Correct Coding – SpeediCath® Flex Coudé Catheter (Coloplast)
DME MAC Joint Publication
Intermittent urinary catheters are eligible for Medicare payment when the requirements described in the Urological Supplies Local Coverage Determination (LCD L33803) and related Policy Article (A52521) are met. Intermittent catheters are classified as “straight” or “coudé” catheters. Straight catheters are flexible and able to bend or adjust to the path of a urethra as it is used. In some clinical scenarios, the urethra is tortuous, constricted or twisted to a degree that makes it difficult to pass a typical straight catheter. In these situations, a coudé catheter is often used. A coudé catheter has a fixed, curved tip that allows it to more easily be moved through a tortuous urethra.
Recently, Coloplast introduced the SpeediCath® Flex Coudé Catheter. Although the term “coudé” is part of the product name, this item is a straight catheter without the characteristic permanent, curved tip that distinguishes a coudé catheter. The SpeediCath® Flex Coudé Catheter has a tip that is thinner and more flexible than the typical straight catheter. Despite the use of the term “coudé” as part of the product name, the SpeediCath® Flex Coudé Catheter is classified as a straight catheter. For Medicare billing purposes, the correct HCPCS code for this product is:
A4351 - INTERMITTENT URINARY CATHETER; STRAIGHT TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, SILICONE ELASTOMER, OR HYDROPHILIC, ETC.), EACH.
Claims for this item must not be submitted using HCPCS code A4352 [INTERMITTENT URINARY CATHETER; COUDÉ (CURVED) TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, SILICONE ELASTOMERIC, OR HYDROPHILIC, ETC.), EACH]. Billing Medicare for this item using A4352 or other HCPCS codes is incorrect coding.
Refer to the Urological Supplies LCD, related Policy Article, and Standard Documentation article for additional information regarding coverage, coding, and documentation.
Suppliers are reminded to access the PDACs Durable Medical Equipment Coding System (DMECS) https://www.dmepdac.com for any questions regarding the correct coding of products or call the PDAC Contact Center at 877-735-1326 between the hours of 8:30 a.m. and 4:00 p.m. CT.
|09/12/2017||Published on PDAC website|