Urology Solutions for Healthcare Professionals

Chart notes must include:

• The medical condition of permanent urinary incontinence or permanent urinary retention.
• The prescribing physician must have medical records supporting a permanent impairment of urination. A permanent condition is expected to last at least 3 months or more. This does not require a determination that there is no possibility of the patient’s condition improving in the future. The plan of care must indicate the type of catheter being used.
• The physician’s plan of care within the medical records should match the plan of care within the DWO.

Chart notes must include:

Same as Straight Tip Catheter

• Documentation in the chart notes indicating that the patient is unable to pass a straight catheter and requires a coude-tip catheter.
• Please note that a diagnosis is not sufficient on its own.

Chart notes must include:

Same as Straight Tip Catheter 

One of the following conditions must be met and documented within the prescribing physician’s medical records:

1. Two distinct UTI’s (Urinary Tract Infections) within a 12-month period while on a program of intermittent catheterization or

    Examples of accepted UTI symptoms, or

• Fever (oral temperature greater than 38º C [100.4º F])
• Systemic leukocytosis
• Change in urinary urgency, frequency, or incontinence
• Appearance of new or increase in autonomic dysreflexia (sweating, bradycardia, blood pressure elevation)
• Physical signs of prostatitis, epididymitis, orchitis
• Increased muscle spasms
• Pyuria (greater than 5 white blood cells [WBCs] per high-powered field)

2. Patient resides in a nursing facility as their primary residence, or 

3. is immunosuppressed, for example, or

• On a regimen of immunosuppressive drugs post-transplant
• On cancer chemotherapy
• Has HIV or AIDS
• Has a drug-induced state such as chronic oral corticosteroid use

4. patient is a spinal cord injured female with neurogenic bladder who is pregnant (covered for the duration of pregnancy only).