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Thread: Cath Kits and Medicare

  1. #1

    Cath Kits and Medicare

    I am new to the Medicare system and understand that they are now providing 200 cath kits per month. I called Medicare today to obtain a list of in network providers for the kits and I was given 3 numbers (2 to local Safeway pharmacies who clearly don't have kits) and 1 to a medical supply company who didn't have any in stock). Does anyone have a list of in network cath supply companies for Medicare? I was previously using the Hollister sterile system but my private insurance company is no longer covering them because they have made Medicare primary (which I am infuriated about by the way....). Thanks!

  2. #2
    I go through CCS Medical. They are great.

    Medicare provides 200 caths now from what I've heard, but not the cath kits unless you have the proper medical documentation you need them because of so many reoccurent uti's.
    Aerodynamically, the bumble bee shouldn't be able to fly, but the bumble bee doesn't know that, so it goes on flying anyways--Mary Kay Ash

  3. #3

    I copied this also to the Equipment section to get more responses.


  4. #4

    Medicare new rules

    I got this from someone today:

    Medicare Guidelines for intermittent catheters (4/1/08)

    · Intermittent catheterization is covered when basic coverage criteria are met and the patient or caregiver can perform the procedure.

    · For each episode of covered catheterization, Medicare will cover:
    o One catheter and an individual packet of lubricant; or
    o One sterile intermittent catheter kit if additional coverage criteria met (see below)

    · When clean, non-sterile catheterization technique is used; Medicare will cover replacement of intermittent catheters on a weekly basis unless there is documentation of the medical necessity for more frequent replacement.

    · Intermittent catheterization using a sterile intermittent catheter kit is covered when the patient meets ONE of the following criteria:
    o Resides in a nursing facility.

    o Is immunosuppressed:
    § Post-transplant on immunosuppressive drugs
    § Chemotherapy for cancer
    § AIDS
    § Chronic oral steroids

    o Radiographic documented vesico-ureteral reflux while on IC
    o Pregnant SCI female (for duration only)
    o Recurrent UTIs (2x/year) on CIC

    Medicare UTI Criteria:

    · UTI if urine culture > 10,000 urinary pathogens AND presence of > 1 sign, sx or lab findings:
    o Fever > 100.4 F
    o Elevated WBC (systemic)
    o Change in urgency, frequency, incontinence
    o Autonomic dysreflexia
    o Prostatitis, epididymitis, orchitis
    o Increase spasms
    o Elevated WBC (urine: > 5 WBC per hpf)


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