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Medicare Coverage of Intermittent Catheters

Medicare requires detailed physician's orders and chart notes to support medical necessity  for intermittent catheters.

  • Click here for a physician order form for catheters containing all required elements by Medicare. 
  • Chart notes may also be called progress notes, clinical notes, physician notes, or office visit notes.
  • Chart must be recent (dated within the prior 12 months), and must document medical necessity for intermittent catheterization.  Refer to applicable sections of the Medicare LCD for Urological Supplies for qualifying criteria for intermittent catheters.
  • If Coude tip catheters are ordered, the chart notes must indicate why coude tip is needed rather than a straight tip catheter.  For example, the inability to pass a straight catheter.
  • If catheters with insertions supplies (catheter kits) are ordered, additional supporting documentation is required, most commonly lab results of UTI's in the prior 12 months while on a program of intermittent catheterization.

 

 

Call (800) 251-4673  |  Fax (877) 226-1484 | Print an Order Form