Urinary Drainage Bags Form
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Background for this Policy
Urinary drainage bags that can be used either as bedside or leg drainage bags may be either multi-use or single use systems. Both the multi-use and the single use bags have a system that prevents urine backflow. However, the single use system is non-drainable.
Urinary collection and retention system are covered as prosthetic devices that replace bladder function in the case of permanent urinary incontinence. There is insufficient evidence to support the medical necessity of a single use system bag rather than the multi-use bag. Therefore, a single use drainage system is subject to the same coverage parameters as the multi-use drainage bags.
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