Tag: coding change
In brief: Catheter code change, Part B premium increase, AdaptHealth debt reduction
November 19, 2025HME News Staff
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...
In brief: Aetna revisits CPAP code change, NHIA pushes bills, Insulet campaigns for diabetes
November 12, 2025HME News Staff
HARTFORD, Conn. - Aetna is once again trying to require adherence codes G8851, G8854 and G8855 for reimbursement for CPAP devices or supplies, the Midwest Association for Medical Equipment Services & Suppliers (MAMES) reports.
The insurer tried the same move earlier this year, but after the HME industry pushed back, saying providers can’t bill these codes, it pulled back the change.
In an October 2025 list of upcoming policy changes and reminders, however, Aetna states:
“Beginning...