January 17, 2007

VIA HAND DELIVERY

Dr. Doran Edwards
Medical Director
Statistical Analysis Durable Medical Equipment Regional Carrier
2300 Springdale Drive
Camden, South Carolina 29020

Re: Coding of Hydrophilic Catheter Kits with Extension Sleeve

Dear Dr. Edwards:

The undersigned organizations write to support the assignment of code A4353 to the Hydrogel Self-Cath catheter kit.

The Hydrogel Self-Cath catheter kit is an innovative product that has the potential to greatly enhance the quality of life of individuals with spinal cord injuries who require sterile intermittent catheterization. Such kits are recommended for individuals with spinal cord injury who require sterile intermittent catheterization due to recurrent systematic infections occurring with clean intermittent catheterization. Likewise, lower infection rates can be achieved with sterile techniques and with pre-lubricated self-contained catheter sets.^1,2 In addition to this kit being consistent with the standards of care for patients with spinal cord injury, the product includes a hydrophilic catheter with a unique feature—an integrated protective sleeve that becomes an extension tube, facilitating direct depositing of urine into a toilet rather than into a collection bag. Therefore, the product can significantly improve the ability of individuals requiring sterile intermittent catheterization to live active and independent lives while reducing the need for assistance from a caregiver and/or nursing support.

Unfortunately, this catheter kit is in danger of being removed from the market due to an inability to receive appropriate coding and adequate reimbursement under the Medicare program. Currently, the Hydrogel catheter kit is reimbursed under codes A4351 and A4352, which provide inadequate reimbursement to cover the costs of manufacturing and distributing the product. Given that the technology associated with the extension sleeve is patented, the removal of this product from the market will represent a significant loss to those patients requiring sterile intermittent catheterization, including individuals with spinal cord injuries. We strongly support the continued availability of this product through proper coding and adequate reimbursement.

In conclusion, we encourage the SADMERC to assign code A4353 to the Hydrogel Self-Cath catheter kit as it originally decided the first time the SADMERC coded this product. Please contact Peter Thomas with any questions.

Thank you for your consideration,

American Association of People with Disabilities
National Council on Independent Living
National Spinal Cord Injury Association
Paralyzed Veterans of America
United Spinal Association