Peridex CAPD Filter Set Form
Procedure is not covered
Background for this Policy
The Peridex Filter Set is used by home continuous ambulatory peritoneal dialysis (CAPD) patients. The Peridex Filter Set is designed to provide sterile filtration during infusion of the dialysis solution in a beneficiary's peritoneal cavity; included in the filter set is a bacterial filter designed to block peritonitis-causing organisms and thus reduce the incidence of peritonitis.
Based upon advice of our medical consultants, we have determined that the Peridex CAPD Filter Set cannot be covered at this time by Medicare because it has not yet been shown to be safe and effective in preventing peritonitis.
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