Summary

Urological supplies are a part of the durable medical equipment, prosthetics, orthotics, and supplies (DME POS) for the purposes of coverage criteria and documentation. Careful attention to guidelines for indications for the appropriate use of supplies and full documentation as required for coverage will streamline the process for appropriate coverage, as well as the appropriate management of patient care.

Checklists are available to assure that orders match the coverage allowed for supplies, and that supplies are ordered when they are needed. Catheter types, especially when varying from straight Foley types, should be justified by criteria set for coverage. Allowable amounts of supplies should be considered and any variation will require additional documentation to justify the adjustments needed. Allowable reasons for variations are also well-defined and should be evaluated from the physician/practitioner to the supplier to assure that the beneficiary is not unduly burdened for costs.

While there are always exceptions, these are the basics for assuring that providers and the urological supplies used are medically necessary, serve patient goals, and provide adequate and accurate documentation to assure coverage and reduce the risk of an unnecessary burden of time and costs to beneficiaries, health care providers, and suppliers.

Coverage Documentation requirements Catheter types and coverage Allowable amounts