[dchavez]

I DO BILLING AND CODING FOR DME COMPANY, OF COURSE IN BILLING SOMETHING NEW IS LEARNED EVERYDAY. I AM TRYING TO BILL FOR INDEWLLING CATHETERS FOR A BENEF. DOES ANYONE KNOW HOW MANY DOES MEDICARE COVER A MONTH?

[DMEisgoodfun]

INDWELLING CATHETERS (A4311 - A4316, A4338 - A4346):

No more than one catheter per month is covered for routine catheter
maintenance. Non-routine catheter changes are covered when documentation
substantiates medical necessity, such as for the following indications:


1.Catheter is accidentally removed (e.g., pulled out by patient)

2.Malfunction of catheter (e.g., balloon does not stay inflated, hole in
catheter)

3.Catheter is obstructed by encrustation, mucous plug, or blood clot

4.History of recurrent obstruction or urinary tract infection for which it
has been established that an acute event is prevented by a scheduled change
frequency of more than once per month

[dchavez]

Okay, i just released 2 boxes of 30 to benef; i went into to noridian and i read they allow 200 a month? Did i realt it wrong? I am confused..

[DMEisgoodfun]

Indwelling is 1/mo. Intermittent is 200/mo.

[dchavez]

Thank you very much for taking the time to answer my question.