Article Detail - JA DME

When determining if additional documentation is needed with the claim, the combined utilization of the catheter codes (A4314, A4315, A4316, A4354) and the additional drainage bag code (A4357) within a month should be considered. For instance, if one unit of A4314 and one unit of A4357 are provided, it should be treated as two drainage bags, which is generally the maximum quantity of drainage bags needed for routine changes. This helps ensure that claims are accurate and that any unusual usage patterns are properly documented and justified.

More information can be found in the Urological Supplies - Policy Article (A52521)