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 |
Tips
Topic | Details |
---|---|
Continued Medical Need |
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Last Updated Wed, 12 Oct 2022 16:57:07 +0000
Related Articles
The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.