WASHINGTON – CMS has issued a final rule that addresses suspicious billing activity within the Medicare Shared Savings Program that resulted in an increase in DMEPOS billing for certain intermittent ...
2. Two intermittent urinary catheter codes are flagged as highly suspect, and payments for them are excluded. Codes are considered suspect when there is an unexplained spike in claims, either in ...
When this happens, a sterile, flexible tube called a urinary catheter is inserted into the urethra (where urine leaves the body) and is gently pushed up until the end rests in your bladder. The ...
The 2025 Physician Fee Schedule includes a methodology to address suspicious billing activity from 2024 onward. 2. The bill addressed two CPT codes identified as suspect: A4352, intermittent urinary ...
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