Becker's Healthcare July 1, 2024
After 11 healthcare organizations urged CMS to remove catheter expenditures from accountable care organization calculations, the agency proposed excluding payment amounts for two catheter codes.
During 2023, there was an unexplainable increase in claims for codes A4352 [Intermittent urinary catheter; Coude (curved) tip, with or without coating (Teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each] and A4353 (Intermittent urinary catheter, with insertion supplies), CMS said.
In 2021, spending for the two codes was $153 million, and in 2023, that figure increased to $3.1 billion, according to Premier, the American Hospital Association and other healthcare groups.
The organizations told CMS about the issue in late April, and two months later, the...
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