November 13, 2023
We are writing with an update on coverage criteria for closed system intermittent catheters (A4353) by CGS and Noridian.
The Urological LCD 33803 outlines coverage requirements for intermittent catheters (A4351, A4352 and A4353). There are five coverage criteria for A4353, of which a beneficiary must meet one to qualify for a closed system catheter (A4353). For criteria #2 Immunosuppression, the LCD lists examples of conditions that commonly cause immunosuppression and states that it is not an all-inclusive list.
This Fall both CGS and Noridian have published that a high-level spinal cord injury (T3 and above) is also an example of immunosuppression, providing clarity to clinicians and the DME community.
1. CGS - October 4, 2023, a Urological Supplies webinar (minute marker 18:37).
2. Noridian – November 1, 2023, published Article
The mission of the Atlantic Coast Medical Equipment Services Association, (ACMESA) is to promote leadership, education and networking for our members. We pledge to advocate for customers and patients with integrity to provide value and comfort in the communities we live and serve.
Adopted November 18, 2016