Coverage

• Urological Supplies Local Coverage Determination (LCD) and Policy Article [PDF]

Documentation

Document Type	Description
Documentation Checklist [PDF]	Suppliers may use this checklist to ensure all required documentation is gathered

 

Reviews/Audits

Review Type	Description
Medical Review	View notifications and findings of pre and post claim reviews completed by Noridian Medical Review Staff

 

Bundling

Per the bundling table listed in Policy Article A52521:

• When the bundled code listed in Column I is billed, the codes in column II are not separately payable.
• When the codes in Column II are provided at the same time, it must be billed with the bundled code listed in Column I.

Column I	Column II
A4310	A4332
A4311	A4310, A4332, A4338
A4312	A4310, A4332, A4344
A4313	A4310, A4332, A4346
A4314	A4310, A4311, A4331, A4332, A4338, A4354, A4357
A4315	A4310, A4312, A4331, A4332, A4344, A4354, A4357
A4316	A4310, A4313, A4331, A4332, A4346, A4354, A4357
A4354	A4310, A4331, A4332, A4357
A4357	A4331
A4358	A4331, A5113, A5114
A5105	A4331, A4358, A5112, A5113, A5114
A5112	A5513, A5114