Product Manual
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839263 9.7” x 6.3” 5 per box A6154
Eakin
®
Fistula and Wound Pouch
Suitable for horizontal cutting area of 9.7” x 6.3”
with remote drainage attachment and tap closure
839264 9.7” x 6.3” 5 per box A6154
Eakin
®
Fistula and Wound Pouch
Open-top pouch for easy access to horizontal cutting
area of 9.7” x 6.3” with remote drainage attachment,
tap closure, and WINDOW
839265 9.7” x 6.3” 5 per box A6154
Eakin
®
Fistula and Wound Pouch
Suitable for vertical cutting area of 9.7” x 6.3” with
remote drainage attachment and tap closure
Product Code Size Qty. HCPCS
Product Code Size Qty. HCPCS
Product Code Size Qty. HCPCS
A4331 Extension Drainage Tube 1 per 6 months
A4330 Stool Collection Pouch As needed
A4333 Urinary Catheter Anchoring Device As needed
A4335 Urinary Supply, Miscellaneous As needed
A4361 Ostomy Faceplate 3 per 6 months
A4362 Skin Barrier, Solid, 4x4 or Equivalent 20 per month
A4363 Ostomy Clamp, Any Type, Replacement Only As needed
A4365 Adhesive Remover Wipes, per 50 As needed
A4367 Ostomy Belt 1 per month
A4371 Ostomy Skin Barrier Powder 10 oz per 6 months
A4385 Skin Barrier, Solid 4x4 or Equivalent, As needed
Extended Wear
A4388 Pouch, Drainable, w/Extended Wear As needed
Barrier Attached
A4390 Pouch, Drainable, w/Extended Wear Barrier, As needed
w/convexity
A4393 Pouch, Urinary, w/Extended Wear Barrier As needed
Attached, w/convexity
A4397 Irrigation Sleeve 4 per month
A4398 Ostomy Irrigation Bag 2 per 6 months
A4399 Ostomy Irrigation Cone/Catheter, and Brush 2 per 6 months
A4406 Ostomy Skin Barrier, Pectin-Based, Paste 4 oz per month
A4407 Skin Barrier, w/Flange, Extended Wear As needed
w/ Convexity
A4409 Skin Barrier, w/Flange, Extended Wear <= 4x4 As needed
A4410 Skin Barrier, w/Flange, Extended Wear > 4x4 As needed
A4413 Pouch, Drainable, High Output, for Barrier As needed
w/Flange
A4414 Skin Barrier, w/Flange, <= 4x4 20 per month
A4415 Skin Barrier, w/Flange, > 4x4 20 per month
A4416 Pouch, closed, w/Barrier Attached, w/Filter 60 per month
A4419 Pouch, closed for use on Barrier w/Flange, 60 per month
w/Filter
A4421 Ostomy Supply, Miscellaneous As needed
A4423 Pouch, closed, for use on Barrier 60 per month
w/Locking Flange, w/Filter
A4425 Pouch, Drainable, with filter for use w/Flange 20 per month
A4426 Pouch, Drainable for use on Barrier 20 per month
w/Locking Flange
A4428 Pouch, Urinary, w/ Extended Wear Barrier As needed
w/Faucet-type Tap
A4432 Pouch, Urinary, for use on Barrier w/Flange, 20 per month
w/Faucet-type Tap
A4434 Pouch, Urinary for use on Barrier 20 per month
w/Locking Flange, w/Faucet-type Tap
A5054 Pouch Closed, for Barrier w/Flange 60 per month
A5055 Stoma Cap, each 31 per month
A5061 Pouch, Drainable, w/Barrier Attached 20 per month
A5063 Pouch, Drainable, for use w/Flange 20 per month
A5071 Pouch, Urinary, w/Barrier Attached 20 per month
A5073 Pouch, Urinary, for Barrier w/Flange 20 per month
A5093 Ostomy Accessory, Convex Insert 10 per month
A5102 Bedside Drainage Bottle w/ or wo/ tubing, 2 per 6 months
rigid or expandable
A5120 Skin Barrier, Wipes, each 150 per 6 months
A5122 Skin Barrier, Solid, 8 X 8 or Equivalent 20 per month
HCPCS HCPCS Medicare Usual
Descriptors Maximum Qty.
Medicare Utilization Charts
839268 9.7” x 6.3” 5 per box A6154
Eakin
®
Fistula and Wound Pouch
Suitable for vertical cutting area of 9.7” x 6.3” with
remote drainage attachment, tap closure, and WINDOW
Product Code Size Qty. HCPCS
839266 11.4” x 5.1” 5 per box A6154
Eakin
®
Fistula and Wound Pouch
Suitable for vertical cutting area of 11.4” x 5.1” with
remote drainage attachment and tap closure
Product Code Size Qty. HCPCS
839280 n/a 5 per box
Eakin
®
Access Window
™
Add to Eakin
®
Fistula and Wound Manager to allow
instant access to the wound (may be used with 839252,
839253, 839262, 839263, 839265, 839266)
Product Code Size Qty. HCPCS
839267 2.4” x 3.14” 10 per box A6154
Eakin
®
Fistula and Wound Pouch
Suitable for cutting area of 2.4” x 3.14” with
remote drainage attachment and tap closure
Product Code Size Qty. HCPCS