 1-pc Pediatric Drainable Pouch
®
Hollister®
141, 144
125
Pouchkins® 1-pc Drainable Pouch w/ Flat SoftFlex® Barrier &
Lock ‘n Roll Closure
SenSura® Post-Op 1-pc Pouch with Window or
Coloplast® Fistula & Wound Management Systems
124
Premier® 1-pc Wound Drainage Collectors
®
Hollister®
®
Premier 1-pc Urostomy Pouch w/ Convex Flextend Barrier
Hollister
®
136
122-123
122
Page #
Ostomy Care Cross Reference
www.coloplast.us
®
SenSura® Xpro 1-pc Urostomy Pouch
Premier® 1-pc Urostomy Pouch w/ Flat Flextend® Barrier
Hollister®
Assura® 1-pc Stoma Cap
Premier® 1-pc Stoma Cap
Hollister®
SenSura® Mio 1-pc Closed Pouch
Premier® 1-pc Closed Pouch w/ Flat SoftFlex® Barrier
®
Coloplast Product
®
Competitive Product Line
Hollister®
Hollister
Brand
Ostomy Care Cross Reference
204
Coloplast
205
®
84-85, 94-95
SenSura® Click 2-pc Convex Light Skin Barrier or
Assura® 2-pc Convex Skin Barrier
1.800.533.0464
1.800.533.0464
Coloplast
SenSura Click Uro 2-pc Urostomy Pouch
CenterPointLock 2-pc Urostomy Pouches
SenSura Uro 1-pc Urostomy Pouch
Karaya 5 1-pc Urostomy Pouch
Hollister
Cavilon™ No-Sting Barrier Film Spray
3M™
Coloplast Prep
Cavilon™ No-Sting Barrier Film
Cavilon™ Moisturizing Lotion
Remover Lotion
3M™
3M™
Sween Cream
Gentle Rain Extra Mild
ConvaTec
Bedside-Care Foam
®
Septi-Soft Concentrate
®
Note: ® or ™ indicate trademarks of 3M or ConvaTec.
®
Bedside-Care®
Bedside-Care® EasiCleanse™ Bath
Bedside-Care® Foam
®
Aloe Vesta® Perineal / Skin Cleanser
Aloe Vesta® Bathing Cloths
ConvaTec®
ConvaTec®
Aloe Vesta® Cleansing Foam
ConvaTec®
Body Wash & Shampoo
Aloe Vesta
ConvaTec
®
®
Baza® Protect
Aloe Vesta® Protective Ointment
ConvaTec®
Sween® Lotion
3M™ Cavilon™ Moisturizing Lotion
3M™
Atrac-Tain® Cream
Cavilon™ Extra Dry Skin Cream
3M™
®
Cavilon Moisturizing Body Cream
3M
™
™
Bedside-Care® Perineal Wash
Cavilon™ Skin Cleanser
3M™
Baza® Protect
Cavilon™ Durable Barrier Cream
3M™
Baza Cleanse & Protect® Lotion
™
Cavilon™ 3-in-1 Incontinence Care Lotion
®
Brava© Skin Barrier Spray (No-Sting)
3M™
™
3M
Sween® Lotion
Avagard™ D Instant Hand Antiseptic with Moisturizers
Isagel®
Competitive Product Line
3M™
Coloplast Product
Brava© Skin Barrier Spray (No-Sting)
Brava© Skin Barrier Wipes (No-Sting)
®
Brand
Note: ® or ™ indicate trademarks of Hollister or 3M.
Cavilon™ No-Sting Barrier Film Wipes
3M™
®
®
SenSura® Mio 1-pc Closed Pouch
Karaya 5® 1-pc Closed Pouch
Hollister®
SenSura® 1-pc Drainable Pouch
Karaya 5® 1-pc Drainable Pouch
Hollister®
Assura® Stoma Cap
CenterPointLock® 2-pc Stoma Cap
®
Hollister®
®
Hollister
CenterPointLock® 2-pc Closed Pouch
Hollister®
58
58
58
58
59
62
60
61
60
58
62
63
51
60
76
66
Page #
76
76
124
122-123
119
101
90-91
89
Skin Care Cross Reference
www.coloplast.us
®
SenSura® Click 2-pc Closed Pouch
CenterPointLock® 2-pc Drainable Pouch
Hollister®
SenSura® Click 2-pc Drainable Pouch
CenterPointLock® 2-pc Convex Skin Barriers w/ Floating Flange
86-87
83
SenSura Click 2-pc Flat Skin Barrier
Page #
CenterPointLock 2-pc Flat Skin Barriers w/ Floating Flange
®
Coloplast Product
®
Competitive Product Line
Hollister®
Hollister
Brand
Ostomy Care Cross Reference
206
207
1.800.533.0464
1.800.533.0464
Coloplast
Baza® Antifungal
Gentle Rain Extra Mild
Aloe Vesta® Protective Barrier Spray
Aloe Vesta® Skin Conditioner
Aloe Vesta® Antifungal Ointment
Septi-Soft
ConvaTec®
ConvaTec®
ConvaTec
Coloplast Prep
AllKare Protective Barrier Wipes
ConvaTec
Baza Cleanse and Protect Lotion
Kendall 2-in-1 Cleanser
Covidien
Kendall™ Antimicrobial Cleanser
Covidien®
Baza Antifungal
Kendall™ Moisturizing Lotion
Kendall Antifungal Cream
Covidien®
Bedside-Care Foam
Provon® Antimicrobial Skin Cleanser
PURELL® Instant Hand Sanitizer with Dermaglycerin System
PROSHIELD Foam & Spray
GOJO® Industries
GOJO® Industries
HEALTHPOINT
Hollister
Sween 24 Cream
®
Restore DimethiCreme Skin Protectant
®
Note: ® or ™ indicate trademarks of Covidien, Dial Corp., GOJO Industries, HEALTHPOINT, or Hollister.
®
Baza Cleanse & Protect® Lotion
Micro-Guard® Powder
Baza® Protect
Restore® Cleanser & Moisturizer
MITRAZOL® Powder 2% Miconazole Nitrate Powder
HEALTHPOINT®
Hollister®
PROSHIELD® Plus
HEALTHPOINT®
®
Isagel®
Isagel®
Isagel
®
Isagel®
®
PURELL® Instant Hand Sanitizer Premium Wipes
®
Isagel®
PURELL 2-in-1 Instant Hand Sanitizer
GOJO® Industries
®
GOJO Industries
®
PURELL® Instant Hand Sanitizer
GOJO® Industries
Isagel®
MediChoice Hand Sanitizer
Donovan Industries
Gentle Rain® Antibacterial
Antimicrobial Liquid Soap
®
Sween® 24 Cream
Dial® Corp
®
Covidien
Kendall™ Moisture Barrier Cream
Covidien®
™
Sween® Lotion
Kendall™ Soothing Ointment
Baza® Protect
Competitive Product Line
Covidien®
Coloplast Product
Bedside-Care® Foam
Bedside-Care® Foam
®
Brand
Note: ® or ™ indicate trademarks of ConvaTec or Covidien.
Kendall™ Body Wash & Shampoo
Covidien®
®
™
Gentle Rain® Extra Mild
Aloe Vesta® Body Wash & Shampoo
ConvaTec®
Bedside-Care® Foam
Aloe Vesta® Cleansing Foam
ConvaTec®
Adhesive Remover (Wipes)
™
AllKare® Adhesive Remover Wipes
®
ConvaTec®
®
®
Sween Cream®
Sensi-Care® Moisturizing Body Cream
ConvaTec®
Critic-Aid® Skin Paste
Sensi-Care® Protective Barrier
ConvaTec®
Bedside-Care®
®
Sensi-Care® Perineal / Skin Cleanser
®
ConvaTec®
®
Sween Cream®
Ostomy Care Skin Barrier Spray (No-Sting)
60
63
64
62
58
66
66
66
66
66
66
59
64
60
60
62
Page #
58
58
63
59
58
76
51
60
62
58
59
64
60
76
58
Page #
Skin Care Cross Reference
www.coloplast.us
Concentrate
Bedside-Care
Aloe Vesta Perineal / Skin Cleanser
ConvaTec®
ConvaTec
®
Coloplast Product
®
Competitive Product Line
®
Brand
Skin Care Cross Reference
208
209
®
Baza Clear
Restore Moisture Barrier Skin Ointment
1.800.533.0464
1.800.533.0464
Coloplast
Gentle Rain® Extra Mild
Sween Cream
Johnson’s® Baby Lotion
Kimcare® Antibacterial Clear Skin Cleanser
Kimcare® Eurobath® Hair & Body Shampoo
Tender Care Pure Lanolin
Johnson & Johnson
Kimberly-Clark®
Kimberly-Clark®
Critic-Aid Skin Paste
Remedy Calazime Protectant Paste
Remedy® Cleansing Body Lotion
Remedy® Clear-Aid™ Skin Protectant
Medline
Medline
Bedside-Care® Foam
Sween Lotion
Baza® Antifungal
Baza Protect
Remedy Nutrashield
Soothe & Cool® Cornstarch Body Powder
Soothe & Cool® Extra Thick Moisturizing Cream
Soothe & Cool® Foaming No-Rinse Perineal Wash
Soothe & Cool Herbal Moisturizing Body Lotion
Soothe & Cool® Herbal Moisturizing Shampoo & Body Wash
Soothe & Cool® Herbal No-Rinse Shampoo & Body Wash
Soothe & Cool® INZO™ Antifungal Cream
Soothe & Cool INZO™ Barrier Cream
Soothe & Cool® Medseptic
Soothe & Cool® Moisture Barrier Ointment
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Note: ® or ™ indicate trademarks of Medline.
Bedside-Care
Soothe & Cool No-Rinse Perineal Wash
®
Medline
®
Sween® Lotion
Soothe & Cool® Moisturizing Body Lotion
Baza® Clear
Sween Cream®
®
Bedside-Care®
Gentle Rain® Extra Mild
®
Sween Cream®
Sween® Body Powder
®
Sween® 24 Cream
Medline
®
®
Critic-Aid Clear
Remedy® Foaming Body Cleanser
Medline
™
Remedy® Skin Repair Cream
Medline
®
Bedside-Care®
Remedy® Dimethicone Skin Protectant
Sween® 24 Cream
Competitive Product Line
Medline
Coloplast Product
Critic-Aid® Clear
Baza Cleanse & Protect® Lotion
®
Brand
Note: ® or ™ indicate trademarks of Hollister, Johnson & Johnson, Kimberly-Clark, Medela or Medline.
®
Medline
®
Bedside-Care® Foam
Remedy® Antimicrobial Cleanser
Medline
Baza® Antifungal
Remedy® Antifungal Cream
Medline
Micro-Guard® Powder
Remedy® Antifungal Powder
®
Gentle Rain® Antibacterial
Sween® Lotion
Gentle Rain Extra Mild
Medline
®
Medela
59
Johnson’s Head-to-Toe Baby Wash
Johnson & Johnson
™
63
®
58
60
62
60
62
64
58
59
60
58
60
63
62
58
60
60
Page #
62
63
62
58
64
64
60
59
59
60
Skin Care Cross Reference
www.coloplast.us
®
63
Johnson’s® Baby Powder: Pure Cornstarch with Aloe Vera & Vitamin E Sween® Body Powder
59
Johnson & Johnson
Sween® Body Powder
Johnson’s® Baby Powder
62
Johnson & Johnson
Gentle Rain® Extra Mild
Page #
Johnson’s® Baby Shampoo
®
Coloplast Product
®
Competitive Product Line
Johnson & Johnson
Hollister
Brand
Skin Care Cross Reference
210
211
1.800.533.0464
1.800.533.0464
Coloplast
Baza Protect
Bedside-Care® Perineal Wash
Sween Cream
Sween® Lotion
Sea-Clens
Soothe & Cool® Skin Cream
Soothe & Cool® Skin Cream -- unscented
Soothe & Cool Skin Paste
Carrington® Moisture Barrier Cream
DiaB™ Cream
CarraWash™ Skin & Perineal Cleanser
RadiaCare Cream Moisturizing Cream
Carrington® Moisture Cream with Zinc
Carrington® Antifungal Cream
Carrington® Skin Balm
MicroKlenz Antiseptic Wound Cleanser
UltraKlenz™ Wound & Skin Cleanser
Radiacare™ Wound Klenz
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
Medline
No-Rinse® Shampoo
Adhesive Tape Remover
Sani-Hands ALC Instant Hand Sanitizing Wipes
No-Rinse® Laboratories
PDI®
Baza Cleanse & Protect Lotion
Comfort Shield Barrier Cloths
Note: ® or ™ indicate trademarks of Medline, No-RInse Laboratories, PDI, or Sage.
Fragrance-Free Essential Bath® Cleansing Washcloths
Essential Bath® Cleansing Washcloths
Sage®
Sage®
Comfort Bath® Cleansing Washcloths
Sage®
Sage
®
Isagel®
Hygienic Cleansing Towelettes
PDI®
Bedside-Care® EasiCleanse™ Bath
Bedside-Care® EasiCleanse™ Bath
Bedside-Care® EasiCleanse™ Bath
Isagel®
Sani-Hands® ALC Pocket Pack
PDI®
Isagel®
®
BZK Antiseptic Towelettes
®
Gentle Rain® Extra Mild
Sea-Clens®
PDI®
®
®
Sea-Clens
Isagel®
Hex-On®
®
CarraKlenz™ Wound & Skin Cleanser
Medline
®
Isagel
DiaB
Medline
PDI
Brava© Adhesive Remover (Wipes)
Epi-Clenz® Hand Sanitizer
Medline
Klenz Wound & Skin Cleanser
Carrington® Enzymatic Odor Eliminator
Medline
™
Soothe & Cool® Moisturizing Body Lotion
Sween® Lotion
Competitive Product Line
Coloplast Product
Sea-Clens®
Sea-Clens®
®
Baza® Antifungal
Baza® Protect
®
Atrac-Tain® Cream
Baza® Protect
®
Medline
™
®
Sween Cream®
Gentle Rain® Extra Mild
Brand
Note: ® or ™ indicate trademarks of Medline.
Sween Cream®
Soothe & Cool® Shampoo & Body Wash Concentrate
Medline
58
58
58
63
66
66
66
66
76
59
53
53
66
66
60
Page #
53
53
53
60
64
62
60
58
61
62
62
60
60
59
59
Page #
Skin Care Cross Reference
www.coloplast.us
™
Gentle Rain Extra Mild
Soothe & Cool Shampoo & Body Wash
Medline
®
Coloplast Product
®
Competitive Product Line
Brand
Skin Care Cross Reference
212
213
www.coloplast.us
1.800.533.0464
1.800.533.0464
Sage
Bedside-Care EasiCleanse Bath
™
Deodorant Essential Bath Cleansing Washcloths
Baza Antifungal
Bedside-Care®
Sween Cream
Baza® Protect
Baza Clear
SECURA Antifungal Greaseless
SECURA™ Dimethicone Protectant
SECURA™ Extra Protective Cream (EPC)
SECURA™ Moisturizing Cleanser
SECURA Moisturizing Cream
SECURA™ Moisturizing Lotion
SECURA™ Personal Cleanser
SECURA™ Protective Cream
SECURA Protective Ointment
SECURA™ Total Body Foam Cleanser
UNICARE™ Moisturizing Lotion
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Baza Clear
Skin-Prep Protective Dressing Pump Spray
NO-STING SKIN-PREP™
UNI SALVE Protective Ointment
REMOVE™ Adhesive Remover Wipes
REMOVE™ Adhesive Remover
Cal Stat® Antiseptic Handrub Plus
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Smith & Nephew
Steris
Note: ® or ™ indicate trademarks of Smith & Nephew or Steris.
™
Brava© Skin Barrier Wipes
UNIDERM™ Moisturizing Cream
Isagel®
Brava© Adhesive Remover Spray (No-sting)
Brava© Adhesive Remover Wipes
®
Brava© Skin Barrier Spray (No-sting)
Sween Cream®
Competitive Product Line
Smith & Nephew
Coloplast Product
Sween® Lotion
Bedside-Care® Foam
®
Bedside-Care®
Sween® Lotion
®
Critic-Aid® Skin Paste
Sween® 24 Cream
®
Brand
Note: ® or ™ indicate trademarks of Sage or Smith & Nephew.
™
™
™
Baza® Antifungal
SECURA™ Antifungal Cream -- Extra Thick
Smith & Nephew
Baza Cleanse & Protect® Lotion
Comfort Shield® Perineal Washcloth w/ Dimethicone
Sage®
Baza Cleanse & Protect® Lotion
Comfort Shield® Incontinence Wipe
®
Coloplast Product
®
Competitive Product Line
Sage®
®
66
76
76
62
76
76
60
Page #
60
58
62
62
58
60
60
58
62
60
64
64
63
63
58
Page #
Skin Care Cross Reference
Brand
Skin Care Cross Reference
214
Coloplast
215
Comfeel Plus Ulcer Dressing
Tegaderm Hydrocolloid Dressings
1.800.533.0464
1.800.533.0464
Coloplast
Purilon Gel
Tegaderm Hydrogel
3M
Biatain Alginate Ag Dressing with SIlver
Comfeel Plus
DuoDERM
ConvaTec
Triad Hydrophilic Wound Dressing
DuoDerm Paste
ConvaTec
Comfeel Plus Ulcer Dressing
Ultec™ Pro
Ultec
Covidien/Kendall™
Biatain Soft-Hold Foam Dressing
Restore Foam Dressing with TRIACT Technology
Purilon Gel
Restore Hydrogel Dressing
Hollister
Note: ® or ™ indicate trademarks of ConvaTec, Covidine/Kendall, Ferris, Hollister or Smith & Nephew.
Algisite™ M
Restore® Extra Thin Hydrocolloid Dressing
Hollister®
Smith & Nephew
Restore® Hydrocolloid Dressing
Hollister®
®
®
Biatain® Alginate Ag Dressing with Silver
Restore® Calcium Alginate Dressing Silver
Hollister®
Biatain® Alginate Dressing
Comfeel® Plus Transparent Dressing
Comfeel® Plus
®
Biatain® Alginate Dressing
Restore® Calcium Alginate Dressing
Hollister®
Biatain® Ag Foam Dressing
®
Restore® Foam Dressing with Silver and TRIACT Technology
®
Hollister®
Hollister
®
Biatain® Foam Dressing
Polymem® Foam
Ferris
Biatain® Alginate Dressing
Curasorb™*
Covidien/Kendall™
Purilon® Gel
Curafil™*
®
Biatain® Foam Dressing
Covidien/Kendall™
™
Covidien/Kendall
COPA™
Covidien/Kendall™
™
Comfeel® Plus Ulcer or Comfeel® Plus Sacral Dressing
DuoDerm® Gel
Purilon® Gel
Competitive Product Line
ConvaTec®
Coloplast Product
™
Brand
Note: ® or ™ indicate trademarks of 3M or ConvaTec.
®
®
Sea-Clens® Wound Cleanser
Shur-Clens® Wound Cleanser
ConvaTec®
Sea-Clens® Wound Cleanser
SAF-Clens® Wound Cleanser
ConvaTec®
Comfeel® Plus Transparent Dressing
DuoDerm® Extra Thin
®
ConvaTec®
®
®
Comfeel® Plus Ulcer or Comfeel® Plus Triangle Dressing
CombiDERM ACD
ConvaTec®
Biatain® Foam Dressings
Versiva® XC Gelling Foam with Hydrofiber® Technology
ConvaTec®
Biatain® Alginate Dressing
Kaltostat® Calcium Sodium Alginate Dressing
ConvaTec®
®
Aquacel Ag Hydrofiber Dressing
ConvaTec
®
®
Biatain® Alginate Dressing
Aquacel® Hydrofiber Dressing
ConvaTec®
Sea-Clens® Wound Cleanser
Tegaderm™ Wound Cleanser
®
3M™
™
49
51
51-52
53
50
49
47-48
46
46-47
49
53
51
51-52
46-47
53
Page #
53
53
53
51
51-52
51
46-47
49
50
49
53
53
46-47
50
49
51
Page #
Wound Care Cross Reference
www.coloplast.us
™
Biatain® Foam Dressing
Tegaderm™ Foam Dressings
3M™
Biatain® Alginate Ag Dressing with SIlver
Tegaderm™ Alginate Ag Dressings
3M™
Biatain® Alginate Dressing
Tegaderm™ Alginate Dressings
®
Coloplast Product
™
Competitive Product Line
3M™
™
3M
Brand
Wound Care Cross Reference
216
217
®
Sea-Clens Wound Cleanser
Restore Wound Cleanser
1.800.533.0464
1.800.533.0464
Woun’Dres® Collagen Hydrogel
Biatain Alginate Dressing
Purilon® Gel
Biatain Alginate Ag Rope Dressing
Optifoam® Gentle
Exuderm® Odorshield
Skintegrity® Hydrogel
Melgisorb Alginate Dressing
Mepilex®
Lyofoam™
Hypergel®
Algisite M Calcium Alginate Dressing
Acticoat™ Absorbent
Medline
Medline
Medline
Mölnlycke
Mölnlycke
Mölnlycke
Mölnlycke
Smith & Nephew
Smith & Nephew
®
Comfeel® Plus Ulcer, Sacral or Transparent Dressings
Biatain Soft Alginate Dressing
Solosite™ Gel
Intrasite Gel
Silvercel® Antimicrobial Alginate Dressing
Tielle® Foam
Nu-Derm® Hydrocolloid Dressing
Nu-Derm Alginate Wound Dressing
Smith & Nephew
Smith & Nephew
Systagenix
Systagenix
Systagenix
Systagenix
Note: ® or ™ indicate trademarks of Smith & Nephew or Systagenix.
®
Purilon Gel
Replicare™
Smith & Nephew
™
Woun’Dres® Collagen Hydrogel
Allevyn™ Gentle
®
Biatain® Foam Dressing
Biatain® Alginate Ag Dressing
®
Comfeel® Plus Ulcer, Sacral or Transparent Dressings
Biatain® Silicone Foam Dressing
Competitive Product Line
Smith & Nephew
Coloplast Product
Biatain® Alginate Ag Dressing or Biatain® Ag Foam Dressing
®
Biatain® Foam Dressing
Biatain® Silicone Foam Dressing
®
Comfeel® Plus Ulcer or Comfeel® Plus Sacral Dressing
Biatain® Silicone Foam Dressing
Brand
Note: ® or ™ indicate trademarks of Hollister, Medline, Mölnlycke, or Smith & Nephew.
™
Biatain Ag Foam Dressings
Optifoam Ag
Medline
®
49
51-52
46-47
50
53
53
51-52
45
Page #
47, 50
50
53
46-47
45
49
53
51-52
45
47-48
46-47
50
49
53
Page #
Wound Care Cross Reference
www.coloplast.us
®
Biatain® Foam Dressings
Optifoam®
Medline
Biatain® Alginate Ag Rope Dressing
Maxorb® Extra AG Alginate Dressing
Medline
Biatain® Alginate Dressing
Maxorb® Extra Alginate Dressing
®
Coloplast Product
®
Competitive Product Line
Medline
Hollister
Brand
Wound Care Cross Reference
218
Coloplast
219
Medicare Utilization - Continence Care
Usual maximum limits for some products from the Medicare
Local Coverage Determinations (LCD) are shown below. Suppliers
should examine their applicable Medicare contractor policies for full
examination of policy requirements, including medical necessity and
documentation.
HCPCS*
Description
A4310
Insert tray without drainage bag and
without catheter (accessories only)
A4311
Insertion tray without drainage bag
with indwelling catheter, foley type,
two-way latex with coating (teflon,
silicone, silicone elastomer, or
hydrophilic, etc.)
Insertion tray with drainage bag with
indwelling catheter foley type, twoway latex with coating (teflon,
silicone, silicone elastomer, or
hydrophilic, etc.)
Lubricant, individual sterile packet,
each
Male external catheter, with or
without adhesive, disposable, each
Intermittent urinary catheter;
straight tip, with or without coating
(teflon, silicone, silicone elastomer,
or hydrophilic, etc.), each
Intermittent urinary catheter; coudé
(curved) tip, with or without coating
(teflon, silicone, silicone elastomer, or
hydrophilic, etc.) each
Intermittent urinary catheter,
with insertion supplies
Insertion tray with drainage bag but
without catheter
Bedside drainage bag, day or night,
with or without anti-reflux device,
with or without tube, each
Urinary drainage bag, leg or
abdomen, vinyl, with or without tube,
with straps, each
A4314
A4332
A4349
A4351
A4352
A4353
A4354
A4357
A4358
Usual Maximum
1 insertion tray
per episode of
indwelling catheter
insertion
1 insertion tray
per episode of
indwelling catheter
insertion
1/month
Medicare Utilization - Ostomy
Medicare Allowables based on Standard Quality of Ostomy
Supplies. The amount of ostomy supplies varies by patient
based on the type of ostomy, its location, its construction, and
the condition of the peristomal skin. The table below shows the
maximum number of items that are usually medically necessary for
patients with ostomies. It may be more or less depending on the
factors that affect the frequency of barrier and pouch change. The
medical necessity for a greater quantity of supplies must be clearly
documented in the patient’s medical record (physician’s signed and
dated order).
HCPCS*
Description
A4357
A4361
A4362
A4367
A4369
A4371
A4394
A4397
A4398
A4399
Bedside drainage bag
2 ea/month
Ostomy faceplate
3 ea/6 months
Skin barrier, solid, 4x4 or equipment*
20 ea/month
Ostomy belt, each
1 ea/month
Skin barrier, liquid, per ounce
2 oz./month
Skin barrier powder, per ounce
10 oz./6 months
Ostomy pouch liquid deodorant
8 oz./month
Irrigation supply sleeve, each
4 ea/month
Irrigation bag, each
2 ea/6 months
Irrigation cone/catheter with or
2 ea/6 months
without brush
Ostomy ring, each
10 ea/month
Ostomy paste (non-pectin based),
4 oz./month
per ounce
Ostomy paste (pectin based), per
4 oz./month
ounce
Two-piece ostomy skin barrier with
20 ea/month
flange, standard wear, NONCONVEX (4x4 inches or smaller)
Two-piece ostomy skin barrier, with
20 ea/month
flange, standard wear, NONCONVEX, greater than 4 x 4
One-piece ostomy closed pouch
60 ea/month
with filter, NON-CONVEX
One-piece ostomy closed pouch
60 ea/month
with filter, CONVEX
Two-piece ostomy closed pouch
60 ea/month
with filter for non-locking system
Ostomy supply, miscellaneous
*no maximum listed
Two-piece ostomy closed pouch
60 ea/month
with filter for locking system
One-piece ostomy drainable pouch
20 ea/month
with filter
Two-piece ostomy drainable pouch
20 ea/month
with filter for non-locking system
Two-piece ostomy drainable pouch
20 ea/month
without filter for locking system
Two-piece ostomy drainable pouch
20 ea/month
with filter for locking system
Two-piece ostomy urinary pouch
20 ea/month
for locking system
Stoma cap
31 ea/month
One-piece ostomy drainable pouch
20 ea/month
A4404
A4405
A4406
A4414
A4415
200/month
35/month
200/month
A4416
A4417
A4419
200/month
200/month
1/month
2/month
A4421
A4423
A4424
A4425
A4426
A4427
2/month
A4433
A5055
A5061
Usual Maximum
Medicare Utilization – Ostomy
Medicare Utilization – Continence
The information in this document is informational only, general
in nature, and does not cover all payers’ rules or policies. This
information was obtained from third party sources and is subject
to change without notice as a result of changes in reimbursement
regulations and payer policies. This document represents no promise
or guarantee by Coloplast Corp. regarding coverage or payment
for products or procedures by CMS or other payers. Providers are
responsible for reporting the codes that most accurately describe
the patient’s medical condition, procedures performed and products
used. Providers should check Medicare bulletins, manuals, program
memoranda and Medicare guidelines to ensure compliance
with Medicare requirements. Inquires should be directed to the
appropriate other payer for non-Medicare coverage situations.
* Elastic Barrier Strips: 40 strips/month
220
www.coloplast.us
1.800.533.0464
1.800.533.0464
Coloplast
221
Description
A5063
Two-piece ostomy drainable pouch
for barrier with flange, non-filter
One-piece ostomy urinary pouch
Two-piece ostomy urinary pouch
Skin barrier wipes or swabs, each
Solid skin barrier, 6x6 or equivalent,
each
Solid skin barrier, 8x8 or equivalent,
each
A5071
A5073
A5120
A5121
A5122
Usual Maximum
20 ea/month
20 ea/month
20 ea/month
150 ea/6 months
20 ea/month
20 ea/month
Medicare Utilization - Wound Care
Usual maximum limits from the Medicare Local Coverage
Determinations (LCD) are shown below. Suppliers should examine
their applicable Medicare contractor policies for full examination of
policy requirements, including medical necessity and documentation.
HCPCS*
Description
A6196
A6197
A6199
Alginate dressing < 16 sq. in.
Once per Day
Alginate dressing >16 < 48 sq. in.
Once per Day
Alginate dressing wound filler, per 6
Once per Day
inches
Sterile foam dressing < 16 sq. in.
Up to 3 times/
without border
week
Sterile foam dressing >16 < 48 sq.
Up to 3 times/
in. without border
week
Sterile foam dressing > 48 sq. in.
Up to 3 times/
without border
week
Sterile foam dressing < 16 sq. in with
Up to 3 times/
border
week
Sterile foam dressing >16 < 48 sq.
Up to 3 times/
in. with border
week
Sterile hydrocolloid dressing < 16 sq.
Up to 3 times/
in. without border
week
Sterile hydrocolloid dressing >16 < 48
Up to 3 times/
sq. in. without border
week
Sterile hydrocolloid dressing > 48 sq.
Up to 3 times/
in. without border
week
Sterile hydrocolloid dressing < 16 sq.
Up to 3 times/
in.with border
week
Sterile hydrocolloid dressing >16 < 48
Up to 3 times/
sq. in. with border
week
Sterile hydrocolloid dressing > 48 sq.
Up to 3 times/
in. with border
week
Sterile hydrocolloid dressing filler,
Up to 3 times/
paste, per ounce
week
Sterile hydrogel dressing gel, filler,
Must substantiate
per ounce
medical necessity
if > 3 fl. oz. per
wound/30 days
Sterile wound cleanser, any type/size
Not covered
under the surgical
dressing benefit
A6209
A6210
A6211
A6212
A6213
A6234
A6235
A6236
A6237
A6238
A6239
A6240
A6248
A6260
Usual Maximum
Medicare Utilization – Wound Care
Medicare Utilization – Ostomy
HCPCS*
A6203
A6204
A6206
A6207
A6251
A6252
222
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1.800.533.0464
1.800.533.0464
Coloplast
223
HCPCS Codes
Coloplast Corporation makes no warranties or guarantees,
expressed or implied, concerning the accuracy or
appropriateness for any particular purpose of the information
contained in this guide. It is provided for informational
purposes only. It is neither legal advice nor advice about
how to code, complete or submit any particular claim for
payment or to increase or maximize reimbursement by any
third party payer. Although we supply this information to the
best of our current knowledge, reimbursement policy
changes frequently change, often without notice. Where
HCPCS codes are listed for individual products, they have
been verified or are in the process of being verified with the
PDAC, the contractor charged with assigning codes to
products billed to the Medicare program.
Recommendations made by the PDAC are intended to
provide guidance for Medicare claims only. Although,
providers should be aware that non-Medicare payers may
follow the PDAC recommendations as well. Existence of or
assignment to a particular code with or without an
associated payment amount does not guarantee coverage
or payment. Because requirements for coverage, codes,
and payment vary from payer to payer, providers should
always verify specific requirements with each payer prior to
submitting claims for payment. Ultimately, the decision for
assigning codes and billing individual claims is the
responsibility of the provider.
A4310
A4311
A4314
A4320
A4322
A4331
A4332
A4334
A4335
A4338
A4340
A4344
A4346
A4349
A4351
A4352
A4353
A4354
A4357
A4358
A4361
A4362
A4367
A4368
A4369
A4371
A4373
A4385
A4388
A4389
A4390
A4391
A4392
224
www.coloplast.us
1.800.533.0464
Insert tray without drainage bag and without catheter
(accessories only)
Insertion tray without drainage bag with indwelling
catheter; Foley type, two-way latex with coating (teflon,
silicone, silicone elastomer or hydrophilic, etc.)
Insertion tray with drainage bag with indwelling catheter,
foley type, two-way latex with coating (teflon, silicone,
silicone elastomer or hydrophilic, etc.)
Irrigation tray with bulb or piston syringe, any purpose
Irrigation syringe, bulb or piston, each
Extension drainage tubing, any type, any length, with
connector/adapter, for use with urinary leg bag or
urostomy pouch, each
Lubricant, individual sterile packet, each
Urinary catheter anchoring device, leg strap, each
Incontinence supply; miscellaneous
Indwelling catheter; Foley type, two-way latex with
coating
(teflon, silicone, silicone elastomer, or hydrophilic, etc.),
each
Indwelling catheter, specialty type, (e.g., coudé,
mushroom, wing, etc.), each
Indwelling catheter; Foley type, two-way, all silicone, each
Indwelling catheter; Foley type, three-way for continuous
irrigation, each
Male external catheter, with or without adhesive,
disposable, each
Intermittent urinary catheter; straight tip, with or without
coating (teflon, silicone, silicone elastomer, or hydrophilic,
etc.), each
Intermittent urinary catheter; coudé (curved) tip, with or
without coating (teflon, silicone, silicone elastomer, or
hydrophilic, etc.), each
Intermittent urinary catheter, with insertion supplies
Insertion tray with drainage bag but without catheter
Bedside drainage bag, day or night, with or without
anti-reflux device, with or without tube, each
Urinary drainage bag, leg or abdomen, vinyl, with or
without tube, with straps, each
Ostomy faceplate, each
Solid skin barrier; solid, 4x4 or equivalent; each
Ostomy belt, each
Ostomy filter, any type, each
Skin barrier liquid, per ounce
Skin barrier powder, per ounce
Skin barrier with flange, CONVEX
Extended wear barrier, solid 4 x 4" or equivalent, each
One-piece ostomy drainable pouch with extended wear
barrier, FLAT
One-piece ostomy drainable pouch with barrier, CONVEX
One-piece drainable pouch with extended wear, CONVEX
One-piece urinary pouch with extended wear barrier,
FLAT
One-piece urinary pouch with standard wear barrier,
CONVEX
1.800.533.0464
Coloplast
HCPCS Codes
HCPCS Codes
Disclaimer
225
HCPCS Codes
HCPCS Codes
HCPCS Codes
A4393
A5071
A5073
A5112
A5113
A5114
A5120
A5121
A5122
A5131
A4394
A4397
A4398
A4399
A4404
A4405
A4406
A4407
A4408
A4409
A4410
A4414
A4415
A4416
A4417
A4419
A4421
A4423
A4424
A4425
A4426
A4427
A4433
A4455
A4456
A5055
A5056
A5057
A5061
A5063
A5071
A5073
A5112
A5113
A5114
226
One-piece urinary pouch with extended wear barrier,
CONVEX
Ostomy pouch liquid deodorant; per fluid ounce
Irrigation supply sleeve, each
Irrigation bag, each
Irrigation cone/catheter with or without brush
Ostomy ring, each
Ostomy paste (non-pectin based), per ounce
Ostomy paste (pectin based), per ounce
Two-piece ostomy skin barrier with flange, extended
wear, CONVEX (4x4 inches or smaller)
Two-piece ostomy skin barrier with flange, extended wear
CONVEX, greater than 4x4
Two-piece ostomy skin barrier with flange, extended wear
(4x4 inches or smaller)
Two-piece ostomy skin barrier with flange, extended
wear, FLAT, greater than 4x4
Two-piece ostomy skin barrier with flange, standard wear,
FLAT (4x4 inches or smaller)
Two-piece ostomy skin barrier, with flange, standard
wear, NON-CONVEX, greater than 4x4
One-piece ostomy closed pouch with filter, FLAT
One-piece ostomy closed pouch with filter, CONVEX
Two-piece ostomy closed pouch with filter for nonlocking system
Ostomy supply, miscellaneous
Two-piece ostomy closed pouch with filter for locking
system
One-piece ostomy drainable pouch with filter
Two-piece ostomy drainable pouch with filter for nonlocking system
Two-piece ostomy drainable pouch without filter for
locking system
Two-piece ostomy drainable pouch with filter for locking
system
Two-piece ostomy urinary pouch for locking system
Adhesive remover or solvent (for tape, cement or other
adhesive), per ounce
Adhesive remover, wipes, any type, each
Stoma cap
One-piece extended wear drainable pouch with filter,
FLAT
One-piece extended wear drainable pouch with filter,
CONVEX
One-piece ostomy drainable pouch
Two-piece ostomy drainable pouch for barrier with flange
One-piece ostomy urinary pouch with standard wear
barrier, FLAT
Two-piece ostomy urinary pouch for barrier with nonlocking flange
Urinary bag, leg or abdomen; latex
Leg strap; latex, replacement only, per set
Leg strap, foam or fabric, replacement only, per set
www.coloplast.us
1.800.533.0464
A6154
A6196
A6197
A6199
A6209
A6210
A6211
A6212
A6213
A6234
A6235
A6236
A6237
A6238
A6239
A6240
A6248
A6260
One-piece ostomy urinary pouch
Two-piece ostomy urinary pouch
Urinary bag, leg or abdomen; latex
Leg strap; latex, replacement only, per set
Leg strap, foam or fabric, replacement only, per set
Skin barrier wipes or swabs, each
Solid skin barrier, 6x6 or equivalent, each
Solid skin barrier, 8x8 or equivalent, each
Appliance cleaner, incontinence and ostomy appliances,
per 16 ounces
Wound pouch, each
Alginate dressing < 16 sq. in.
Alginate dressing >16 < 48 sq. in.
Alginate dressing wound filler, per 6 inches
Sterile foam dressing < 16 sq. in. without border
Sterile foam dressing >16 < 48 sq. in. without border
Sterile foam dressing > 48 sq. in. without border
Sterile foam dressing < 16 sq. in. with border
Sterile foam dressing >16 < 48 sq. in. with border
Sterile hydrocolloid dressing < 16 sq. in. without border
Sterile hydrocolloid dressing >16 < 48 sq. in. without
border
Sterile hydrocolloid dressing > 48 sq. in. without border
Sterile hydrocolloid dressing < 16 sq. in. with border
Sterile hydrocolloid dressing >16 <
48 sq. in. with border
Sterile hydrocolloid dressing > 48 sq. in. with border
Sterile hydrocolloid dressing filler, paste, per ounce
Sterile hydrogel dressing gel, filler, per fluid ounce
Wound cleanser any type/size
1.800.533.0464
Coloplast
227
228
www.coloplast.us
1.800.533.0464
Page #
Continence
110 ............... 13
112 ............... 13
114 ............... 13
116 ............... 13
208 ............... 13
210 ............... 13
212 ............... 13
214 ............... 13
240 ............... 13
305 ............... 13
306 ............... 13
308 ............... 13
310 ............... 13
408 ......... 13, 35
410 ......... 13, 35
412 ......... 13, 35
414 ......... 13, 35
416 ......... 13, 35
418 ............... 13
450 ............... 13
460 ............... 13
475 ............... 30
486 ............... 33
582 ............... 33
586 ............... 33
588 ............... 33
608 ......... 15, 33
610 ......... 15, 33
612 ......... 15, 33
614 ......... 15, 33
806 ............... 15
808 ............... 15
810 ............... 15
812 ......... 15, 34
814 ......... 15, 34
816 ............... 15
818 ............... 15
1008 ....... 18, 35
1010 ....... 18, 35
1012 ....... 18, 35
1014 ....... 18, 35
1016 ....... 18, 35
1108 ....... 19, 35
1110 ....... 19, 35
1112 ....... 19, 35
1114 ....... 19, 35
1116 ....... 19, 35
2114 ............. 19
2214 ............. 19
2614 ............. 19
2814 ............. 19
2816 ............. 19
3114 ............. 18
3214 ............. 18
3408 ............. 43
1.800.533.0464
Code
Page #
3614 ............. 18
3814 ............. 18
3816 ............. 18
4065 ............. 43
4110 ............. 12
4112 ............. 12
4114 ............. 12
4116 ............. 12
4200-B .... 25, 43
4210 ............. 12
4212 ............. 12
4214 ............. 12
4306 ............. 12
4308 ............. 12
4310 ............. 12
4408 ............. 12
4410 ............. 12
4412 ............. 12
4414 ............. 12
4416 ............. 12
4418 ............. 12
4608 ............. 14
4610 ............. 14
4612 ............. 14
4614 ............. 14
4808 ............. 14
4810 ............. 14
4812 ............. 14
4814 ............. 14
4816 ............. 14
5021 ............. 36
5021H .................
5025 ............. 36
5025H ........... 36
5030 ............. 36
5030H ........... 36
5035 ............. 36
5035H ........... 36
5040 ............. 36
5040H ........... 36
5062 ............. 26
5070 ............. 31
5100 ....... 23, 38
5110 ............. 24
5120 ............. 39
5120H ........... 39
5125 ............. 37
5130 ....... 37, 38
5130H ........... 37
5135 ............. 37
5135H ........... 37
5140 ............. 37
5140H ........... 37
5161 ....... 25, 41
5167 ....... 25, 41
5170 ............. 26
Code
Page #
5171 ............. 26
5174 ............. 26
5190 ............. 23
5200 ....... 23, 38
5200H ........... 37
5205 ............. 37
5205H ........... 37
5210 ....... 24, 37
5210H ........... 37
5212 ............. 37
5215 ............. 37
5221 . 23, 36, 39
5221H ........... 39
5225 ....... 23, 36
5225H ..... 23, 36
5230 . 23, 36, 38
5230H ..... 23, 36
5235 ....... 23, 36
5235H ..... 23, 36
5240 ....... 23, 36
5240H ..... 23, 36
5290 ............. 23
5300 ....... 23, 38
5310 ............. 24
5330 ............. 38
5390 ............. 23
5400 ....... 23, 38
5410 ....... 24, 43
5420 ............. 43
5430 ............. 38
5490 ............. 23
5500 ....... 23, 38
5510 ............. 38
5530 ............. 38
5590 ............. 23
5603 ...................
5604 ...................
5605 ...................
5606 ............. 38
5607 ............. 38
6100 ............. 22
6130 ............. 22
6200 ............. 22
6230 ............. 22
6300 ............. 22
6330 ............. 22
6400 ............. 22
6430 ............. 22
6500 ............. 22
6530 ............. 22
7077 ............. 40
7078 ............. 40
7079 ............. 40
7080 ....... 30, 43
7087 ............. 40
7088 ............. 40
Coloplast
Index
Code
229
Page #
7089 ............. 40
7090 ....... 30, 43
7092 ............. 30
7093 ............. 41
7094 ............. 41
7096 ............. 41
7097 ............. 41
7200 ....... 24, 37
7250 ....... 24, 37
7275 ....... 24, 37
7800 ............. 38
7850 ............. 38
7875 ............. 38
8000 . 24, 38, 39
8030 . 24, 37, 39
8100 ............. 24
8200 . 24, 37, 38
8205 ....... 24, 37
8212 ............. 34
8214 ............. 34
8230 ....... 24, 37
8235 ....... 24, 37
8300 ............. 24
8305 ............. 24
8400 . 24, 37, 38
8430 ....... 24, 37
8500 ............. 24
9000 ....... 40, 41
9001 ....... 40, 41
9002 ....... 40, 41
9003 ....... 40, 41
9010 ............. 41
9408 ............. 35
9410 ............. 35
9412 ............. 35
9414 ............. 35
9416 ............. 35
19408 ........... 35
19410 ........... 35
19412 ........... 35
19414 ........... 35
19416 ........... 35
21026 ..... 40, 41
21027 ..... 40, 41
21034 ..... 40, 41
21053 ........... 25
21054 . 25, 40, 41
21346 ........... 26
21356 ........... 26
22011 ..... 36, 39
22011H ......... 39
22012 ..... 36, 39
22012H ......... 39
22013 ..... 36, 39
22013H ......... 39
22014 ..... 36, 39
Coloplast
Code
Page #
22014H ......... 39
22025 ..... 21, 22
22030 ........... 22
22035 ........... 22
22040 ..... 22, 38
22121 . 22, 36, 39
22125 ..... 22, 36
22130 ..... 22, 36
22135 ..... 22, 36
22312 ........... 30
25502 ........... 26
28005 ........... 35
28005S ... 17, 35
28006 ........... 35
28006S ... 17, 35
28007 ........... 35
28007S ... 17, 35
28008 ........... 35
28008S ... 17, 35
28009 ........... 17
28009S ......... 17
28022S ......... 17
28023S ... 17, 34
28024S ... 17, 34
28026S ... 17, 34
28027 ..... 17, 34
28027S ......... 17
28028 ..... 17, 34
28028S ......... 17
28029S ......... 17
28032 ........... 17
28032S ......... 17
28033S ......... 17
28036 ........... 17
28036S ... 17, 34
28037 ........... 17
28037S ......... 17
28191 ........... 34
28192 ........... 34
28194 ........... 34
28241 ........... 34
28242 ........... 34
28244 ........... 34
28408 ........... 10
28410 ........... 10
28412 ........... 10
28414 ........... 10
28416 ........... 10
28418 ........... 10
28481 ........... 16
28482 ........... 16
28483 ........... 16
28484 ........... 16
28485 ........... 16
28486 ........... 16
28490 ........... 14
Code
Page #
28492 ........... 14
28494 ........... 14
28499 ........... 16
28500 ..... 16, 34
28501 ..... 16, 34
28502 ..... 16, 34
28503 ..... 16, 34
28504 ........... 16
28506 ........... 10
28508 ........... 10
28510 ........... 10
28512 ........... 10
28514 ........... 10
28516 ........... 10
28522 ........... 16
28524 ........... 16
28578 . 11, 16, 34
28580 ..... 11, 34
28582 ..... 11, 34
28584 ..... 11, 34
28606 ........... 10
28608 ........... 10
28610 ........... 10
28612 ........... 10
28638 ........... 34
28640 ........... 34
28642 ........... 34
28644 ........... 34
28706 ........... 10
28708 ........... 10
28710 ........... 10
28812 ........... 11
28814 ........... 11
34050 ........... 43
50501 ........... 31
51619 ..... 25, 41
51670 ........... 41
51679 ........... 25
68001 ........... 27
68003 R or L . 27
68004 ........... 27
68006 R or L . 27
68007 ........... 27
68300 ........... 31
90000 ........... 31
278809 ......... 16
AA 6C18 ....... 28
AA 6C20 ....... 28
AA 6C22 ....... 28
AA 6C24 ....... 28
AA 6106 ........ 28
AA 6108 .. 28, 32
AA 6110 .. 28, 32
AA 6112 .. 28, 32
AA 6114 .. 28, 32
AA 6116 .. 28, 32
1.800.533.0464
Code
AA 6118
AA 6120
AA 6122
AA 6124
AA 6308
AA 6310
AA 6312
AA 6314
AA 6316
AA 6318
AA 6320
AA 6322
AA 6324
AA 6408
AA 6410
AA 6412
AA 6414
AA 6416
AA 6418
AA 6420
AA 6422
AA 6424
CS 0120
CS 0140
CS 0160
CS 1120
CS 1140
CS 1160
UC 1008
UC 1010
UC 1012
UC 1014
UC 1016
UC 1018
UC 1020
UC 1022
UC 1024
UC 3516
UC 3518
UC 3520
UC 6012
UC 6014
UC 6016
UC 6018
UC 6020
UC 6022
UC 6512
UC 6514
UC 6516
UC 6518
UC 6520
UC 6522
UC 6524
UT 7015
UT 7030
UT 7035
Page #
.. 28, 32
.. 28, 32
.. 28, 32
.. 28, 32
........ 28
........ 28
. 29, 32, 42
. 29, 32, 42
. 29, 32, 42
. 29, 32, 42
. 29, 33, 42
. 29, 33, 42
.. 29, 42
........ 28
........ 28
........ 29
........ 29
........ 29
........ 29
........ 29
........ 29
........ 29
........ 33
........ 33
........ 33
........ 33
........ 33
........ 33
....... 32
....... 32
....... 32
....... 32
....... 32
....... 32
....... 32
....... 32
....... 32
....... 42
....... 42
....... 42
....... 32
....... 32
....... 32
....... 32
....... 33
....... 33
....... 42
....... 42
....... 42
....... 42
....... 42
....... 42
....... 42
........ 43
........ 43
........ 43
1.800.533.0464
Code
Page #
Ostomy
0420 ........... 187
0421 ........... 187
0509 ............. 91
0925 ............. 91
1003 ............. 94
1110 ............. 94
1500 ............. 93
1500H ........... 93
1525 ........... 187
1527 ........... 187
1751 ........... 116
1752 ........... 116
1754 ........... 115
1755 ........... 115
1756 ........... 115
1757 ........... 115
1758 ........... 115
1759 ........... 115
1789 ........... 172
1907 ........... 187
2041 ............. 91
2115 ........... 174
2125 ........... 174
2156 ........... 171
2161 ........... 171
2182 ........... 171
2310 ............. 90
2315 ............. 90
2320 ............. 90
2325 ............. 90
2330 ............. 90
2340 ............. 90
2350 ............. 90
2501 ... 152, 181
2650 ............. 89
2655 ........... 187
2801 . 113, 171, 184
2802 ... 113, 184
2807 ... 114, 172
2808 ........... 114
2831 ........... 106
2832 ........... 106
2833 ........... 106
2836 ........... 112
2837 ........... 112
2846 ........... 112
2847 ........... 112
2881 ........... 106
2882 ........... 106
2883 ........... 106
3210 ........... 187
3215 ........... 187
3220 ........... 187
4215 ..... 88, 187
4220 ............. 88
Code
Page #
4237
4240
4241
4247
4250
4260
4540
4550
4560
5070
5170
5540
5560
5570
5575
5580
5585
5600
5700
5800
5810
5825
5830
5835
5900
5901
5920
5925
5930
5935
5940
5945
5950
5960
6100
6101
6300
6325
6330
6335
6340
6345
6350
6360
6541
6542
6551
6552
6561
6562
6641
6642
6644
6651
6652
6654
............. 88
........... 185
........... 184
............. 88
........... 185
........... 185
........... 185
........... 185
........... 185
............. 92
........... 176
........... 181
........... 181
........... 154
........... 154
........... 153
........... 153
........... 181
........... 181
........... 179
........... 180
........... 179
........... 179
........... 179
........... 180
........... 180
........... 180
........... 180
........... 180
........... 180
........... 180
........... 180
........... 180
........... 180
........... 186
........... 186
........... 180
........... 181
........... 181
........... 181
........... 181
........... 181
........... 181
........... 181
........... 183
........... 183
........... 183
........... 183
........... 183
........... 184
........... 184
........... 184
........... 184
........... 184
........... 184
........... 184
Coloplast
Index
Index
230
Code
231
Page #
6661 ........... 184
6662 ........... 184
6664 ........... 184
7067 ........... 187
7680 ........... 187
8009 ........... 174
8114 ........... 112
8115 ........... 112
8116 ........... 112
9500 ..... 91, 163
10011 . 100, 182,
185
10012 ......... 100
10013 ......... 100
10015 ......... 100
10016 ......... 100
10017 ......... 100
10021 . 100, 185
10022 ......... 100
10023 ......... 100
10025 ......... 100
10026 ......... 100
10027 ......... 100
10031 . 100, 185
10032 ......... 100
10035 ......... 100
10036 ......... 100
10041 ......... 100
10045 ......... 100
10101 . 123, 170
10102 ......... 123
10103 ......... 123
10104 ......... 123
10105 ......... 123
10106 ......... 123
10108 ......... 123
10154 . 103, 104
10155 ......... 104
10156 ......... 104
10164 . 103, 184
10165 . 103, 184
10166 . 103, 184
10167 ......... 103
10461 ......... 175
10471 ......... 135
10472 ......... 135
10473 ......... 135
10474 ......... 135
10475 ......... 135
10476 ......... 135
10477 ......... 135
10478 ......... 135
10479 ......... 135
10480 ......... 135
10481 ......... 135
10482 ......... 135
Coloplast
Code
10483
10484
10485
10486
10487
10488
10489
10490
10491
10492
10493
10494
10495
10496
10502
10503
10504
10505
10506
10512
10513
10514
10515
10516
10522
10523
10524
10525
10531
10551
10561
10562
10563
10564
10565
10566
10567
10568
10571
10572
10573
10586
10811
10821
10822
10823
10824
10831
10833
10834
10835
10870
10871
10872
10873
10874
Page #
......... 135
......... 135
......... 135
......... 135
......... 135
......... 135
......... 136
......... 135
......... 135
......... 136
......... 136
......... 136
......... 136
......... 136
... 97, 172
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
........... 97
......... 121
......... 121
......... 121
......... 121
......... 121
......... 121
......... 121
......... 121
......... 121
......... 121
......... 121
......... 121
. 138, 175
......... 138
......... 138
......... 138
......... 138
......... 138
......... 137
......... 137
......... 137
......... 137
. 137, 175
. 137, 175
......... 137
......... 137
......... 137
Code
Page #
10881 ......... 136
10883 ......... 136
10884 ......... 136
10885 ......... 136
10911 ......... 125
10912 . 125, 183
10914 ......... 125
10915 . 125, 183
10917 . 125, 183
10918 ......... 125
11001 ......... 118
11002 ......... 118
11003 ......... 131
11004 ......... 117
11005 ......... 156
11006 ......... 131
11007 ......... 131
11008 ......... 156
11009 ......... 117
11010 ......... 117
11011 ......... 101
11011K ....... 130
11012 ......... 101
11015 ......... 101
11016 ......... 101
11021 ......... 101
11022 ......... 101
11023 ......... 101
11024 ......... 101
11025 ......... 101
11026 ......... 101
11027 ......... 101
11028 ......... 101
11031 ......... 101
11032 ......... 101
11035 ......... 101
11036 ......... 101
11041 ......... 101
11045 ......... 101
11114 ......... 102
11115 ......... 102
11124 . 102, 183
11125 ......... 102
11126 . 102, 182
11127 ......... 102
11135 . 102, 183
11136 . 102, 184
11185 . 102, 182,
183
11186 . 102, 182,
183
11194 . 102, 182,
183
11195 ......... 102
11196 ......... 102
11197 ......... 102
1.800.533.0464
Code
11301
11302
11303
11304
11305
11306
11307
11308
11312
11313
11314
11315
11401
11402
11412
11413
11421
11422
11425
11426
11461
11462
11463
11471
11472
11473
11474
11482
11483
11484
11486
11487
11488
11491
11492
11497
11498
11512
11514
11515
11517
11518
11590
11591
11612
11690
11803
11804
11805
11806
11807
11808
11809
11814
11816
11817
Page #
......... 123
......... 123
......... 123
......... 124
......... 124
......... 124
......... 123
......... 124
......... 123
......... 123
......... 123
......... 123
... 99, 173
........... 98
........... 99
........... 98
........... 99
........... 98
........... 98
........... 98
... 98, 173
........... 97
........... 97
........... 98
........... 97
........... 97
........... 98
........... 97
........... 97
........... 98
........... 97
........... 97
........... 98
... 99, 173
........... 99
........... 99
........... 99
......... 124
......... 124
. 124, 183
......... 124
......... 124
......... 124
......... 124
......... 124
......... 124
......... 142
......... 142
......... 142
......... 142
......... 142
......... 142
......... 142
......... 143
......... 143
......... 143
1.800.533.0464
Code
11818
11819
11841
11844
11845
11846
11851
11854
11855
11856
12000
12010
12011
12020
12021
12030
12042
12050
12060
12061
12100
12110
12130
12134
12135
12136
12137
12140
12144
12145
12146
12147
12149
12170
12174
12175
12176
12177
12202
12203
12213
12216
12222
12223
12262
12272
12273
12274
12281
12282
12283
12284
12344
12345
12346
12354
Page #
......... 143
......... 143
......... 105
......... 105
......... 105
......... 105
. 105, 184
. 104, 185
. 104, 185
. 104, 185
......... 187
......... 188
......... 188
......... 188
......... 188
......... 188
......... 188
........... 89
... 90, 187
... 90, 187
......... 179
......... 151
......... 150
......... 150
......... 150
......... 150
......... 179
......... 151
......... 151
......... 151
......... 151
......... 151
......... 151
......... 150
......... 150
......... 150
......... 150
......... 150
......... 122
......... 122
......... 122
......... 122
......... 122
......... 122
......... 121
......... 121
......... 121
......... 122
......... 122
......... 121
......... 121
......... 122
......... 113
......... 113
......... 113
......... 113
Code
12355
12356
12374
12375
12376
12384
12385
12386
12416
12419
12432
12433
12471
12472
12474
12527
12528
12529
12533
12567
12568
12569
12577
12578
12579
12595
12596
12620
12630
12660
12670
12701
12702
12703
12704
12705
12706
12707
12708
12716
12719
12800
12801
12802
12803
12805
12808
12810
12818
12820
12830
12834
12835
12836
12840
12841
Page #
......... 113
......... 113
......... 112
......... 112
......... 112
......... 112
......... 112
......... 112
......... 150
......... 150
......... 155
......... 155
......... 154
......... 154
......... 154
......... 111
......... 111
......... 111
. 148, 149
......... 182
......... 182
......... 182
......... 111
......... 111
......... 111
......... 155
......... 155
......... 148
......... 148
......... 148
......... 148
......... 108
......... 108
......... 108
......... 108
......... 108
......... 108
......... 108
......... 108
......... 108
......... 108
......... 160
... 91, 161
......... 160
... 91, 161
......... 161
......... 160
......... 160
......... 161
........... 94
........... 93
........... 94
........... 94
........... 94
......... 182
......... 106
Coloplast
Index
Index
232
Code
233
12842
12844
12845
12847
12848
12991
12992
12993
12994
12995
12996
12997
13703
13706
13840
13844
13845
13846
13860
13870
13874
13875
13876
13924
13925
13926
13964
13965
13966
13974
13975
13976
13984
13985
13986
14010
14015
14021
14031
14041
14050
14060
14070
14103
14106
14163
14164
14165
14166
14173
14174
14175
14176
14196
14204
14205
Page #
......... 106
......... 106
......... 106
......... 106
......... 106
......... 155
......... 155
......... 155
......... 155
......... 155
......... 155
......... 155
......... 149
......... 149
......... 145
......... 145
......... 145
......... 145
......... 145
......... 145
......... 145
......... 145
......... 145
......... 111
......... 111
......... 182
......... 111
......... 111
......... 111
......... 110
......... 110
......... 110
......... 110
......... 110
......... 110
... 92, 163
... 92, 163
... 92, 163
... 92, 163
... 92, 163
......... 162
......... 162
......... 162
......... 147
......... 147
......... 147
......... 147
......... 147
......... 147
......... 147
......... 147
......... 147
......... 147
. 147, 148
. 114, 172
......... 114
Coloplast
Code
14206
14222
14224
14225
14226
14227
14228
14229
14232
14233
14234
14235
14236
14237
14238
14239
14243
14246
14249
14250
14251
14252
14254
14255
14257
14258
14261
14262
14263
14271
14272
14273
14274
14275
14276
14277
14278
14281
14282
14283
14291
14292
14293
14294
14295
14296
14297
14298
14301
14302
14303
14304
14305
14306
14307
14308
Page #
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
114
153
115
115
115
115
115
115
109
109
109
109
109
109
109
109
109
109
109
106
106
106
106
106
106
106
107
107
107
107
107
107
107
107
107
107
107
107
107
107
108
108
108
108
108
108
108
108
125
125
125
125
125
125
169
169
Code
14309
14312
14314
14316
14317
14318
14319
14326
14327
14328
14329
14331
14332
14333
14334
14342
14344
14346
14347
14349
14355
14356
14357
14359
14361
14362
14363
14364
14379
14401
14403
14404
14405
14406
14408
14411
14412
14414
14415
14421
14422
14423
14424
14431
14432
14434
14435
14441
14442
14444
14445
14451
14452
14453
14454
14511
Page #
......... 125
......... 183
......... 183
. 129, 170
......... 129
......... 183
......... 129
......... 128
......... 128
......... 128
......... 128
......... 129
......... 129
......... 129
......... 129
......... 127
......... 127
. 128, 170
......... 128
......... 128
......... 128
......... 127
......... 127
......... 127
......... 127
......... 127
......... 183
......... 127
......... 126
......... 126
......... 126
......... 146
......... 146
......... 126
......... 126
......... 146
......... 146
......... 146
......... 146
......... 146
......... 146
......... 146
......... 146
......... 152
......... 152
......... 152
......... 152
......... 151
......... 151
......... 151
......... 151
......... 152
......... 152
......... 152
......... 152
......... 145
1.800.533.0464
Code
Page #
14512 ......... 145
14513 ......... 179
14514 ......... 179
14521 ......... 128
14525 ......... 128
14527 ......... 127
14552 . 129, 170
14553 ......... 129
14554 ......... 129
14555 ......... 129
14601 ......... 126
14602 ......... 126
14603 ......... 126
14642 ......... 126
14643 ......... 126
14644 ......... 126
14645 ......... 126
14646 ......... 126
14681 ......... 169
14682 ......... 169
14691 ......... 169
14692 ......... 169
14717 ......... 153
15480 . 141, 179,
181
15484 ......... 141
15521 ......... 139
15522 ......... 139
15523 ......... 139
15524 ......... 139
15531 ......... 139
15532 ......... 139
15533 ......... 139
15534 ......... 139
15606 ......... 140
15608 . 140, 179
15623 ......... 140
15624 ......... 140
15633 ......... 140
15634 ......... 140
15695 ......... 141
15696 ......... 141
15697 ......... 141
15698 ......... 141
15821 . 139, 179,
180, 181
15860 ......... 144
15861 ......... 179
15869 ......... 144
15870 ......... 144
15871 ......... 144
15874 ......... 144
15875 ......... 144
15876 ......... 144
15879 ......... 144
15954 ......... 110
1.800.533.0464
Code
Page #
15955 ......... 110
15956 ......... 110
15972 ......... 182
15973 ......... 182
15974 ......... 109
15975 ......... 109
15976 ......... 109
15981 ......... 140
15982 ......... 110
15983 ......... 110
15984 ......... 109
15985 ......... 109
15986 ......... 109
15991 ......... 140
15992 ......... 140
15993 ......... 140
15994 ......... 140
19001 ......... 160
19004 ......... 141
19010 ......... 159
19011 ......... 159
19020 ......... 159
19021 ......... 159
19030 ......... 159
19040 ......... 103
19041 ......... 103
19042 ......... 103
19050 ......... 103
19051 ......... 103
19052 ......... 103
19075 ... 90, 187
21001 ......... 130
21002 ......... 130
21003 ......... 130
21365 ........... 92
25502 ......... 176
26555 . 88, 164, 187
32105 ... 89, 187
32155 ... 89, 187
32205 ... 89, 187
120105 . 88, 188
120115 . 88, 188
120205 . 89, 188
120215 . 89, 188
120307 . 87, 188
120427 . 87, 188
120700 . 87, 164
120721 . 87, 164
120740 . 87, 164
Skin Care
0089
0101
0102
0107
0117
.............
.............
.............
.............
.............
75
79
79
79
79
Code
Page #
0119
0222
0283
0402
0403
0406
0407
0408
0424
0505
0506
0809
0821
0822
0824
0830
0849
0901
0904
1002
1005
1006
1246
1300
1301
1318
1337
1400
1410
1452
1453
1455
1607
1611
1622
1644
1645
1673
1701
1702
1703
1707
1710
1762
1764
1768
1802
1805
1806
1814
1843
1873
1877
1880
1944
1947
............. 79
............. 76
. 68, 76, 79
............. 68
............. 76
............. 68
............. 68
....... 68, 76
............. 68
............. 71
............. 71
............. 77
............. 78
............. 78
............. 78
............. 78
............. 78
............. 78
............. 78
............. 77
............. 70
....... 70, 77
............. 77
............. 66
............. 66
............. 79
............. 72
............. 78
............. 78
....... 67, 78
....... 67, 78
............. 67
............. 72
. 72, 77, 79
............. 72
....... 74, 77
............. 74
............. 77
............. 76
............. 76
............. 76
............. 76
............. 76
............. 66
............. 66
....... 66, 77
............. 69
............. 79
............. 77
. 69, 77, 79
............. 69
............. 70
............. 70
............. 70
............. 70
............. 70
Coloplast
Index
Index
234
Code
235
Index
236
Code
Page #
7011 ............. 76
7015 ............. 70
7021 ............. 77
7031 ............. 78
7041 ............. 74
7051 ............. 76
7055 ............. 67
7056 ............. 67
7065 ............. 79
7066 ............. 76
7067 . 68, 76, 79
7068 ....... 68, 76
7069 ............. 68
7090 ............. 68
7091 ............. 68
7092 ............. 68
7095 ............. 68
7143 ............. 66
7145 ............. 66
7146 ....... 66, 78
7147 ....... 66, 78
7201 . 67, 76, 78
7203 ............. 76
7205 ....... 67, 78
7207 ....... 67, 78
7229 ............. 76
7230 ....... 67, 76
7231 ............. 67
7233 . 67, 76, 77
7234 . 67, 76, 77
7235 ....... 67, 76
7236 ....... 67, 76
7251 ............. 75
7252 ............. 75
7300 ............. 66
7301 ............. 66
7565 ............. 70
7566 ............. 70
7567 ............. 70
7570 ............. 72
7571 ............. 72
7572 ............. 72
7581 ............. 79
7583 ............. 79
7584 ............. 79
7662 ............. 76
7664 ............. 76
7666 ............. 79
7710 ............. 71
7712 ....... 71, 79
7725 ....... 71, 79
7726 ............. 79
7910 ............. 73
7912 ............. 73
67088 ........... 71
Coloplast
Code
Page #
Wound Care
0925
1061
1063
1166
1964
1967
2041
3110
3115
3120
3146
3213
3218
3233
3280
3283
3285
3350
3353
3356
3410
3412
3413
3416
3420
3423
3430
3434
3435
3444
3465
3467
3470
3473
3475
3485
3488
3530
3533
3536
3539
3542
3545
3705
3710
3715
3740
3755
3760
3765
3780
3810
3812
3814
3816
............. 55
............. 57
............. 57
............. 57
............. 57
............. 57
............. 55
............. 55
............. 55
....... 55, 60
............. 55
............. 56
............. 56
............. 56
............. 56
............. 56
............. 56
............. 56
............. 56
............. 56
............. 50
............. 60
............. 50
............. 50
............. 50
............. 50
............. 50
............. 49
............. 49
............. 49
............. 60
............. 60
............. 50
............. 50
............. 50
............. 51
............. 50
....... 55, 60
....... 55, 60
............. 55
............. 55
............. 60
............. 60
............. 53
............. 53
............. 53
............. 53
............. 54
............. 54
............. 54
............. 54
............. 60
............. 60
............. 60
............. 60
Code
Page #
3818 ............. 60
3900 ............. 57
3903 ............. 57
3906 ............. 57
3910 ............. 58
3912 ............. 58
3915 ............. 58
3920 ............. 58
6105 ....... 50, 60
7690 ............. 57
9610 ............. 60
9612 ............. 60
9622 ............. 51
9625 ............. 51
9632 ....... 51, 60
9635 ....... 51, 60
9636 ............. 52
9637 ............. 52
9638 ............. 52
9641 ............. 52
9643 ............. 52
33436 ........... 49
33437 ........... 49
33438 ........... 49
33445 ........... 49
33446 ........... 49
46100 ........... 59
46120 ........... 59
46150 ........... 59
46200 ........... 59
46250 ........... 59
46300 ........... 59
46320 ........... 59
46350 ........... 59
46390 ........... 59
46450 ........... 59
1.800.533.0464
Coloplast develops products
and services that make life easier
for people with very personal and
private medical conditions.
Working closely with the people
who use our products, we create
solutions that are sensitive to
their special needs. We call this
intimate healthcare.
Our business includes ostomy
care, urology and continence
care and wound and skin care.
We operate globally and employ
more than 8,500 people.
For additional information, contact us at:
1.800.533.0464
[email protected]
www.coloplast.us
Coloplast Corp.
Minneapolis, MN 55411
1.800.533.0464
The Coloplast logo is a registered trademark of Coloplast A/S.
© 2014 Coloplast Corp. All rights reserved.
Velcro® is a registered trademark of Velcro Industries B.V.
www.coloplast.us
M1170N 11.14

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