New LCD for intermittent catheters expands coverage
By HME News Staff
Updated 10:23 AM CST, Mon November 17, 2025
WASHINGTON – Documentation of any spinal cord injury diagnosis is sufficient to establish Medicare coverage for sterile catheter kits (A4297 and A4353) starting Jan. 1, according to a new local coverage determination (LCD) and policy article from the Durable Medical Equipment Medicare Administrative Contractors (DME MACs).
The expanded coverage, which better aligns with current clinical evidence, will help to reduce serious urinary tract infections (UTIs), AAHomecare stated in a bulletin.
“The clarification streamlines coverage by allowing documentation of SCI alone to automatically qualify a beneficiary as immunocompromised for sterile catheter kits, allowing patients access to sterile kits without requiring them to have two UTIs,” the association stated.
The new LCD incorporates the new and revised HCPCS codes for intermittent catheters, including separate codes for hydrophilic catheters.
AAHomecare called out the Intermittent Catheter Coding Reform Coalition (ICCRC) for its collaborative approach and continued advocacy to improve coverage for beneficiaries.
You can find the new LCD and policy article at the links below:
- Final LCD: Urological Supplies (L33803)
- Policy Article: Urological Supplies (A52521)
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