Medical Supplies and Equipment Bulletin - March 2006

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Use Of Intermittent Catheters

Catheterization in a home setting does not require a sterile technique, clean intermittent catheterization is the recognized technique. The practice of re-using one's intermittent catheter is common throughout the world. Rehabilitation patients are taught the technique before discharge to their home.

If a client needs to learn the technique or requires a refresher on the technique, they can ask their Doctor to refer them to the Community Care Nurse(s) for teaching of clean intermittent catheterization.

The Non-Insured Health Benefits (NIHB) Program will fund 3 intermittent catheters per week for clients requiring intermittent catheterization.

The intermittent catheter benefit code is 99400421, not benefit code 99400418 (external catheters disposable) which are the condom catheters.

Incontinence Supplies

(Disposable underwear and undergarments. Disposable underwear and undergarments include disposable diapers, pull-up briefs and incontinence liners/pads.)

Manufacturers of incontinence supplies have charts that indicate the maximum absorbancy of each of their products. Different products are available for clients with different needs and it is important that the product be chosen according to the manufacturers' absorbancy charts.

Today's incontinence products are made with wetness indicators, refastenable tapes and a leakage barrier technology that keeps the wetness inside the disposable underwear or undergarment and away from the skin. If the product is chosen according to the absorbancy needed by the client a maximum of 4-6 incontinence supplies per day will meet the client's needs.

The NIHB Program will fund 4-6 incontinence supplies per day.

Sterile Dressing Trays

(exception benefit)

Universal care precautions are needed for the care of all wounds. The most important practice for prevention is hand washing for 10 to 15 seconds. The state of the wound and the client's medical situation dictate the appropriate aseptic precaution.

Sterile dressing trays are exception benefits under the NIHB Program. Exception benefits require a detailed medical explanation. To ensure prompt processing of the provider's Prior Approval (PA) request, the following information must be included:

1. the client's diagnosis;
2. where the client lives (at home, long term care facility, group home facility...);
3. the site and the size of each lesion or wound;
4. the etiology of this condition, if pertinent the underlying medical conditions or events delaying the healing process;
5. the treatment plan, frequency of dressing change and the expected healing time; and
6. the amount of product requested (manufacturer name, product name or number, size of dressing, quantity).

The above information may be obtained from the client, the client's nurse or family Doctor before submitting the prior approval.

Shipping Costs And The Use Of Delivery Codes

In 2003, NIHB created delivery codes to ensure shipping costs were clearly identified by providers. This is a reminder that, when applicable, shipping costs must be billed under the appropriate delivery codes i.e., providers must use the benefit code 99400819 for the shipping costs of mobility equipment, benefit code 99400820 for the shipping costs of incontinence supplies and benefit code 99400262 for the shipping costs of oxygen equipment.

However, this does not apply to the recycling program in British Columbia. Providers for the recycling program do not bill the shipping costs separately.