Woman sitting on couch with argile compression socks

UROLOGICAL SUPPLIES AND YOU

Why Do I Need Urological Supplies?

Urological supplies are for people who have trouble urinating on their own. They are designed for urinary retention and help remove urine from the body. This could be caused by many things, such as a blockage in the urethra, or an issue with the nervous system that won't allow the bladder muscles to relax. Catheters are inserted into the bladder through the urethra allowing trapped urine to leave the body. Urine travels through the catheter and often collects into a drainage bag.

The Different Types of Catheters

Red two-way catheters

INDWELLING (FOLEY) TWO-WAY CATHETERS

Foley catheters are the most common type of indwelling catheter. They feature two separate channels (called lumens): one for draining urine, and one for inflating the balloon tip with sterile water to keep the catheter in place. People who have mobility issues, such as quadriplegia, may use Foley catheters.

  • Sometimes called a “two-way Foley catheter” or “balloon catheter”
  • Also available with a third channel (three-way) used to irrigate the inside of the bladder for people prone to develop clots or sediment
  • Silicone options in both two-way and three-way for those with latex allergies or sensitivities
  • They are usually used for a month at a time
  • They carry a higher risk of infection than other catheters
  • Typically prescribed to people who cannot use a catheter on their own
Straight tip catheters

INTERMITTENT CATHETERS - STRAIGHT TIP

Unlike Foley catheters, Intermittent catheters are designed to be used once and then thrown away. They're usually made of a special soft plastic (PVC) and a lubricant is used to make their use easy and painless. People who have difficulty emptying their bladder use Intermittent catheters.

  • Also called straight catheters, “in and out” catheters, and “self-cath” catheters
  • Should not be reused
  • Less risk of infection than indwelling catheters
  • Prescribed to people who have the ability to catheterize themselves regularly
catheters with a coude tip

INTERMITTENT CATHETERS - COUDE TIP

Coude catheters have bent or tapered tips. They're designed to help the catheter maneuver around blockages or obstructions in the urethra, such as an enlarged prostate. Coude catheters can come in many different styles, including indwelling and intermittent. People with obstructions or blockages in the urethra use coude catheters.

  • Contain an indicator that allows the user to know the direction of the tip during use
  • Should not be reused
  • Less risk of infection than indwelling catheters
  • Typically prescribed to people experiencing a blockage or obstruction in the urethra
one red rubber catheter

RED RUBBER CATHETERS

Red Rubber catheters are a type of intermittent catheter. They function exactly the same, but are made of a thin rubber latex instead of plastic. Red Rubber catheters are used by people who need intermittent catheters, but prefer red rubber latex over plastic.

  • Softer and more flexible than plastic intermittent catheters
  • “Classic” catheter made of natural rubber latex instead of plastic
condom-style catheters

EXTERNAL (CONDOM) CATHETERS

Male external catheters are also known as condom catheters. These are different from the other catheters because they are external, so they are not inserted into the body.

These catheters fit like a condom, so they can be slipped over the penis in the same way. Usually they will have an adhesive that seals against the skin of the penis, preventing leakage. A tube connects to the front of the catheter, allowing the urine to flow out into a collection bag.

Male external catheters are generally used for continuous draining of the bladder. Male external catheters should be changed daily.

closed system catheter kit

CLOSED SYSTEM CATHETERS

Closed System catheters are all-in-one disposable systems that include a catheter, lubricant, and collection bag. They help protect against infection by reducing exposure of the catheter to bacteria and other contaminants. People who are more prone to UTIs or other infections use Closed System catheters.

  • Comes pre-lubricated and ready for use
  • Designed to reduce contact between the catheter and outside sources, reducing the potential for infection
  • Collects urine in a sealed, disposable drainage bag
  • Typically prescribed to people that are prone to UTIs or other infections

Other Supplies

insertion tray example

INSERTION TRAYS

Insertion Trays are packaged sterile with all of the compo- nents needed to insert a Foley Catheter.

Having all the items needed standardizes the procedure and adds convenience.

The trays are sterile and are in- tended for single patient use.

irrigation tray example

IRRIGATION TRAYS

Irrigation Trays contain all of the components needed to flush catheters.

Irrigation is a procedure to open a plugged urinary catheter.

Normal saline is inserted into the catheter to remove the plug so that the urine can drain from the bladder.

bottle of lubricating jelly

LUBRICATING JELLY

If you use un-coated intermit- tent catheters you will want to use a water soluable lubricant.

Simply apply to your catheter to ease discomfort from urethral friction.

Available in tubes or single-use packets.

leg bag

LEG BAGS

A urinary leg bag holds urine that drains from your catheter.

It fits under your clothes and allows you to do your normal daily activities.

nighttime drain bag

NIGHT/DRAIN BAGS

A night bag is a larger bag that holds urine that drains from your catheter during the night.

Your night bag should either be attached to your leg bag or to the catheter valve. It should be placed on a stand next to your bed, near the floor, to collect urine as you sleep.

straps and holders

STRAPS/HOLDER

Leg bag straps help hold the leg bag comfortably in place.

They also help prevent skin damage due to slippage against the skin.

Insurance Allowables

GENERAL DESCRIPTION HCPCS MEDICARE STANDARD ALLOWED QUANTITY MEDICAID STANDARD ALLOWED QUANTITY
INTERMITTENT CATHETERS
Intermittent urinary catheter, straight tip, with or without coating, each A4351 200 per month 150-180 per month
Intermittent urinary catheter, coude (curved) tip, with or without coating, each
  • Seldom medically necessary for female patients
  • Additional documentation is always required to justify medical necessity of coude tip. Coude justifications include: urethral strictures or other inability to catheterize with a striaght tip catheter
A4352 200 per month 150-180 per month
Intermitent urinary catheter with insertion supplies A4353 200 per month 150-180 per month
CONDOM CATHETERS
Male external catheter, with or without adhesive, disposable, each A4349 35 per month 60 per month
FOLEY CATHETERS
Indwelling catheter; Foley type, 2-way latex with coating, each A4338 1 per month 1 per month
Indwelling catheter; specialty type (ie: coude, mushroom, wing, etc), each A4340 1 per month 1 per month
Indwelling catheter; Foley type, 2-way all silicone, each A4344 1 per month 1 per month
ACCESSORIES
Insertion Supplies (w/o bag) A4310 1 per month 1 per month
Irrigation Tray A4320 non-routine usage only 4 per month
Lubricant, bottle A4402 (per ounce) 13 per month 13 per month
Lubricant, packet A4332 (per packet) 200 per month 288 per month
Leg Bag A4358 2 per month 2 per month
Drain (Night) Bag A4357 2 per month 2 per month
Drain Bottles A4102 1 every 3 months 1 per month
Catheter Straps/Holder A4114 physician determined 2 per month
Gloves A4927 not covered 400 per month

Documents Required From Your Physician to Bill Insurance

There are two items Insurance companies require for coverage consideration:

  • Standard Written Order (SWO) - A standard form with detailed information
  • Medical Records - Specific information that is needed in a patient's medical records

The SWO and Medical Records have Medicare requirements - some insurance companies may request more. There may also be deductible and/or co-insurance requirements that will affect payment and customers may always waive their insurance benefits and privately pay.

Urological Standard Written Order

MEDICAL RECORD INFORMATION

Standard Urological Supplies

  • Beneficiary has permanent urinary incontinence or permanent urinary retention
  • Frequency of use (number of times per day that beneficiary performs self-catherization) • impairment of urination is not expected to be medically or surgically corrected within 3 months

Coude Catheters

  • All standard information
  • Documentation of inability to catheterize with a straight tip catheter and why

Sterile Catheters

  • All standard information
  • The beneficiary meets one of the following criteria:
    • The beneficiary resides in a nursing facility.
    • The beneficiary is immunosuppressed
    • The beneficiary has radiologically documented vesico-ureteral reflux while on a program of intermittent catheterization.
    • The beneficiary is a spinal cord injured female with neurogenic bladder who is pregnant (qualifies only for the duration of the pregnancy).
    • The beneficiary has had distinct, recurrent urinary tract infections while on a program of sterile intermittent catheterization with A4351/A4352 and sterile lubricant A4332, twice within the 12-months prior to the initiation catheterization with the sterile intermittent catheters kits
      • 10,000 colony forming units of a urinary pathogen; AND
      • Fever (oral temperature greater than 38o C [100.4o F]); or
      • Systemic leukocytosis; or
      • Change in urinary urgency, frequency, or incontinence; or
      • Appearance of new or increase in autonomic dysreflexia (sweating, bradycardia, blood pressure elevation); or
      • Physical signs of prostatitis, epididymitis, orchitis; or
      • Increased muscle spasms; or
      • Pyuria (greater than 5 white blood cells [WBCs] per high-powered field).

Irrigation

  • Routine or Non-Routine irrigation
  • Documentation of why irrigation is needed
    • acute obstruction
    • history of obstruction of the catheter and the patency of the catheter cannot be maintained by intermittent irrigation
    • preventative
  • Indicate the rate of solution administration and the duration of need

Frequently Asked Questions

WHAT SIZE OF CATHETER SHOULD I USE?

The French catheter scale, or French unit (Fr), is commonly used to measure the outside diam- eter of catheters. To determine the French size catheter that works best for your body, consult with your prescribing healthcare professional.

HOW MANY CATHETERS CAN I GET PER MONTH?

Medicare will allow for the usual maximum of 200 catheters per month or one catheter for each episode of catheterization. Other payers allowed catheters per month may differ from Medi- care's, so it is important for you to check with your insurance plan to see how many catheters your plan allows.

HOW WILL I KNOW WHEN THE CATHETER IS IN MY BLADDER?

When the urinary catheter enters your bladder, urine should begin to flow out of the catheter. This process will continue until your bladder is completely empty.

CAN I REUSE CATHETERS?

Washing and reusing catheters can be both time-consuming and inconvenient, not to mention unhealthy! While rewashing catheters may work for some, many people experience recurring urinary tract infections (UTIs). However, studies show that sterile urinary catheter use (using a catheter one time and disposing of it) can reduce urinary tract infections. Most major insurance companies, including Medicare, recommend sterile use.

I AM CURRENTLY USING STRAIGHT INTERMITTENT CATHETERS BUT AM STILL HAVING SOME PROBLEMS WITH URINARY TRACT INFECTIONS. WHAT CAN I DO?

You should talk to your physician/clinician and discuss trying a Closed System intermittent cathe- ter. These products are “touchless” meaning your hands do not have to touch the catheter.

WHAT CAN I DO TO PREVENT URINARY TRACT INFECTIONS (UTIS)?

A urinary tract infection (UTI) or catheter-associated urinary tract infection (CAUTI) is one of the most common complications that catheter-users may experience. Washing and reusing catheters may cause urinary tract infections. Therefore, one of the first steps you can take to reduce your risk of infection is to start sterile intermittent catheterization. This means using one sterile catheter straight from the package and then disposing of it after use.

CAN I BRING CATHETERS ON AN AIRPLANE?

Yes, many people travel with their catheters. Planning ahead of time can help ensure you have plenty of supplies in case of the unexpected, such as lost luggage or flight delays.