Urological Supplies

Medicare covers urological supplies only when they meet Medicare benefit eligibility and are reasonable and necessary; specific HCPCS-coded supplies have defined clinical indications, documentation requirements, and quantity limits. Routine limits include one indwelling catheter per month, specified monthly/quarterly quantities for drainage systems, a 200-unit/month cap for many intermittent catheter supplies, and strict rules on sterile kit billing, irrigation use, and refill/ordering procedures; deviations require strong medical record justification and prior documentation (SWO/WOPD, POD).

"Items are covered if they are in an eligible Medicare benefit category, are reasonable and necessary for diagnosis/treatment or to improve function of a malformed body member, and meet applicable M..."

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