HCPCS Code A5120: Skin Barrier, Wipes or Swabs, Each

HCPCS code A5120 is defined as a "Skin barrier, wipes or swabs, each," used in ostomy care to protect the skin around the stoma from irritation and damage caused by adhesives and bodily fluids.

Medicare covers HCPCS code A5120 (skin barrier wipes or swabs) as medically necessary ostomy supplies. Coverage requires a valid prescription and supplier enrollment in Medicare. Medicare Part B covers HCPCS code A5120 when billed as a durable medical equipment (DME) benefit, typically paying 80% of the approved amount after the Part B deductible, with the patient responsible for the remaining 20% coinsurance. Usual maximum quantities apply; amounts above the usual maximum require medical-record justification.

Documentation requirements for HCPCS code A5120 include a standard written order with patient details, item description (HCPCS code or narrative), quantity, practitioner’s name and signature, and order date. Medical records must verify the need for ostomy care due to a surgically created stoma. The AU modifier is required on claims. Delivery and refill documentation are necessary for compliance. Quantity limits and medical necessity must be documented, especially for amounts exceeding usual limits.