Urological Supplies - JA DME
Urological Supplies
The Standard Written Order (SWO) requirements are in effect for dates of service January 1, 2020 and after.
Refer to the SWO page for the elements needed in this streamlined order.
Coverage
- Urinary Drainage Bags (230.17) National Coverage Determination (NCD)
- Urological Supplies Local Coverage Determination (LCD)
- Urological Supplies Policy Article
Documentation
- Clinician Checklist Urological Supplies [PDF] - Checklist to assist clinicians with coverage and documentation requirements
- Clinician Letter - Intermittent Urinary Catheterization [PDF] - Letter may be sent to clinicians to assist in obtaining documentation
- Urological Supplies Documentation Checklist [PDF] - Checklist to ensure suppliers gather all required documentation
Reviews/Audits
- Medical Review - View notifications/findings of pre/post claim reviews completed by Noridian Medical Review
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 |
Last Updated Thu, 07 Oct 2021 19:13:57 +0000
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