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| MEDICARE'S USUAL MAXIMUM QUANTITY FOR UROLOGICAL SUPPLIES |
| The quantity of urological supplied needed by a patient is determined by many factors. There will be variation according to individual need and their needs may vary over time. The table below lists the maximum number of items/units of service that are usually medically necessary. The actual quantity needed for a particular patient may be more or less than the amount listed. The medical necessity for use of a greater quantity of supplies than the amounts listed must be clearly documented in the patient's medical record. |
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| Code |
Description |
Amount |
| A4328 |
Female external urinary collection device, pouch, each |
1/day |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
35/month |
| A4351 |
Intermittent urinary catheter |
200/month |
| A4353 |
Intermittent urinary catheter with insertion supplies |
200/month |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
2/month |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
2/month |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz |
1/month |
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| HCPCS CODE DISCLAIMER |
| As a service to Hollister customers, HCPCS codes are included in this eCatalog for all applicable Hollister products. Because HCPCS codes and DMERC coverage policies are constantly revised and updated, always consult your Provider Manual and DMERC Medical Review Policies before completing claims. |
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| EXPLANATION OF THIRD PARTY CODE REIMBURSEMENT SYSTEM |
| To facilitate reimbursement of Hollister products, some Third Party Payment Programs require the use of an eleven-digit reimbursement code. Every Hollister manufactured product can be identified by an eleven-digit code. The first five numbers in the code identify the manufacturer and the last six numbers in the code represent the product stock number. In order to utilize this coding system, follow these examples: |
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- The Third Party Reimbursement Number for the InView Male External Catheter, Stock Number 97529, is: 08380-0975-29. 08380 identifies Hollister Incorporated. 0975-29 identifies the product stock number.
- The Third Party Reimbursement Number for the Bedside Drainage Collection System, Stock Number 9839, is: 08380-0098-39. 08380 identifies Hollister Incorporated. 0098-39 identifies the product stock number.
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| The reimbursement information provided by Hollister Incorporated is intended to provide general information relevant to coding and reimbursement of Hollister products only. Reimbursement policies can vary considerably from one insurer to another. Coverage and payment policies for the same insurer,such as Medicare, can vary from one region to another, and may change from time to time. Hollister does not guarantee coverage or payment of products listed in our product catalog. This information is designed as a guideline only. HCPCS codes shown in the eCatalog are effective 1-1-2005. |
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