[Regina]

I am suddenly getting denials for surgical lubricant(A4402) provided with catheters as not medically necessary. Can anyone help me with this? Thanks!

[Regina]

I am still having this problem, and am wondering if anyone else is also. I was checking policy, and this is on the Region A LCD site-

For each episode of covered catheterization, Medicare will cover: A. One catheter (A4351, A4352) and an individual packet of lubricant (A4332); or B. One sterile intermittent catheter kit (A4353) if additional coverage criteria (see below) are met. So, does this mean that they no longer cover lubricant by the tube?

[annszcz]

We have been being paid, by A4402 with Kx modifier only. = A4402kx.
I would check your modifier.

[Regina]

I am getting the denial with the KX mod.
We are billing for A4352, which is a coude intermittent catheter with or without coating. Could that be the issue?

[annszcz]

For each episode of covered catheterization, Medicare will cover:
One catheter (A4351, A4352) and an individual packet of lubricant (A4332
You may want to supply the pt the A4332 per packet.(Steril Lubricant)
Per above Medicare's guidelines.

The code we are billing A4402 is paying no guidelines attach to
just Lubricant per 0z. I looked more into our account we are billing The pt is also receiving
other supplies, so maybe that is why we are rec'ing pymt for the A4402. Pt has Non sterile items
also, Etc.)
Hope this was little more helpful to you