The American Association for Homecare and its incontinence care manufacturer members, Coloplast, Hollister, and Wellspect submitted a request to CMS to discontinue existing HCPCS Level II code A4351, “Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each” and establish seven new HCPCS Level II codes to further distinguish the functionalities of straight tip intermittent urinary catheters.


The current HCPCS code covers such a broad range of intermittent urinary catheters that CMS and its contractors often do not know specifically what they are paying for, which leads to vulnerabilities in the administration of the Medicare program. Additionally, the wide variation in functionality between products currently classified under HCPCS code A4351 creates a lack of transparency, which may result in patients receiving the least expensive intermittent urinary catheter described by the HCPCS code being used. However, this catheter may not meet the patient’s clinical needs to consistently perform successful self-catheterization.


The groups met with CMS in August to discuss this issue in greater detail, and WOCN is still awaiting an update from the agency.