NCDActive
Peridex CAPD Filter Set
NCD197
Effective: May 1, 1989
Updated: December 31, 2025
Policy Summary
Medicare does not cover the Peridex CAPD Filter Set for home continuous ambulatory peritoneal dialysis because it has not been shown to be safe and effective in preventing peritonitis. The device, intended to provide sterile filtration and block organisms during CAPD infusion, is therefore considered non-covered; the policy provides no documentation or frequency provisions for coverage.
Coverage Criteria Preview
Key requirements from the full policy
"Peridex CAPD Filter Set is not a covered Medicare benefit because it has not been demonstrated to be safe and effective for preventing peritonitis."
Sign up to see full coverage criteria, indications, and limitations.