Hi Jennifer,
Yes, catheter changes can be covered in home health.
40.1.1 - General Principles Governing Reasonable and Necessary Skilled
Nursing Care
Some services may be classified as a skilled nursing service on the basis of complexity
alone (e.g., intravenous and intramuscular injections or
insertion of catheters) and, if
reasonable and necessary to the treatment of the patient's illness or injury, would be
covered on that basis.
EXAMPLE 8:
Following a cerebrovascular accident (CVA), a patient has an in-dwelling
Foley catheter
because of urinary incontinence, and is expected to require the catheter for a long and
indefinite period. The medical condition of the patient must be described and
documented to support the need for nursing skilled services in the home health plan of
care. Periodic visits to change the catheter as needed, treat the symptoms of catheter
malfunction, and teach proper catheter care would be covered as long as they are
reasonable and necessary, although the patient is stable, even if there is an expectation
that the care will be needed for a long and indefinite period. However, at every home
health visit, the patient’s current medical condition must be described and there must be
documentation to support the need for continued skilled nursing services
Vickie Brand, BSN, RN, PHN
Lead Compliance Specialist, Home Health & Hospice
Allina Home Care Services
Mail Route 10733 • 2925 Chicago Avenue, Minneapolis, MN 55407
Hours: Mon, Wed, Thurs 5:00 am-3:30 pm
From: medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org>
On Behalf Of Jenifer Baker
Sent: Thursday, March 24, 2022 4:23 PM
To: medicarecompliance@list.mnhomecare.org
Subject: [External Mail] Monthly cath changes
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I was just informed that we are able to keep a Medicare patient for monthly catheter changes? Is this accurate? I thought that was not a skilled service that Medicare would allow to continue since it would not be intermittent and short
term?
--
Jenifer Baker, OTR, PTA, COS-C
Agency Director
Firstat Nursing Services
Comprehensive Home Care and Therapy Services
2395 Ariel St. N,
Suite A
Maplewood, MN 55109
Office: 651-288-0222 ext. 2003
Direct Number: 651-409-4378
Fax: 651-288-0214
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