Urological Supplies - JA DME
Urological Supplies
Coverage
- Urinary Drainage Bags (230.17) National Coverage Determination (NCD)
- Urological Supplies Local Coverage Determination (LCD)
- Urological Supplies Policy Article
Documentation
- Standard Documentation Requirements for All Claims Submitted to DME MACs
- 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 Fri, 28 Jan 2022 14:34:56 +0000
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