2019PRODUCT CATALOG AND ORDERING INFORMATION...M0066703061 08714729302667 .035 150 Angled 3cm...

Visualization Products

Guidewires

Dilation Products

Stone Retrieval Devices

Ureteral Stents

Ureteral Catheters

Nephrostomy Products

Lithotripsy Products

Prostate Health

Procedure Accessories

Pelvic Floor Products

Urology and Pelvic Health

PRODUCT CATALOG AND ORDERING INFORMATION2019

C-CODE CROSS-REFERENCE TO BOSTON SCIENTIFIC PRODUCTS

KEY POINTS OF THE GUIDE

• Thisdocumentcross-referencesBostonScientificproductsattheUPN/ordernumberleveltoCMSassignedCategoryC-codesor indicatestherearenoapplicableC-Codes.

• ItalsoincludesaResourceList(seepage92)thatcitessourcesofinformationonMedicarepolicyforAPCsandthePass-ThroughList. Specifically,ithighlightsProgramMemoranda,includingthoseinwhichtheC-codeswerepublished,retiredandreinstated;andothernoticesfromCMS.

• Seepages91-92formoreinformation. Important-Please note:HealtheconomicandreimbursementinformationprovidedbyBostonScientificCorporationisgatheredfromthird-partysourcesandissubjecttochangewithoutnoticeasaresultofcomplexandfrequentlychanginglaws,regulations,rulesandpolicies.Thisinformationispresentedforillustrativepurposesonlyanddoesnotconstitutereimbursementorlegaladvice.BostonScientificencouragesproviderstosubmitaccurateandappropriateclaimsforservices.Itisalwaystheprovider’sresponsibilitytodeterminemedicalnecessity,thepropersitefordeliveryofanyservicesandtosubmitappropriatecodes,charges,andmodifiersforservicesthatarerendered.BostonScientificrecommendsthatyouconsultwithyourpayers,reimbursementspecialistsand/orlegalcounselregardingcoding,coverageandreimbursementmatters.BostonScientificdoesnotpromotetheuseofitsproductsoutsidetheircleared/approved(asapplicable)label.

BostonScientificCorporationusesafullycomputerizedorderentrysystemfortheconvenienceofourcustomers.Thesystemenables Customer Service Representatives to provide you with instant order entryaswellasup-to-dateorderstatusinformation.

ThesystemusesUPNordernumbersforeachproduct.Thebold bluenumbersaretheoldordernumbers(seeexample).Pleaseuseeitherofthesenumberswhenplacinganorder.

BostonScientificCustomerServiceRepresentativeswillbehappytohelpyouwithanyquestions.Weareeagertomaketheordering procedureassimpleandefficientaspossible.

Ordering Numbers

Bold Blue Typeisanexampleofoldordernumber

Sensor™ Dual-Flex PTFE-Nitinol

OrderNumber

Diameter(in)

Length(cm)

M0066703081 .035 150

M0066703011 .035 150

M0066703121 .038 150

M00667030 21 .038 150

To place an order, call Boston Scientific Customer Service 1.888.272.1001

1

VISUALIZATION PRODUCTS

LithoVue™ Single-Use Digital Flexible Ureteroscope .................. 5

LithoVue SUD only

LithoVueSystemWorkstation

LithoVuewithImageandVideoCapture

LithoVue Empower™ Retrieval Deployment Device

GUIDEWIRES

Sensor™ Guidewires .....................7

SensorDual-FlexNitinolGuidewires with Hydrophilic Tip (10cmFlexibleProximalEnd)

Sensor PTFE-Nitinol Guidewires with Hydrophilic Tip

ZIPwire™ Guidewires ................ 7-8

Standard ZIPwire Guidewires

EnhancedBentson-TypeStiffShaft ZIPwire Guidewires

Bentson-Type ZIPwire Guidewires

EnhancedStiffShaftZIPwireGuidewires

Zebra™ Guidewires ....................... 9

ZebraGuidewires

PTFE Coated Guidewires ..........9-10

PTFECoatedGuidewires(FixedCore)

PTFE Coated Guidewires (FixedCore,StiffBodied)

PTFECoatedGuidewires(MoveableCore)

AmplatzSuperStiff™ Coated Guidewires

Lubriglide™ Coated Guidewires ....... 11

LubriglideCoatedGuidewires (FixedCore)

LubriglideCoatedGuidewires (FixedCore,StiffBodied)

LubriglideCoatedGuidewires (MoveableCore)

DILATION PRODUCTS

Ureteral Access Sheaths .............. 13

Navigator™ HD Ureteral Access Sheath Sets

NavigatorUreteralAccessSheathSets

Ureteral Balloon Dilation Catheters ............................... 14-15

UroMaxUltra™BalloonDilatationCatheters(Kits)

UroMaxUltraBalloonDilatationCatheters

Passport™BalloonDilatationCatheters(Kits)

Passport Balloon Dilatation Catheters

Encore™26Inflator

Ureteral Dilators ..........................16

NottinghamOne-StepHydrogelCoated Ureteral Dilators

Ureteral Dilator System with Procedural Sheath Set

Ureteral Dilatation Set

Ureteral Dilators

STONE RETRIEVAL DEVICES

Nitinol Retrieval Devices ........19-20

Zero Tip™NitinolStoneRetrievalBaskets

Dakota™ Nitinol Stone Retrieval Devices

Escape™NitinolStoneRetrievalBaskets

OptiFlex™NitinolStoneRetrievalBaskets

Graspit™ Nitinol Stone Retrieval Forceps

Stainless Steel Retrieval Devices .............................................. 20-23

Bagley™HelicalStoneRetrievalBaskets

Gemini™PairedWireHelicalStoneRetrievalBaskets

SeguraHemisphere™StoneRetrievalBaskets

Tricep™Hooked-ProngGraspingForceps

TricepHooked-ProngGraspingForceps with Spool Handle

Leslie Parachute™Multi-WireStone SweepingDevices

LithoCatch™ImmobilizationDevice

Antiretropulsion Devices .............23

Stone Cone™NitinolUrologicalRetrievalCoils

URETERAL STENTS

Stent Store ............................ 25-40

Polaris™ Ultra Ureteral Stent Sets (DualDurometerPercuflex™Material with HydroPlus™Coating)

Polaris Loop Ureteral Stent Sets (DualDurometerPercuflexMaterial withHydroPlusCoating)

PercuflexPlusUreteralStentSets (withHydroPlusCoating)

PercuflexPlusUreteralStentSets (withHydroPlusCoatingandBraidedRetrievalLine)

PercuflexUreteralStents

Contour™ Ureteral Stent Sets (with HydroPlus Coating)–ASofterPercuflexMaterialStent

Contour Ureteral Stent Sets (with HydroPlus CoatingandBraidedRetrievalLine)

Contour VL™UreteralStents(PercuflexMaterialwithHydroPlusCoating)

ContourInjectionStentSets(withHydroPlusCoating)–APercuflexMaterialStent

ContourVLInjectionStentSets(withHydroPlusCoating)–APercuflexMaterialStent

MardisSoftUreteralStentSets (withHydroPlusCoating)

Stretch™VLFlexima™ Ureteral Stent Sets (withHydroPlusCoating)

Ureteral Stents and Sets .........41-42

Retromax™ Plus Endopyelotomy Stents

PercuflexUrinaryDiversionStentSets (OpenTipConfiguration)

PercuflexUrinaryDiversionStentSets (ClosedTipConfiguration)

Stent Accessories ....................... 42

Ureteral Stent Positioners

Table of Contents UrologyandPelvicHealth(TableofContents1of3)


2

URETERAL CATHETERS

Torqueable Catheters ............ 45-48

Dual Lumen Ureteral Catheter

Imager™IIUrologyTorqueCatheters

UreteralCatheter:OpenEndUreteralCatheter

UreteralCatheter:AngledTipUreteralCatheter(Setswith.035"PTFEBentsonTipGuidewire)

Axxcess™Catheter:OpenEndUreteralCatheter

C-Flex™ Ureteral Catheter: FlexibleTipOpenEndUreteralCatheterSet

C-FlexUreteralCatheter: OpenEndUreteralCatheterSet

C-FlexUreteralCatheter: PigtailUreteralCatheterSet

NEPHROSTOMY PRODUCTS

Percutaneous Kits .................. 51-52

LingemanPercutaneousTractKit with ZIPwire™ Guidewire

Percutaneous Tract Kit with ZIPwire Guidewire

Percutaneous Access Set

PercutaneousAccessSets–PigtailCatheter

Introducer Sets ............................52

NaviGuide™ Percutaneous Access Needle

TLA Introducer Needle and Sheath Set

Balloon Dilation Catheters ..........53

NephroMax™HighPressureNephrostomy Balloon Catheters

NephroMaxHighPressureNephrostomy BalloonCatheter(Kits)

Inflation Devices .........................53

Encore™26Inflator

Dilators and Sheaths ............. 54-55

Clear Renal Sheath

AmplatzTypeRenalDilator/SheathSet

Amplatz Type Graduated Renal Dilation Set

Amplatz Type Renal Dilators (IndividualComponents)

AmplatzTypeRenalSheath(Set)

Amplatz Type Renal Sheaths (IndividualComponents)

8/10Dilator/SheathSet

Torqueable Catheters ................. 56

Imager™IIUrologyTorqueCatheters

Occlusion Balloon Catheters ...... 56

Occluder™OcclusionBalloonCatheters

Drainage Catheters ................57-58

MalecotNephrostomyCatheters

Re-Entry™MalecotNephrostomyCatheterSets

Percuflex™LockingLoopAllPurposeDrainageCatheters with Fader Tip™

PercuflexLockingLoopNephrostomyCatheters with Fader Tip

PercuflexCombinationStent/NephrostomyCatheter

PercuflexLockingLoopNephrostomyCatheters

LITHOTRIPSY PRODUCTS

Laser Systems .............................61

Lumenis™ Laser Systems

Lumenis Pulse™120HMosesUpgrade

Laser Fibers ...........................61-63

Flexiva™ TracTip™HighPowerSingle-Use LaserFibers

Flexiva IDTracTipHighPowerSingle-UseLaserFibers

FlexivaHighPowerSingle-UseLaserFibers

Flexiva IDHighPowerSingle-UseLaserFibers

AccuTrac™Single-UseHolmiumLaserFibers

AccuMax™Single-UseHolmiumLaserFibers

Moses™ LaserFibers

SlimLine EZ™SISSingle-UseLaserFibers

SlimLineSISReusableLaserFibers

Laser Accessories ........................63

Accessories for Lumenis Brand Holmium and DualWavelengthLaserSystems

Dual-Energy Lithotripter Systems ................................ 64-67

Swiss LithoClast®TrilogySystemKit

SwissLithoClastTrilogySingle-UseProbeKits

SwissLithoClastTrilogySystemAccessories

SwissLithoClastTrilogySingle-UseAccessories(Optional)

SwissLithoClastTrilogyCart

Swiss LithoClast Select Accessories

SwissLithoClastUltrasoundProbes (NotcompatiblewithSwissLithoClast StandardProbe)

SwissLithoClastPneumaticProbes

(TableofContents2of3)

Table of Contents UrologyandPelvicHealth


3

PROSTATE HEALTH

BPH Laser Systems ..................... 69

GreenLight™ Laser Therapy

Rezūm™WaterVaporTherapy

Holmium Laser Therapy (vaporizationandenucleation)

Resection Devices for Use with Various Resectoscopes .......... 70-71

CompatibleforUsewithCircon/ACMIBrandUSAElite System™/USASeries™ Resectoscope

CompatibleforUsewithCircon/ACMIBrandClassic Series™ Resectoscope

CompatibleforUsewithStorzBrandSingleStem Resectoscope

CompatibleforUsewithStorzBrandDoubleStem Resectoscope

CompatibleforUsewithOlympusBrand OES™SingleStemResectoscope

CompatibleforUsewithOlympusBrand OESProSeriesResectoscope

CompatibleforUsewithWolfBrandE-LineSeries Resectoscope

Bladder Tumor Resection Loops .72

BladderTumorResection(TURBT)Loops

Forceps .......................................73

Piranha™3FrenchUreteroscopicBiopsyForcep

Suture Capturing Devices ............73

Capio™RPSuturingDevicesforRadicalProstatectomy

Laser Devices ......................... 74-75

Aura XP™ Laser Therapy

OtherLaserSystemAccessories

PROCEDURE ACCESSORIES

Inflation Device ...........................77

Encore™26Inflator

Bladder Evacuation Device ..........77

Urovac™ Bladder Evacuator

Irrigation Devices and Accessories ............................ 77-78

SAPS™SingleActionPumpingSystem

SAPSCFContinuousFlowSingleActionPumpingSystem

Other .....................................78-79

UroLok™ II Scope Adaptor

ESP™RadiationReductionExaminationGloves

ConnectingTubes

Ureteral Catheter Connectors

DrainageBagConnectors

Gateway™AdvantageY-Adapter

PELVIC FLOOR PRODUCTS

Mid-Urethral Sling Systems ....... 81-82

AdvantageFit™System(Transvaginal)

Advantage™System(Transvaginal)

Lynx™System(Suprapubic)

Obtryx™ II System with PrecisionBlue™Design HaloorCurved(Transobturator)

Obtryx SystemHaloorCurved(Transobturator)

Solyx™SISSystem(SingleIncision)

Injectable Implant ...................... 83 Coaptite™InjectableImplant

Suturing Systems .................. 84-85

Capio™SLIMSutureCapturingDevice

CapioSutureCapturingDevices

CapioCLTransvaginalSuture CapturingDevice

Capio Sutures

Sacrocolpopexy .......................... 86

UPsylon™Y-Mesh

Polyform™SyntheticMesh

Pelvic Floor Reconstruction Synthetic Mesh Kit ..................... 86

Uphold™LITEVaginalSupportSystemwithCapioSLIMSutureCapturingDevice

Biologic Graft Materials ...............87

Xenform™SoftTissueRepairMatrix

Repliform™TissueRegenerationMatrix

Pelvic Floor Accessories ..............87 Single-Step™ Pelvic Drape

Product index ........................89-90

C-code Cross-Reference to Boston Scientific Products ...........91

C-code Resource List .................... 92

Terms and Conditions ................93

(TableofContents3of3)

Table of Contents UrologyandPelvicHealth


4

NOTES

VISUA

LIZATIONPRODU

CTS

VISU

ALI

ZATI

ONPR

ODU

CTS


5

VISUALIZATION PRODUCTS

LITHOVUE™ SINGLE-USE DIGITAL FLEXIBLE URETEROSCOPE

LithoVue SUD only

Order Number GTIN Number Description Unit

M0067913500 8714729874805 LithoVue-GlobalStandard ea

M0067913600 8714729874812 LithoVue-GlobalReverse ea

ApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.

LithoVue System Workstation (Includes Touch PC, Cart, Power Cord and User's Manual)


M0067911000 8714729874522 LithoVueSystemWorkstation-Global ea


LithoVue with Image and Video Capture


M0067913900 04907034602001 TEACUR-4MD ea


LithoVue Empower™ Retrieval Deployment Device


M0067919900 08714729977612 LithoVue Empower ea



6

NOTES

GUIDEW

IRES

GUID

EWIR

ES


7

GUIDEWIRES

SENSOR™ GUIDEWIRES

Sensor Dual-Flex Nitinol Guidewires with Hydrophilic Tip (10cm Flexible Proximal End)

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style

M0066703081 08714729302681 .035 150 Straight 3cmFlexible bx5

M0066703011 08714729302612 .035 150 Angled 3cmFlexible bx5


M00667030 21 08714729302629 .038 150 Angled 3cmFlexible bx5

ApplicableMedicareC-codes:C1769-guidewire

Sensor PTFE-Nitinol Guidewires with Hydrophilic Tip

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style






ZIPWIRE™ GUIDEWIRES

Standard ZIPwire Guidewires

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style

M006630200B1 08714729802433 .018 150 Straight 3cmFlexible bx5


M006630202B1 08714729802440 .025 150 Angled 3cmFlexible bx5










8

GUIDEWIRES

Bentson-Type ZIPwire Guidewires

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style






Enhanced Stiff Shaft ZIPwire Guidewires

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style








ZIPWIRE™ GUIDEWIRES (Continued)

Enhanced Bentson-Type Stiff Shaft ZIPwire Guidewires

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style







9

GUIDEWIRES

ZEBRA™ GUIDEWIRES

Zebra Guidewires

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style









SuppliedwithTorqueViseApplicableMedicareC-codes:C1769-guidewire

PTFE COATED GUIDEWIRES

PTFE Coated Guidewires (Fixed Core)

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style

M0066201070 08714729077046 .025 150 Straight 3cmFlexible ea


M0066201250 08714729056669 .035 150 Straight 15cmFlexible;Bentson-Type ea




PTFE Coated Guidewires (Fixed Core, Stiff Bodied)

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style



M0066201110 08714729077077 .035 150 3mm“J” ea


M0066201020 08714729005735 .038 150 3mm“J” ea



10

GUIDEWIRES

PTFE COATED GUIDEWIRES (Continued)

PTFE Coated Guidewires (Moveable Core)

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip DesignShape Unit

M0066201300 08714729057093 .035 150 Straight ea

M0066201210 08714729077084 .035 150 3mm“J” ea

M0066201030 08714729012627 .038 150 Straight ea

M0066201220 08714729077091 .038 150 3mm“J” ea


Amplatz Super Stiff™ Coated Guidewires

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style

M0066401041 08714729191148 .035 145 Straight 7cmFlexible,Bentson-Type bx5

M0066401051 08714729191155 .035 145 3mm“J” bx5

M0066401081 08714729191186 .035 145 Straight 3.5cmFlexible bx5

M0066401061 08714729191162 .038 145 Straight 6cmFlexible,Bentson-Type bx5

M0066401071 08714729191179 .038 145 3mm“J” bx5

M0066401091 08714729191193 .038 145 Straight 3.5cmFlexible bx5



11

GUIDEWIRES

Lubriglide Coated Guidewires (Moveable Core)

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip DesignShape Unit

M0066001300 08714729057062 .035 150 Straight ea

M0066001030 08714729011392 .038 150 Straight ea


Lubriglide Coated Guidewires (Fixed Core, Stiff Bodied)

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

Unit(Shape) (Style)



LUBRIGLIDE™ COATED GUIDEWIRESLubriglide Coated Guidewires (Fixed Core)

OrderNumber

GTINNumber

Diameter(in)

Length(cm)

Tip Design

UnitShape Style


M0066001060 08714729012603 .032 150 Straight18cmCoilwith3cmFlexible;

Lunderquist-Typeea






12

NOTES

DILATIONPRODU

CTS

DILA

TION

PROD

UCT

S


13

DILATION PRODUCTS

URETERAL ACCESS SHEATHS

Navigator Ureteral Access Sheath Sets

OrderNumber

GTINNumber

FrenchSize

Length (cm) Unit

M0062502000 08714729429920 11/13 28 ea

M0062502020 08714729429944 11/13 36 ea

M0062502040 08714729429968 11/13 46 ea

M0062502060 08714729470359 13/15 28 ea

M0062502080 08714729429999 13/15 36 ea

M0062502100 08714729430018 13/15 46 ea

M0062502011 08714729469575 11/13 28 bx5

M0062502031 08714729469582 11/13 36 bx5

M0062502051 08714729469599 11/13 46 bx5

M0062502071 08714729469605 13/15 28 bx5

M0062502091 08714729469612 13/15 36 bx5

M0062502111 08714729469629 13/15 46 bx5

ApplicableMedicareC-codes:C1894-introducer/sheath,otherthanguiding,otherthanintracardiacelectrophysiological,non-laser

Single-Tapered Tip

Navigator™ HD Ureteral Access Sheath Sets

OrderNumber

GTINNumber

FrenchSize

Length (cm) Unit

M0062502210 08714729839064 11/13 28 ea

M0062502220 08714729837978 11/13 36 ea

M0062502230 08714729837985 11/13 46 ea

M0062502240 08714729838272 12/14 28 ea

M0062502250 08714729837992 12/14 36 ea

M0062502260 08714729837558 12/14 46 ea

M0062502270 08714729839071 13/15 28 ea

M0062502280 08714729839088 13/15 36 ea

M0062502290 08714729839095 13/15 46 ea



14

UroMax Ultra Balloon Dilatation Catheters

OrderNumber

GTINNumber

BalloonInflated O.D.

BalloonLength

(cm)

Catheter SizeUsableLength

(cm)

RecommendedGuidewire

(in) Unit(Fr) (mm) (Fr) (mm)

M0062251000 08714729341109 12 4 4 5.8 1.9 75 .038 eaM0062251010 08714729341116 15 5 4 5.8 1.9 75 .038 eaM0062251020 08714729341123 18 6 4 5.8 1.9 75 .038 eaM0062251030 08714729341130 21 7 4 5.8 1.9 75 .038 eaM0062251040 08714729341147 24 8 4 5.8 1.9 75 .038 eaM0062251050 08714729341154 30 10 4 5.8 1.9 75 .038 eaM0062251060 08714729341161 12 4 6 5.8 1.9 75 .038 eaM0062251070 08714729341178 15 5 6 5.8 1.9 75 .038 eaM0062251080 08714729341185 18 6 6 5.8 1.9 75 .038 eaM0062251090 08714729341192 21 7 6 5.8 1.9 75 .038 eaM0062251100 08714729341208 24 8 8 5.8 1.9 75 .038 eaM0062251110 08714729341222 30 10 8 5.8 1.9 75 .038 eaM0062251150 08714729341239 12 4 10 5.8 1.9 75 .038 eaM0062251160 08714729341246 15 5 10 5.8 1.9 75 .038 eaM0062251170 08714729341253 18 6 10 5.8 1.9 75 .038 eaM0062251180 08714729341260 21 7 10 5.8 1.9 75 .038 ea

ApplicableMedicareC-codes:C1726-catheter,balloondilatation,non-vascular

DILATION PRODUCTS

URETERAL BALLOON DILATION CATHETERS

UroMax Ultra™ Balloon Dilatation Catheters (Kits)

OrderNumber

GTINNumber


BalloonLength

(cm)


(cm)

RecommendedGuidewire

(in) Unit(Fr) (mm) (Fr) (mm)

M0062251200 08714729341277 12 4 4 5.8 1.9 75 .038 eaM0062251210 08714729341284 15 5 4 5.8 1.9 75 .038 eaM0062251220 08714729341291 18 6 4 5.8 1.9 75 .038 eaM0062251230 08714729341307 21 7 4 5.8 1.9 75 .038 eaM0062251240 08714729341314 24 8 4 5.8 1.9 75 .038 eaM0062251250 08714729341321 30 10 4 5.8 1.9 75 .038 eaM0062251260 08714729341338 12 4 6 5.8 1.9 75 .038 eaM0062251270 08714729341345 15 5 6 5.8 1.9 75 .038 eaM0062251280 08714729341352 18 6 6 5.8 1.9 75 .038 eaM0062251290 08714729341369 21 7 6 5.8 1.9 75 .038 eaM0062251300 08714729341376 24 8 8 5.8 1.9 75 .038 eaM0062251310 08714729341383 30 10 8 5.8 1.9 75 .038 eaM0062251350 08714729341390 12 4 10 5.8 1.9 75 .038 eaM0062251360 08714729302421 15 5 10 5.8 1.9 75 .038 eaM0062251370 08714729302438 18 6 10 5.8 1.9 75 .038 eaM0062251380 08714729302445 21 7 10 5.8 1.9 75 .038 ea

KitIncludes:UroMaxUltraHighPressureBalloonDilatationCatheter,Encore™26InflatorApplicableMedicareC-codes:C1726-catheter,balloondilatation,non-vascular


15

DILATION PRODUCTS

URETERAL BALLOON DILATION CATHETERS (Continued)

Passport™ Balloon Dilatation Catheters (Kits)

OrderNumber

GTINNumber


BalloonLength

(cm)

TipLength

(cm)

ShaftDiameter

(Fr)

UsableLength

(cm) Unit(Fr) (mm)

M0062181200 08714729042570 12 4 2 2 3.0 150 ea

M0062181210 08714729042587 12 4 2 4 3.0 150 ea

M0062181300 08714729042594 12 4 4 2 3.0 150 ea

M0062181310 08714729042600 12 4 4 4 3.0 150 ea

KitIncludes:PassportBalloonBalloonDilatationCatheterandEncore™26InflatorApplicableMedicareC-codes:C1726-catheter,balloondilatation,non-vascular

Passport Balloon Dilatation Catheters

OrderNumber

GTINNumber


BalloonLength

(cm)

TipLength

(cm)

ShaftDiameter

(Fr)

UsableLength

(cm) Unit(Fr) (mm)

M0062181000 08714729154921 12 4 2 2 3.0 150 ea

M0062181010 08714729042549 12 4 2 4 3.0 150 ea

M0062181100 08714729191872 12 4 4 2 3.0 150 ea

M0062181110 08714729154969 12 4 4 4 3.0 150 ea

ApplicableMedicareC-codes:C1726-catheter,balloondilatation,non-vascular

Encore™ 26 Inflator

OrderNumber

GTINNumber Description Unit

M0067101131 08714729761815 20mlEncore26InflatorwithPressureGauge bx5

M0067101140 08714729755814 20mlEncore26InflatorwithPressureGauge ea



16

DILATION PRODUCTS

URETERAL DILATORSNottingham One-Step Hydrogel Coated Ureteral Dilators

OrderNumber

GTINNumber

Taper Size From/To(Fr)

Taper Length(cm)

Usable Length(cm) Unit

M0062301000 08714729192053 6/10 4 70 ea

M0062301010 08714729012443 6/12 4 70 ea

M0062301100 08714729192060 10/16 4 70 ea

M0062301150 08714729192077 12/18 4 70 ea


Ureteral Dilators

OrderNumber

GTINNumber

O.D. Size(Fr)


M0062401100 08714729005339 6 70 ea

M0062401110 08714729192084 8 70 ea

M0062401120 08714729005353 10 70 ea

M0062401130 08714729005360 12 70 ea

M0062401140 08714729005377 14 70 ea

M0062401150 08714729005384 16 70 ea


Ureteral Dilator System with Procedural Sheath Set

OrderNumber


M0062501000 08714729192091 Ureteral Dilators and Procedural Sheath Set ea

SetIncludes:One6,8,10,12,and14FrC-Flex™RadiopaqueDilatorwithHydroPlus™Coating;One16FrO.D.,14FrI.D.x37.5cmLengthRadiopaquePTFEProceduralSheath;.038”PTFECoatedGuidewireApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.

Ureteral Dilatation Set

OrderNumber


M0062401000 08714729005322 Ureteral Dilatation Set ea

SetIncludes:One6,8,10,12,14,and16FrC-FlexRadiopaqueDilatorwithHydroPlusCoatingand.038”PTFECoatedGuidewireApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.


17

NOTES


18

NOTES

STONE RETRIEVA

LDEVICES

STON

E RE

TRIE

VAL

DEVI

CES


19


NITINOL RETRIEVAL DEVICES

4-wire“O”Tip

Zero Tip™ Nitinol Stone Retrieval Baskets

OrderNumber

GTINNumber Description

Sheath O.D.(Fr)

Working Length(cm)

Basket O.D.(mm)

SheathMaterial Unit

M0063901040 08714729469636 ZeroTipNitinol4WireBasket 1.9 90 12 Polyimide/PTFE ea






Includes: IntroducerApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.

Dakota™ Nitinol Stone Retrieval Devices

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)

Basket O.D.(mm) Unit

M0063905000 08714729937364 DakotaNitinolStoneRetrievalDevice 1.9 120 8 ea

M0063905010 08714729937371 DakotaNitinolStoneRetrievalDevice 1.9 120 11 ea


1.9Fr“O”Tip

Positive Action Detachable Handle

Positive Action Detachable HandlePositive Action Detachable Handle

Escape™ Nitinol Stone Retrieval Baskets

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)


M0063902000 08714729121282 EscapeNitinolStoneRetrievalBasket 1.9 90 11–15 ea

M0063902010 08714729121299 EscapeNitinolStoneRetrievalBasket 1.9 120 11–15 ea

Includes:Y-Adaptor,T-ConnectorApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.


20


NITINOL RETRIEVAL DEVICES (Continued)

Graspit™ Nitinol Stone Retrieval Forceps

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)

Basket O.D.(mm)

SheathMaterial Unit

M0063204000 08714729341741 Nitinol2-ProngForceps 2.6 90 8 Polyimide/PTFE ea





OptiFlex™ Nitinol Stone Retrieval Baskets

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)


M0063903000 08714729767596 OptiFlexNitinolStoneRetrievalBasket 1.3 90 11 ea

M0063903010 08714729772859 OptiFlexNitinolStoneRetrievalBasket 1.3 120 11 ea


STAINLESS STEEL RETRIEVAL DEVICES

Bagley™ Helical Stone Retrieval Baskets

OrderNumber

GTINNumber

Sheath O.D.(Fr)

Working Length(cm)


M0063401210 08714729043478 1.9 90 10 eaM0063401220 08714729043485 1.9 120 10 ea



21


STAINLESS STEEL RETRIEVAL DEVICES (Continued)

Gemini™ Paired Wire Helical Stone Retrieval Baskets

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)


M0063303040 08714729074281 3WireBasket,“O”Tip 2.4 90 11 ea


M0063303070 08714729074311 3WireBasket,5cmFiliformTip 2.4 120 11 ea

























22



Segura Hemisphere™ Stone Retrieval Baskets

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)

Basket O.D.(mm)

SheathMaterial Unit

M0063801060 08714729341901 4WireBasket,“O”Tip 2.4 90 16 Polyimide eaM0063801070 08714729341918 4WireBasket,“O”Tip 2.4 120 16 Polyimide eaM0063801020 08714729341888 4WireBasket,“O”Tip 3.0 90 16 Polyimide eaM0063801000 08714729341864 4WireBasket,“O”Tip 3.0 120 16 Polyimide eaM0063801120 08714729341949 4WireBasket,“O”Tip 3.0 90 20 Polyimide ea M0063801100 08714729341925 4WireBasket,“O”Tip 3.0 120 20 Polyimide eaM0063801160 08714729341963 4WireBasket,“O”Tip 4.5 90 16 PTFE eaM0063801180 08714729341970 4WireBasket,“O”Tip 4.5 90 20 PTFE eaM0063801190 08714729341987 4WireBasket,5cmFiliformTip 4.5 90 20 PTFE ea


Tricep™ Hooked-Prong Grasping Forceps

OrderNumber


Sheath O.D.(Fr) Working Length (cm)

SheathMaterial Unit

M0063701100 08714729192183 RetractingGraspingForceps 2.4 90 PTFE eaM0063701110 08714729192190 RetractingGraspingForceps 2.4 120 PTFE eaM0063701000 08714729192176 3-ProngMini-ThrowGraspingForceps 3.0 90 PTFE eaM0063701010 08714729163770 3-ProngMini-ThrowGraspingForceps 3.0 120 PTFE eaM0063701140 08714729192206 RetractingGraspingForceps 3.0 90 PTFE eaM0063701150 08714729192213 RetractingGraspingForceps 3.0 120 PTFE eaM0063701220 08714729192244 Extra-StrengthGraspingForceps 3.0 90 Polyimide eaM0063701230 08714729192251 Extra-StrengthGraspingForceps 3.0 120 Polyimide ea


Tricep Hooked-Prong Grasping Forceps with Spool Handle

OrderNumber


Sheath O.D.(Fr) Working Length (cm)

SheathMaterial Unit

M0063701180 08714729192220 Non-RetractingGraspingForceps 3.0 90 Polyimide eaM0063701190 08714729192237 Non-RetractingGraspingForceps 3.0 120 Polyimide ea



23


LithoCatch™ Immobilization Device

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)

Basket O.D.(mm)

SheathMaterial Unit

M0068404120 08714729257899 12WireBasket,“O”Tip 2.2 110 7 Polyimide ea



Leslie Parachute™ Multi-Wire Stone Sweeping Devices

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)

Basket O.D.(cm) Unit

M0063203000 08714729162025 LeslieParachuteBasket,“O”Tip 3.1 90 10.5 eaM0063203010 08714729162032 LeslieParachuteBasket,5cmFiliformTip 3.1 90 10.5 eaM0063203020 08714729162049 LeslieParachuteBasket,“O”Tip 3.1 120 10.5 eaM0063203030 08714729162056 LeslieParachuteBasket,5cmFiliformTip 3.1 120 10.5 ea


Coil

Sheath RadiopaqueMarker

Stone Cone™ Nitinol Urological Retrieval Coils

OrderNumber


Sheath O.D.(Fr)

Working Length(cm)

O.D.(mm)

SheathMaterial Unit

M0063903100 08714729430209 Nitinol Retrieval Coil 3.0 115 7 PTFE ea

M0063903200 08714729430223 Nitinol Retrieval Coil 3.0 115 10 PTFE ea

Includes:J-IntroducerApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.

ANTIRETROPULSION DEVICES


24

NOTES

URETERA

LSTEN

TS

URE

TERA

LST

ENTS


25

URETERAL STENTS

STENT STORE

Polaris™ Ultra Ureteral Stent Sets (Dual Durometer Percuflex™ Material with HydroPlus™ Coating)

FrenchSize x LengthBetweenPigtails

WithoutWire

ea

.035" Sensor™ PTFE-NitinolFlexible Tip

ea

.038" SensorPTFE-Nitinol

Dual-Flexea

.038" Stiff ShaftPTFE

Straight 3cmFlexible Tip

ea

Order Number GTIN Number Order Number GTIN Number Order Number GTIN Number Order Number GTIN Number

5 x 10 M0061921110 08714729125372 M006192111090 08714729125389 M006192111120 08714729766094 M006192111010 08714729789734

5 x 12 M0061921120 08714729125402 M006192112090 08714729125419 M006192112120 08714729766124 M006192112010 08714729781301

5 x 14 M0061921130 08714729125426 M006192113090 08714729125433 M006192113120 08714729766155 M006192113010 08714729781318

5 x 16 M0061921140 08714729125440 M006192114090 08714729125457 NA NA M006192114010 08714729784821

5 x 18 M0061921150 08714729125464 M006192115090 08714729125471 NA NA M006192115010 08714729798828

5 x 20 M0061921200 08714729124269 M006192120090 08714729124276 NA NA M006192120010 08714729790259

5 x 22 M0061921210 08714729124283 M006192121090 08714729124290 M006192121120 08714729766278 M006192121010 08714729779483

5 x 24 M0061921220 08714729124306 M006192122090 08714729124313 M006192122120 08714729766308 M006192122010 08714729784272

5 x 26 M0061921230 08714729124320 M006192123090 08714729124337 M006192123120 08714729766339 M006192123010 08714729779537

5 x 28 M0061921240 08714729124344 M006192124090 08714729124351 M006192124120 08714729766360 M006192124010 08714729784289

5 x 30 M0061921250 08714729124368 M006192125090 08714729124375 M006192125120 08714729766391 M006192125010 08714729798835

6 x 20 M0061921300 08714729124382 M006192130090 08714729124399 M006192130120 08714729766421 M006192130010 08714729779490

6 x 22 M0061921310 08714729124405 M006192131090 08714729124412 M006192131120 08714729766452 M006192131010 08714729782995

6 x 24 M0061921320 08714729124429 M006192132090 08714729124436 M006192132120 08714729766483 M006192132010 08714729784302

6 x 26 M0061921330 08714729124443 M006192133090 08714729124450 M006192133120 08714729766513 M006192133010 08714729779520

6 x 28 M0061921340 08714729124467 M006192134090 08714729124474 M006192134120 08714729766544 M006192134010 08714729779476

6 x 30 M0061921350 08714729124498 M006192135090 08714729124856 M006192135120 08714729766575 M006192135010 08714729798842

7 x 20 M0061921400 08714729124504 M006192140090 08714729124511 M006192140120 08714729766605 M006192140010 08714729786160

7 x 22 M0061921410 08714729124528 M006192141090 08714729124535 M006192141120 08714729766636 M006192141010 08714729779506

7 x 24 M0061921420 08714729124542 M006192142090 08714729124559 M006192142120 08714729766667 M006192142010 08714729784340

7 x 26 M0061921430 08714729124566 M006192143090 08714729124573 M006192143120 08714729766698 M006192143010 08714729784357

7 x 28 M0061921440 08714729124580 M006192144090 08714729124597 M006192144120 08714729766728 M006192144010 08714729784371

7 x 30 M0061921450 08714729124603 M006192145090 08714729124610 M006192145120 08714729766759 M006192145010 08714729798859

8 x 20 M0061921500 08714729124627 M006192150090 08714729124634 M006192150120 08714729766780 M006192150010 08714729784814

8 x 22 M0061921510 08714729124641 M006192151090 08714729124658 M006192151120 08714729766810 M006192151010 08714729786108

8 x 24 M0061921520 08714729125150 M006192152090 08714729124672 M006192152120 08714729766841 M006192152010 08714729784807

8 x 26 M0061921530 08714729720942 M006192153090 08714729720959 M006192153120 08714729766872 M006192153010 08714729784395

8 x 28 M0061921540 08714729124702 M006192154090 08714729124719 M006192154120 08714729766902 M006192154010 08714729779513

8 x 30 M0061921550 08714729124726 M006192155090 08714729124733 M006192155120 08714729766933 M006192155010 08714729798866

Each Stent Supplied with Attached Retrieval Line and Stent PositionerSetIncludes:PolarisUltraDualDurometerUreteralStentwithPercuflexMaterialandHydroPlusCoating,andAttachedRetrievalLine,StentPositioner,Axxcess™6FrUreteralCatheter,andSpecifiedGuidewireApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


26

URETERAL STENTS

STENT STORE (Continued)

Polaris™ Ultra Ureteral Stent Sets (Dual Durometer Percuflex™ Material with HydroPlus™ Coating) (Continued)


.038"ZIPwire™


ea

.035" Stiff ShaftZIPwire


ea

.035"ZIPwire


ea



ea


5 x 10 M006192111170 08714729766100 M006192111180 08714729776963 M006192111190 08714729766117 M006192111050 08714729798873

5 x 12 M006192112170 08714729766131 M006192112180 08714729776970 M006192112190 08714729766148 M006192112050 08714729798880

5 x 14 M006192113170 08714729766162 M006192113180 08714729776987 M006192113190 08714729766179 M006192113050 08714729798897

5 x 16 M006192114170 08714729766193 M006192114180 08714729776994 M006192114190 08714729766209 M006192114050 08714729798903

5 x 18 M006192115170 08714729766223 M006192115180 08714729777007 M006192115190 08714729766230 M006192115050 08714729798910

5 x 20 M006192120170 08714729766254 M006192120180 08714729777014 M006192120190 08714729766261 M006192120050 08714729798927

5 x 22 M006192121170 08714729766285 M006192121180 08714729777021 M006192121190 08714729766292 M006192121050 08714729798934

5 x 24 M006192122170 08714729766315 M006192122180 08714729777038 M006192122190 08714729766322 M006192122050 08714729780410

5 x 26 M006192123170 08714729766346 M006192123180 08714729777045 M006192123190 08714729766353 M006192123050 08714729780427

5 x 28 M006192124170 08714729766377 M006192124180 08714729777052 M006192124190 08714729766384 M006192124050 08714729784296

5 x 30 M006192125170 08714729766407 M006192125180 08714729777069 M006192125190 08714729766414 M006192125050 08714729798941

6 x 20 M006192130170 08714729766438 M006192130180 08714729777076 M006192130190 08714729766445 M006192130050 08714729798958

6 x 22 M006192131170 08714729766469 M006192131180 08714729777083 M006192131190 08714729766476 M006192131050 08714729798965

6 x 24 M006192132170 08714729766490 M006192132180 08714729777090 M006192132190 08714729766506 M006192132050 08714729784319

6 x 26 M006192133170 08714729766520 M006192133180 08714729777106 M006192133190 08714729766537 M006192133050 08714729778219

6 x 28 M006192134170 08714729766551 M006192134180 08714729777113 M006192134190 08714729766568 M006192134050 08714729784326

6 x 30 M006192135170 08714729766582 M006192135180 08714729777120 M006192135190 08714729766599 M006192135050 08714729784197

7 x 20 M006192140170 08714729766612 M006192140180 08714729777137 M006192140190 08714729766629 M006192140050 08714729784333

7 x 22 M006192141170 08714729766643 M006192141180 08714729777144 M006192141190 08714729766650 M006192141050 08714729798972

7 x 24 M006192142170 08714729766674 M006192142180 08714729777151 M006192142190 08714729766681 M006192142050 08714729798989

7 x 26 M006192143170 08714729766704 M006192143180 08714729777168 M006192143190 08714729766711 M006192143050 08714729784364

7 x 28 M006192144170 08714729766735 M006192144180 08714729777175 M006192144190 08714729766742 M006192144050 08714729798996

7 x 30 M006192145170 08714729766766 M006192145180 08714729777182 M006192145190 08714729766773 M006192145050 08714729799009

8 x 20 M006192150170 08714729766797 M006192150180 08714729777199 M006192150190 08714729766803 M006192150050 08714729799016

8 x 22 M006192151170 08714729766827 M006192151180 08714729777205 M006192151190 08714729766834 M006192151050 08714729799023

8 x 24 M006192152170 08714729766858 M006192152180 08714729777212 M006192152190 08714729766865 M006192152050 08714729784388

8 x 26 M006192153170 08714729766889 M006192153180 08714729777229 M006192153190 08714729766896 M006192153050 08714729784401

8 x 28 M006192154170 08714729766919 M006192154180 08714729777236 M006192154190 08714729766926 M006192154050 08714729784418

8 x 30 M006192155170 08714729766940 M006192155180 08714729777243 M006192155190 08714729766957 M006192155050 08714729784425

Each Stent Supplied with Attached Retrieval Line and Stent PositionerSetIncludes:PolarisUltraDualDurometerUreteralStentwithPercuflexMaterialandHydroPlusCoating,andAttachedRetrievalLine,StentPositioner,Axxcess™6FrUreteralCatheter,andSpecifiedGuidewireApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


27

URETERAL STENTS


Kidney Coil(Firm Durometer Percuflex Material)

Tapered Tip

Bladder Loop Design(Soft Durometer Percuflex Material)

Polaris™ Loop Ureteral Stent Sets (Dual Durometer Percuflex™ Material with HydroPlus™ Coating)


WithoutWire

ea

.035" Sensor™ PTFE-Nitinol

Dual-Flexea

.038" Sensor PTFE-Nitinol

Dual-Flexea



ea


5 x 10 M0061552110 08714729765349 M006155211090 08714729765356 M006155211120 08714729775782 M006155211010 08714729788430

5 x 12 M0061552120 08714729420965 M006155212090 08714729777427 M006155212120 08714729790808 M006155212010 08714729790785

5 x 14 M0061552130 08714729420972 M006155213090 08714729774808 M006155213120 08714729775799 M006155213010 08714729773313

5 x 16 M0061552140 08714729420989 M006155214090 08714729765370 M006155214120 08714729788478 M006155214010 08714729774334

5 x 18 M0061552150 08714729420996 M006155215090 08714729765394 M006155215120 08714729778349 M006155215010 08714729788485

5 x 20 M0061552200 08714729421009 M006155220090 08714729777434 M006155220120 08714729788522 M006155220010 08714729778325

5 x 22 M0061552210 08714729421016 M006155221090 08714729765417 M006155221120 08714729775911 M006155221010 08714729775744

5 x 24 M0061552220 08714729421023 M006155222090 08714729765431 M006155222120 08714729782162 M006155222010 08714729775928

5 x 26 M0061552230 08714729421030 M006155223090 08714729765455 M006155223120 08714729774891 M006155223010 08714729788546

5 x 28 M0061552240 08714729421047 M006155224090 08714729765479 M006155224120 08714729774679 M006155224010 08714729788553

5 x 30 M0061552250 08714729421054 M006155225090 08714729777441 M006155225120 08714729784180 M006155225010 08714729788560

6 x 20 M0061552300 08714729421061 M006155230090 08714729775652 M006155230120 08714729775669 M006155230010 08714729775645

6 x 22 M0061552310 08714729421078 M006155231090 08714729765493 M006155231120 08714729775508 M006155231010 08714729775515

6 x 24 M0061552320 08714729421085 M006155232090 08714729765516 M006155232120 08714729775492 M006155232010 08714729774426

6 x 26 M0061552330 08714729421092 M006155233090 08714729755432 M006155233120 08714729775522 M006155233010 08714729773740

6 x 28 M0061552340 08714729421108 M006155234090 08714729765547 M006155234120 08714729774785 M006155234010 08714729775539

6 x 30 M0061552350 08714729421115 M006155235090 08714729773771 M006155235120 08714729775546 M006155235010 08714729788584

7 x 20 M0061552400 08714729421122 M006155240090 08714729777458 M006155240120 08714729782155 M006155240010 08714729788607

7 x 22 M0061552410 08714729421139 M006155241090 08714729774037 M006155241120 08714729774730 M006155241010 08714729775409

7 x 24 M0061552420 08714729421146 M006155242090 08714729765561 M006155242120 08714729785446 M006155242010 08714729778479

7 x 26 M0061552430 08714729421153 M006155243090 08714729765585 M006155243120 08714729778356 M006155243010 08714729774518

7 x 28 M0061552440 08714729421160 M006155244090 08714729765608 M006155244120 08714729775485 M006155244010 08714729775621

7 x 30 M0061552450 08714729421177 M006155245090 08714729775607 M006155245120 08714729776123 M006155245010 08714729775577

8 x 20 M0061552500 08714729421184 M006155250090 08714729777465 M006155250120 08714729782131 M006155250010 08714729788638

8 x 22 M0061552510 08714729421191 M006155251090 08714729765622 M006155251120 08714729778363 M006155251010 08714729775416

8 x 24 M0061552520 08714729421207 M006155252090 08714729765646 M006155252120 08714729788652 M006155252010 08714729784203

8 x 26 M0061552530 08714729421214 M006155253090 08714729765660 M006155253120 08714729814856 M006155253010 08714729776031

8 x 28 M0061552540 08714729421221 M006155254090 08714729765684 M006155254120 08714729776208 M006155254010 08714729784227

8 x 30 M0061552550 08714729421238 M006155255090 08714729777472 M006155255120 08714729778332 M006155255010 08714729788669

Each Stent Supplied with Attached Retrieval Line and Stent PositionerSetIncludes:PolarisLoopDualDurometerUreteralStentwithPercuflexMaterialandHydroPlusCoating,andAttachedRetrievalLine,StentPositioner,Axxcess™6FrUreteralCatheter,andSpecifiedGuidewireApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


28

URETERAL STENTS


Kidney Coil(Firm Durometer Percuflex Material)

Tapered Tip

Bladder Loop Design(Soft Durometer Percuflex Material)

Polaris™ Loop Ureteral Stent Sets (Dual Durometer Percuflex™ Material with HydroPlus™ Coating) (Continued)


.038"ZIPwire™


ea



ea

.035"ZIPwire


ea



ea


5 x 10 M006155211170 08714729778417 M006155211180 08714729777489 M006155211190 08714729765363 M006155211050 08714729788447

5 x 12 M006155212170 08714729788454 M006155212180 08714729777496 M006155212190 08714729778110 M006155212050 08714729790792

5 x 14 M006155213170 08714729778424 M006155213180 08714729777502 M006155213190 08714729778127 M006155213050 08714729783756

5 x 16 M006155214170 08714729778431 M006155214180 08714729777519 M006155214190 08714729765387 M006155214050 08714729788461

5 x 18 M006155215170 08714729788508 M006155215180 08714729777526 M006155215190 08714729765400 M006155215050 08714729788492

5 x 20 M006155220170 08714729788539 M006155220180 08714729777533 M006155220190 08714729778134 M006155220050 08714729788515

5 x 22 M006155221170 08714729778448 M006155221180 08714729777540 M006155221190 08714729765424 M006155221050 08714729778318

5 x 24 M006155222170 08714729774815 M006155222180 08714729775935 M006155222190 08714729765448 M006155222050 08714729774839

5 x 26 M006155223170 08714729774631 M006155223180 08714729777557 M006155223190 08714729765462 M006155223050 08714729775942

5 x 28 M006155224170 08714729776192 M006155224180 08714729777564 M006155224190 08714729765486 M006155224050 08714729774624

5 x 30 M006155225170 08714729778455 M006155225180 08714729777571 M006155225190 08714729778141 M006155225050 08714729776154

6 x 20 M006155230170 08714729788577 M006155230180 08714729777588 M006155230190 08714729778158 M006155230050 08714729782148

6 x 22 M006155231170 08714729775591 M006155231180 08714729777595 M006155231190 08714729765509 M006155231050 08714729773641

6 x 24 M006155232170 08714729775638 M006155232180 08714729774013 M006155232190 08714729765523 M006155232050 08714729755463

6 x 26 M006155233170 08714729774433 M006155233180 08714729773788 M006155233190 08714729765530 M006155233050 08714729755456

6 x 28 M006155234170 08714729775751 M006155234180 08714729774792 M006155234190 08714729765554 M006155234050 08714729774297

6 x 30 M006155235170 08714729788591 M006155235180 08714729777601 M006155235190 08714729778165 M006155235050 08714729775553

7 x 20 M006155240170 08714729788621 M006155240180 08714729777618 M006155240190 08714729778172 M006155240050 08714729788614

7 x 22 M006155241170 08714729775430 M006155241180 08714729777625 M006155241190 08714729778189 M006155241050 08714729782124

7 x 24 M006155242170 08714729775447 M006155242180 08714729777632 M006155242190 08714729765578 M006155242050 08714729786092

7 x 26 M006155243170 08714729774938 M006155243180 08714729774686 M006155243190 08714729765592 M006155243050 08714729774488

7 x 28 M006155244170 08714729775454 M006155244180 08714729775560 M006155244190 08714729765615 M006155244050 08714729774716

7 x 30 M006155245170 08714729778486 M006155245180 08714729777649 M006155245190 08714729775614 M006155245050 08714729775584

8 x 20 M006155250170 08714729778493 M006155250180 08714729777656 M006155250190 08714729778196 M006155250050 08714729788645

8 x 22 M006155251170 08714729776079 M006155251180 08714729777663 M006155251190 08714729765639 M006155251050 08714729778301

8 x 24 M006155252170 08714729776024 M006155252180 08714729777670 M006155252190 08714729765653 M006155252050 08714729784210

8 x 26 M006155253170 08714729776055 M006155253180 08714729776062 M006155253190 08714729765677 M006155253050 08714729776048

8 x 28 M006155254170 08714729775973 M006155254180 08714729776000 M006155254190 08714729765691 M006155254050 08714729774723

8 x 30 M006155255170 08714729788676 M006155255180 08714729777687 M006155255190 08714729778202 M006155255050 08714729784234

Each Stent Supplied with Attached Retrieval Line and Stent PositionerSetIncludes:PolarisLoopDualDurometerUreteralStentwithPercuflexMaterialandHydroPlusCoating,andAttachedRetrievalLine,StentPositioner,Axxcess™6FrUreteralCatheter,andSpecifiedGuidewireApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


29

URETERAL STENTS


Tapered Tip Large Side Ports Placement Markers

Firm Durometer Percuflex Material with HydroPlus Coating

Percuflex™ Plus Ureteral Stent Sets (with HydroPlus™ Coating)


WithoutWire

ea



ea

.038" ZIPwire™


ea



ea


4.8 x 10 M0061751950 08714729067566 NA NA NA NA M006175195180 08714729776918

4.8 x 12 M0061751960 08714729067580 NA NA NA NA M006175196180 08714729776178

4.8 x 14 M0061751970 08714729067603 NA NA NA NA M006175197180 08714729776925

4.8 x 16 M0061751980 08714729067627 NA NA NA NA M006175198180 08714729774600

4.8 x 18 M0061751990 08714729067641 NA NA NA NA M006175199180 08714729774853

4.8 x 20 M0061752500 08714729143970 NA NA NA NA M006175250180 08714729774280

4.8 x 22 M0061752510 08714729067719 NA NA NA NA M006175251180 08714729776130

4.8 x 24 M0061752520 08714729056805 NA NA NA NA M006175252180 08714729773139

4.8 x 26 M0061752530 08714729056812 NA NA NA NA M006175253180 08714729772736

4.8 x 28 M0061752540 08714729067757 NA NA NA NA M006175254180 08714729772941

4.8 x 30 M0061752550 08714729067771 NA NA NA NA M006175255180 08714729776093

6 x 20 M0061752600 08714729067788 M006175260010 08714729268857 M006175260170 08714729773429 M006175260180 08714729776109

6 x 22 M0061752610 08714729067795 M006175261010 08714729339991 M006175261170 08714729765752 M006175261180 08714729773665

6 x 24 M0061752620 08714729056829 M006175262010 08714729340003 M006175262170 08714729764748 M006175262180 08714729772835

6 x 26 M0061752630 08714729041184 M006175263010 08714729302032 M006175263170 08714729762706 M006175263180 08714729767848

6 x 28 M0061752640 08714729041191 M006175264010 08714729302063 M006175264170 08714729765769 M006175264180 08714729772750

6 x 30 M0061752650 08714729067849 M006175265010 08714729302070 M006175265170 08714729774709 M006175265180 08714729772811

7 x 20 M0061752700 08714729067856 M006175270010 08714729302087 M006175270170 08714729774860 M006175270180 08714729776932

7 x 22 M0061752710 08714729067863 M006175271010 08714729268864 M006175271170 08714729773900 M006175271180 08714729774228

7 x 24 M0061752720 08714729056836 M006175272010 08714729340034 M006175272170 08714729765776 M006175272180 08714729772958

7 x 26 M0061752730 08714729041207 M006175273010 08714729340041 M006175273170 08714729764700 M006175273180 08714729772767

7 x 28 M0061752740 08714729041214 M006175274010 08714729340058 M006175274170 08714729773344 M006175274180 08714729772774

7 x 30 M0061752750 08714729056843 M006175275010 08714729302094 M006175275170 08714729774419 M006175275180 08714729772965

8 x 20 M0061752800 08714729067917 M006175280010 08714729268871 M006175280170 08714729774129 NA NA

8 x 22 M0061752810 08714729067924 M006175281010 08714729268888 M006175281170 08714729773917 M006175281180 08714729776956

8 x 24 M0061752820 08714729056850 M006175282010 08714729302100 M006175282170 08714729765783 M006175282180 08714729774778

8 x 26 M0061752830 08714729041221 M006175283010 08714729302117 M006175283170 08714729774303 M006175283180 08714729773450

8 x 28 M0061752840 08714729067931 M006175284010 08714729340065 M006175284170 08714729765790 M006175284180 08714729773290

8 x 30 M0061752850 08714729067948 M006175285010 08714729268895 M006175285170 08714729773610 M006175285180 08714729773368

EachStentSuppliedwithAttachedRetrievalLineandStentPositioner,andPigtailStraightenerwhereapplicable.SetIncludes:PercuflexPlusStentwithHydroPlusCoating,Axxcess™6FrUreteralCatheterandSpecifiedGuidewire8FrStentsSuppliedwithPositionerAssemblyNA=NotAvailableApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


30

URETERAL STENTS


Percuflex™ Plus Ureteral Stent Sets (with HydroPlus™ Coating) (Continued)


.035" ZIPwire™


ea



ea

.035" Sensor™

PTFE-NitinolDual-Flex

ea

.038"Sensor


ea


4.8 x 10 M006175195190 08714729765707 M006175195050 08714729285465 NA NA NA NA

4.8 x 12 M006175196190 08714729765714 M006175196050 08714729285472 NA NA NA NA

4.8 x 14 M006175197190 08714729765721 M006175197050 08714729297246 NA NA NA NA

4.8 x 16 M006175198190 08714729776185 M006175198050 08714729297260 M006175198090 08714729421276 NA NA

4.8 x 18 M006175199190 08714729774846 M006175199050 08714729297284 NA NA NA NA

4.8 x 20 M006175250190 08714729776161 M006175250050 08714729339946 M006175250090 08714729421290 NA NA

4.8 x 22 M006175251190 08714729774211 M006175251050 08714729339953 M006175251090 08714729421306 NA NA

4.8 x 24 M006175252190 08714729765738 M006175252050 08714729339960 M006175252090 08714729421313 NA NA

4.8 x 26 M006175253190 08714729765745 M006175253050 08714729339977 M006175253090 08714729421320 NA NA

4.8 x 28 M006175254190 08714729773535 M006175254050 08714729170082 M006175254090 08714729421337 NA NA

4.8 x 30 M006175255190 08714729773801 M006175255050 08714729339984 M006175255090 08714729421344 NA NA

6 x 20 M006175260190 08714729774693 M006175260050 08714729460657 NA NA M006175260120 08714729421368

6 x 22 M006175261190 08714729776147 M006175261050 08714729460725 M006175261090 08714729421375 M006175261120 08714729421382

6 x 24 M006175262190 08714729773702 M006175262050 08714729460794 M006175262090 08714729421399 M006175262120 08714729421405

6 x 26 M006175263190 08714729772996 M006175263050 08714729460862 M006175263090 08714729421412 M006175263120 08714729421429

6 x 28 M006175264190 08714729774112 M006175264050 08714729460930 M006175264090 08714729421436 M006175264120 08714729421443

6 x 30 M006175265190 08714729776017 M006175265050 08714729461005 NA NA NA NA

7 x 20 M006175270190 08714729776116 M006175270050 08714729461081 M006175270090 08714729421474 M006175270120 08714729421481

7 x 22 M006175271190 08714729775980 M006175271050 08714729461159 M006175271090 08714729421498 NA NA

7 x 24 M006175272190 08714729767831 M006175272050 08714729461227 M006175272090 08714729421511 M006175272120 08714729421528

7 x 26 M006175273190 08714729773177 M006175273050 08714729461296 M006175273090 08714729421535 M006175273120 08714729421542

7 x 28 M006175274190 08714729773207 M006175274050 08714729461364 M006175274090 08714729421559 M006175274120 08714729421566

7 x 30 M006175275190 08714729774648 M006175275050 08714729461432 M006175275090 08714729421573 NA NA

8 x 20 M006175280190 08714729775997 NA NA NA NA M006175280120 08714729421603

8 x 22 NA NA M006175281050 08714729461586 NA NA M006175281120 08714729421627

8 x 24 M006175282190 08714729776352 M006175282050 08714729461661 M006175282090 08714729421634 NA NA

8 x 26 M006175283190 08714729774945 M006175283050 08714729461739 NA NA M006175283120 08714729421665

8 x 28 M006175284190 08714729774952 M006175284050 08714729461807 NA NA M006175284120 08714729421689

8 x 30 NA NA M006175285050 08714729461876 NA NA NA NA

SetIncludes:PercuflexPlusStentwithHydroPlusCoatingandattachedRetrievalLine,StentPositioner,Axxcess™6FrUreteralCatheterandSpecifiedGuidewire8FrStentsSuppliedwithPositionerAssemblyandPigtailStraightenerNA=NotAvailableApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


31

URETERAL STENTS


Percuflex™ Plus Ureteral Stent Sets (with HydroPlus™ Coating and Braided Retrieval Line)


WithoutGuidewire

ea

Order Number GTIN Number

4.8 x 22 M0061755510 08714729421726

4.8 x 24 M0061755520 08714729421801

4.8 x 26 M0061755530 08714729421887

4.8 x 28 M0061755540 08714729421962

6 x 20 M0061755600 08714729422044

6 x 22 M0061755610 08714729422167

6 x 24 M0061755620 08714729422280

6 x 26 M0061755630 08714729422402

6 x 28 M0061755640 08714729422518

6 x 30 M0061755650 08714729340089

7 x 22 M0061755710 08714729422730

7 x 24 M0061755720 08714729422853

7 x 26 M0061755730 08714729422976

7 x 28 M0061755740 08714729423096

8 x 22 M0061755810 08714729423232

8 x 24 M0061755820 08714729423355

8 x 26 M0061755830 08714729423461

8 x 28 M0061755840 08714729423584

EachStentSuppliedwithAttached(Braided)RetrievalLineandStentPositionerSetIncludes:PercuflexPlusStentwithHydroPlusCoating,Axxcess™6FrUreteralCatheterandSpecifiedGuidewire8FrStentsSuppliedwithPositionerAssemblyandPigtailStraightenerApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


32

URETERAL STENTS


Tapered Tip

Firm Durometer Percuflex Material

Large Side Ports

Placement Marker

Percuflex™ Ureteral Stents


WithoutGuidewire

ea



ea

.038" ZIPwire™


ea

.035"ZIPwire


ea



ea

Order Number GTIN Number Order Number GTIN Number Order Number GTIN Number Order Number GTIN Number Order Number GTIN Number

4.8 x 22 M0061453500 08714729040255 NA NA NA NA M006145350190 08714729788058 M006145350050 08714729297055

4.8 x 24 M0061453510 08714729040262 NA NA NA NA M006145351190 08714729778394 M006145351050 08714729339748

4.8 x 26 M0061453520 08714729040279 NA NA NA NA M006145352190 08714729775812 M006145352050 08714729339755

4.8 x 28 M0061453530 08714729040286 NA NA NA NA M006145353190 08714729779384 M006145353050 08714729297062

6 x 20 M0061453590 08714729040309 M006145359010 08714729297086 M006145359170 08714729788089 NA NA NA NA

6 x 22 M0061453600 08714729040316 NA NA NA NA NA NA NA NA

6 x 24 M0061453610 08714729040323 M006145361010 08714729339779 M006145361170 08714729775836 M006145361190 08714729775966 M006145361050 08714729458012

6 x 26 M0061453620 08714729040330 M006145362010 08714729339786 M006145362170 08714729775898 M006145362190 08714729775843 M006145362050 08714729458104

6 x 28 M0061453630 08714729040347 M006145363010 08714729339793 M006145363170 08714729775805 M006145363190 08714729775850 M006145363050 08714729458197

6 x 30 M0061453640 08714729040354 M006145364010 08714729297093 NA NA M006145364190 08714729777809 NA NA

7 x 20 M0061453690 08714729040361 M006145369010 08714729297109 M006145369170 08714729788171 NA NA NA NA

7 x 22 M0061453700 08714729040378 M006145370010 08714729297116 NA NA NA NA M006145370050 08714729458470

7 x 24 M0061453710 08714729040385 M006145371010 08714729339809 M006145371170 08714729774884 NA NA M006145371050 08714729458562

7 x 26 M0061453720 08714729040392 M006145372010 08714729339816 M006145372170 08714729775881 M006145372190 08714729785361 M006145372050 08714729458654

7 x 28 M0061453730 08714729040408 M006145373010 08714729339823 M006145373170 08714729788232 NA NA M006145373050 08714729458746

7 x 30 M0061453740 08714729040415 M006145374010 08714729297123 NA NA M006145374190 08714729775768 M006145374050 08714729458838

8 x 20 M0061453790 08714729040422 M006145379010 08714729339830 NA NA NA NA NA NA

8 x 22 M0061453800 08714729040439 M006145380010 08714729297130 M006145380170 08714729788300 NA NA NA NA

8 x 24 M0061453810 08714729040446 M006145381010 08714729297147 NA NA M006145381190 08714729788355 NA NA

8 x 26 M0061453820 08714729040453 M006145382010 08714729301950 NA NA M006145381170 08714729788331 NA NA

8 x 28 M0061453830 08714729040460 M006145383010 08714729301967 M006145383170 08714729775775 M006145381180 08714729788348 M006145383050 08714729459286

8 x 30 M0061453840 08714729040477 M006145384010 08714729297154 NA NA NA NA NA NA

EachStentSuppliedwithAttachedRetrievalLineandStentPositioner,andPigtailStraightenerwhereapplicable.SetIncludes:PercuflexStent,Axxcess™6FrUreteralCatheterandSpecifiedGuidewire8FrStentsSuppliedwithPositionerAssemblyNA=NotAvailableApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


33

URETERAL STENTS


Soft Durometer Percuflex Material with HydroPlus Coating

Tapered TipLarge Side Ports

Placement Markers

Contour™ Ureteral Stent Sets (with HydroPlus™ Coating) – A Softer Percuflex™ Material Stent


WithoutWire

ea



ea

.038" ZIPwire™


ea



ea


6 x 20 M0061802200 08714729058441 M006180220010 08714729058458 M006180220170 08714729789185 M006180220180 08714729789192

6 x 22 M0061802210 08714729058472 M006180221010 08714729058489 M006180221170 08714729765868 M006180221180 08714729777908

6 x 24 M0061802220 08714729058502 M006180222010 08714729058519 M006180222170 08714729764731 M006180222180 08714729773030

6 x 26 M0061802230 08714729058533 M006180223010 08714729058540 M006180223170 08714729764724 M006180223180 08714729772729

6 x 28 M0061802240 08714729058564 M006180224010 08714729058571 M006180224170 08714729773238 M006180224180 08714729772828

6 x 30 M0061802250 08714729058595 M006180225010 08714729058601 M006180225170 08714729764717 M006180225180 08714729773979

7 x 20 M0061802300 08714729058625 M006180230010 08714729058632 M006180230170 08714729779360 M006180230180 08714729776680

7 x 22 M0061802310 08714729058656 M006180231010 08714729058663 M006180231170 08714729773863 M006180231180 08714729776703

7 x 24 M0061802320 08714729058687 M006180232010 08714729058694 M006180232170 08714729773405 M006180232180 08714729774105

7 x 26 M0061802330 08714729058717 M006180233010 08714729058724 M006180233170 08714729773160 M006180233180 08714729772804

7 x 28 M0061802340 08714729058731 M006180234010 08714729058748 M006180234170 08714729773757 M006180234180 08714729772934

7 x 30 M0061802350 08714729058762 M006180235010 08714729058779 M006180235170 08714729776307 M006180235180 08714729776291

8 x 20 M0061802400 08714729058793 M006180240010 08714729058809 M006180240170 08714729776376 M006180240180 08714729789208

8 x 22 M0061802410 08714729058823 M006180241010 08714729058830 M006180241170 08714729773504 M006180241180 08714729776383

8 x 24 M0061802420 08714729058854 M006180242010 08714729058861 M006180242170 08714729774099 M006180242180 08714729774822

8 x 26 M0061802430 08714729058885 M006180243010 08714729058892 M006180243170 08714729773818 M006180243180 08714729773191

8 x 28 M0061802440 08714729058915 M006180244010 08714729058922 M006180244170 08714729776604 M006180244180 08714729774471

8 x 30 M0061802450 08714729058946 M006180245010 08714729058953 M006180245170 08714729789222 M006180245180 08714729776321

EachStentSuppliedwithAttachedRetrievalLineandStentPositioner,andPigtailStraightenerwhereapplicable.SetIncludes:ContourStentwithHydroPlusCoating,Axxcess™6FrUreteralCatheterandSpecifiedGuidewire8FrStentsSuppliedwithPositionerAssemblyApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


34

URETERAL STENTS


Contour™ Ureteral Stent Sets (with HydroPlus™ Coating) – A Softer Percuflex™ Material Stent (Continued)


.035" Stiff ShaftZIPwire™


ea



ea

.035" Sensor™


ea

.038" Sensor


ea


6 x 20 M006180220190 08714729776581 M006180220050 08714729462040 M006180220090 08714729423942 M006180220120 08714729423966

6 x 22 M006180221190 08714729779315 M006180221050 08714729462118 M006180221090 08714729423980 M006180221120 08714729424000

6 x 24 M006180222190 08714729781066 M006180222050 08714729462187 M006180222090 08714729424024 M006180222120 08714729424048

6 x 26 M006180223190 08714729773658 M006180223050 08714729462248 M006180223090 08714729424062 M006180223120 08714729424086

6 x 28 M006180224190 08714729776611 M006180224050 08714729462309 M006180224090 08714729424109 M006180224120 08714729424123

6 x 30 M006180225190 08714729784241 M006180225050 08714729462378 M006180225090 08714729424147 NA NA

7 x 20 M006180230190 08714729776574 M006180230050 08714729462446 M006180230090 08714729424185 NA NA

7 x 22 M006180231190 08714729777755 M006180231050 08714729462514 M006180231090 08714729424222 M006180231120 08714729424246

7 x 24 M006180232190 08714729777762 M006180232050 08714729462583 M006180232090 08714729424260 M006180232120 08714729424284

7 x 26 M006180233190 08714729774556 M006180233050 08714729462651 M006180233090 08714729424307 M006180233120 08714729424321

7 x 28 M006180234190 08714729774907 M006180234050 08714729462729 M006180234090 08714729424345 M006180234120 08714729424369

7 x 30 M006180235190 08714729777892 M006180235050 08714729462798 M006180235090 08714729424383 NA NA

8 x 20 M006180240190 08714729781073 NA NA NA NA NA NA

8 x 22 M006180241190 08714729779377 M006180241050 08714729462934 NA NA NA NA

8 x 24 M006180242190 08714729781080 M006180242050 08714729463009 M006180242090 08714729424505 NA NA

8 x 26 M006180243190 08714729774617 NA NA NA NA NA NA

8 x 28 M006180244190 08714729789215 M006180244050 08714729463146 NA NA NA NA

8 x 30 NA NA NA NA NA NA NA NA

SetIncludes:ContourStentwithHydroPlusCoatingandAttachedRetrievalLine,StentPositioner,Axxcess™6FrUreteralCatheterandSpecifiedGuidewire8FrStentsSuppliedwithPositionerAssemblyandPigtailStraightenerNA=NotAvailableApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


35

URETERAL STENTS


Contour™ Ureteral Stent Sets (with HydroPlus™ Coating and Braided Retrieval Line)


WithoutGuidewire

ea



ea

.038" ZIPwire™


ea

Order Number GTIN Number Order Number GTIN Number Order Number GTIN Number

6 x 20 M0061805200 08714729285496 NA NA M006180520170 08714729776338

6 x 22 M0061805210 08714729285502 M006180521010 08714729424765 M006180521170 08714729789253

6 x 24 M0061805220 08714729285519 M006180522010 08714729424871 M006180522170 08714729789277

6 x 26 M0061805230 08714729285526 M006180523010 08714729424987 M006180523170 08714729789307

6 x 28 M0061805240 08714729285533 M006180524010 08714729425090 M006180524170 08714729776499

6 x 30 M0061805250 08714729285540 NA NA M006180525170 08714729789352

7 x 22 M0061805310 08714729285557 NA NA M006180531170 08714729789376

7 x 24 M0061805320 08714729285564 M006180532010 08714729425427 M006180532170 08714729789406

7 x 26 M0061805330 08714729285571 M006180533010 08714729425533 M006180533170 08714729776628

7 x 28 M0061805340 08714729285588 M006180534010 08714729425649 M006180534170 08714729789444

7 x 30 NA NA NA NA NA NA

8 x 24 M0061805420 08714729285625 NA NA M006180542170 08714729789468

8 x 26 M0061805430 08714729425977 NA NA M006180543170 08714729789499

EachStentSuppliedwithAttached(Braided)RetrievalLineandStentPositionerSetincludes:ContourStentwithHydroPlusCoating(withBraidedRetrievalLine),StentPositioner,Axxcess™6FrUreteralCatheterandSpecifiedGuidewire8FrStentsSuppliedwithPositionerAssemblyandPigtailStraightenerNA=NotAvailableApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


36

URETERAL STENTS


Soft Durometer Percuflex Material with HydroPlus Coating

Tapered TipNautilus™ Kidney Coil

Nautilus Bladder CoilPlacement Markers

Contour VL™ Ureteral Stents (Percuflex™ Material with HydroPlus™ Coating)


WithoutGuidewire

ea



ea

.038" ZIPwire™


ea



ea


4.8 x 22-30 M0061801550 08714729058410 M006180155010* 08714729058427* M006180155170* 08714729765806 M006180155180 08714729772866

6 x 22-30 M0061801560 08714729067986 M006180156010 08714729067993 M006180156170 08714729765820 M006180156180 08714729772743

7 x 22-30 M0061801570 08714729068020 M006180157010 08714729058434 M006180157170 08714729765844 M006180157180 08714729772989

Each Stent Supplied with Attached Retrieval Line and Stent Positioner

SetIncludes:ContourVariableLengthStent,SpecifiedGuidewire,Axxcess™6FrUreteralCatheter

ApplicableMedicareC-codes: C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral

*4.8stentsonlyavailablewitha.035

Contour VL Ureteral Stents (Percuflex Material with HydroPlus Coating)


.035"ZIPwire


ea



ea

.035" Sensor™

PTFE-Nitinol5cm Straight Tip

ea

.035" Sensor


ea


4.8 x 22-30 M006180155190 08714729765813 M006180155050 08714729423720 NA NA M006180155090 08714729423768

6 x 22-30 M006180156190 08714729765837 M006180156050 08714729423782 M006180156080 08714729423812 M006180156090 08714729423829

7 x 22-30 M006180157190 08714729765851 M006180157050 08714729423867 NA NA NA NA

SetIncludes:ContourVariableLengthStentwithAttachedRetrievalLine,StentPositioner,SpecifiedGuidewire,Axxcess6FrUreteralCatheterNA=NotAvailableApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


37

URETERAL STENTS


Contour™ Injection Stent Sets (with HydroPlus™ Coating) – A Percuflex™ Material Stent

OrderNumber

GTINNumber

FrenchSize

Length BetweenPigtails (cm) Unit

M0061856070* 08714729340560* 4.8 24 eaM0061856080* 08714729340577* 4.8 26 eaM0061856090* 08714729340584* 4.8 28 ea

M0061856120 08714729346142 6 22 eaM0061856130 08714729346159 6 24 eaM0061856140 08714729346166 6 26 eaM0061856150 08714729346173 6 28 eaM0061856160 08714729346180 6 30 ea

M0061856170 08714729346197 7 20 eaM0061856180 08714729340676 7 22 eaM0061856190 08714729340683 7 24 eaM0061856200 08714729340690 7 26 eaM0061856210 08714729340706 7 28 eaM0061856220 08714729340713 7 30 ea

*4.8FrStentsavailableonlywitha.035"PTFECoatedGuidewireEachStentSetSuppliedwithAttachedRetrieval,InjectionPositionerandReleasedSleevewithInjectionHub.ApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire


38

URETERAL STENTS


Variable Length Kidney Coil with Drainage Holes

Retrieval Line

Contour VL™ Injection Stent Sets (with HydroPlus™ Coating) – A Percuflex™ Material Stent

OrderNumber

GTINNumber

FrenchSize


M0061856290* 08714729340782* 4.8 30 eaM0061856300 08714729340799 6 30 eaM0061856310 08714729340805 7 30 ea

EachStentSuppliedwithAttachedRetrievalLine,.038"PTFECoatedGuidewire,InjectionPositionerwithLuerLockAdaptor,ReleaseSleeve*4.8FrStentsavailableonlywitha.035"PTFECoatedGuidewireApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire


39

URETERAL STENTS


Placement Marker

Retrieval Line

Mardis Soft Ureteral Stent Sets (with HydroPlus™ Coating)


.035" Lubriglide™

CoatedGuidewire

ea

.038" Lubriglide

CoatedGuidewire

ea

.038" ZIPwire™


ea



ea


4.8 x 10 M0061251150 08714729065715 NA NA NA NA NA NA

4.8 x 12 M0061251160 08714729178224 NA NA NA NA NA NA

4.8 x 14 M0061251170 08714729178217 NA NA NA NA NA NA

4.8 x 16 M0061251180 08714729065746 NA NA NA NA NA NA

4.8 x 18 M0061251190 08714729065753 NA NA NA NA NA NA

4.8 x 22 M0061251210 08714729047728 NA NA NA NA NA NA

4.8 x 24 M0061251220 08714729047735 NA NA NA NA NA NA

4.8 x 26 M0061251230 08714729047742 NA NA NA NA NA NA

4.8 x 28 M0061251240 08714729037859 NA NA NA NA NA NA

6 x 20 NA NA M0061251300 08714729037873 NA NA NA NA

6 x 22 NA NA M0061251310 08714729037880 M0061265310 08714729757634 M0061265710 08714729757771

6 x 24 NA NA M0061251320 08714729047759 M0061265320 08714729756835 M0061265720 08714729757689

6 x 26 NA NA M0061251330 08714729047766 M0061265330 08714729756842 M0061265730 08714729757696

6 x 28 NA NA M0061251340 08714729047773 M0061265340 08714729757641 M0061265740 08714729757702

6 x 30 NA NA M0061251350 08714729037927 NA NA NA NA

7 x 20 NA NA M0061251400 08714729037934 NA NA NA NA

7 x 22 NA NA M0061251410 08714729178361 NA NA NA NA

7 x 24 NA NA M0061251420 08714729047780 NA NA NA NA

7 x 26 NA NA M0061251430 08714729047797 NA NA NA NA

7 x 28 NA NA M0061251440 08714729047803 M0061265440 08714729757658 M0061265840 08714729757733

7 x 30 NA NA M0061251450 08714729056768 M0061265450 08714729757665 M0061265850 08714729757740

8 x 20 NA NA M0061251500 08714729037996 NA NA NA NA

8 x 22 NA NA M0061251510 08714729038009 NA NA NA NA

8 x 24 NA NA M0061251520 08714729038016 NA NA NA NA

8 x 26 NA NA M0061251530 08714729047810 M0061265530 08714729756828 M0061265930 08714729757757

8 x 28 NA NA M0061251540 08714729047827 M0061265540 08714729757672 M0061265940 08714729757764

SetIncludes:MardisSoftStentwithHydroPlusCoatingwithAttachedRetrievalLine(exceptfor4.8Frsize),StentPositioner,SpecifiedGuidewire,Axxcess™6FrUreteralCatheterNA=NotAvailableApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


40

URETERAL STENTS


Placement Markers

Retrieval Line

NautilusTM Bladder Coil

Stretch™ VL Flexima™ Ureteral Stent Sets (with HydroPlus™ Coating)

French Size x

Length Between Pigtails

WithoutGuidewire

ea



ea

.035" Stiff ShaftZIPwire™


ea


4.8 x 22-30 M0061851550 08714729160786 NA M006185155180 08714729777250

6 x 22-30 M0061851560 08714729160809 M006185156010 08714729160816

7 x 22-30 M0061851570 08714729160823 M006185157010 08714729160830 NA

Each Stent Supplied with Attached Retrieval Line and Stent PositionerSetIncludes:StretchVLStent,SpecifiedGuidewire,Axxcess™6FrUreteralCatheterApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire; C1758-catheter,ureteral

Stretch VL Flexima Ureteral Stent Sets (with HydroPlus Coating)

French Size x

Length Between Pigtails

.035"ZIPwire


ea

.035" PTFE


ea

.035" Sensor™

PTFE-Nitinol5cm Straight Tip

ea


4.8 x 22-30 M006185155190 08714729776253 M006185155050 08714729297727 M006185155080 08714729297734

6 x 22-30 M006185156190 08714729778097 NA M006185156080 08714729297741

7 x 22-30 M006185157190 08714729778103 NA M006185157080 08714729297765

SetIncludes:StretchVLStentwithAttachedRetrievalLine,StentPositioner,SpecifiedGuidewire,Axxcess6FrUreteralCatheterNA=NotAvailableApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire;C1758-catheter,ureteral


41

URETERAL STENTS

URETERAL STENTS AND SETS

7Fr Distal Diameter

14Fr ProximalDiameter

Retromax™ Plus Endopyelotomy Stents

OrderNumber

GTINNumber

Taper SizeFrom/To (Fr)


M0061451470 08714729170549 14/7 22 eaM0061451480 08714729171546 14/7 24 eaM0061451490 08714729171553 14/7 26 eaM0061451500 08714729171560 14/7 28 eaM0061451510 08714729171577 14/7 30 ea

EachStentSuppliedwithMetalTipStentPositioner

ApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem

Large Side Ports

Detachable Hub

Percuflex™ Urinary Diversion Stent Sets (Open Tip Configuration)

OrderNumber

GTINNumber

FrenchSize


M0061602050 08714729297161 6 80 eaM0061602100 08714729297178 7 80 eaM0061602150 08714729297185 8 80 ea

SetIncludes:(2)PercuflexUrinaryDiversionStents,(1).038"StiffBodiedPTFECoatedGuidewire,(2)Color-CodedCatheterAdaptorsand(2)DrainageBagConnectorsApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire


42

URETERAL STENTS

URETERAL STENTS AND SETS (Continued)

Large Side Ports

Percuflex™ Urinary Diversion Stent Sets (Closed Tip Configuration)

OrderNumber

GTINNumber

FrenchSize


M0061602250 08714729297192 6 80 eaM0061602300 08714729297208 7 80 eaM0061602350 08714729297215 8 80 ea

SetIncludes:(2)PercuflexUrinaryDiversionStents,(1).038"StiffBodiedPTFECoatedGuidewire,(2)Color-CodedCatheterAdaptorsand(2)DrainageBagConnectors

ApplicableMedicareC-codes:C2617-stent,non-coronary,temporary,withoutdeliverysystem;C1769-guidewire

STENT ACCESSORIES

RadiopaqueMarker

Ureteral Stent Positioners

OrderNumber

GTINNumber

FrenchSize

Length(cm) Unit

M0061802001 08714729462026 4.8 45 bx10M0061802011 08714729041245 6 45 bx10M0061802021 08714729041252 7 45 bx10M0061802031 08714729041269 8 45 bx10

RadiopaqueMarkeronAllSizesExceptthe4.8FrUreteralStentPositioner



43

NOTES


44

NOTES

URETERA

LCATH

ETERS

URE

TERA

LCA

THET

ERS


45

TORQUEABLE CATHETERS

GreenGuidewireLumen.038"

YellowInjectionLumen.050"

.038"Guidewire

Dual Lumen Ureteral Catheter

OrderNumber

GTINNumber

O.D. Size(Fr)

Working Length(cm)

Recommended Guidewire (in)

InjectionLumen (in) Unit

M0064051000 08714729012689 10 54 .038 .050 ea

Imager™ II Urology Torque Catheters

OrderNumber


O.D. Size(Fr)

Working Length(cm) Unit

M0064003001 08714729430261 C1 5 65 bx5M0064003011 08714729430278 C2 5 65 bx5M0064003021 08714729430285 Straight 5 65 bx5M0064003031 08714729430292 Bern 5 65 bx5M0064003041 08714729430308 JB1 5 65 bx5M0064004021 08714729430315 Straight 5 100 bx5M0064004031 08714729430322 Bern 5 100 bx5M0064004041 08714729430339 JB1 5 100 bx5M0064005031 08714729430346 Bern 5 40 bx5

ApplicableMedicareC-codes:C1758-catheter,ureteral

URETERAL CATHETERS


46

URETERAL CATHETERS

Ureteral Catheters: Open End Ureteral Catheters

OrderNumber


Catheter O.D. Size(Fr)

Working Length(cm)

Tip O.D. Size(Fr) Unit

M0064002001 08714729342076 OpenTip 4 70 - bx20M0064002011 08714729342083 OpenTip 5 70 - bx20M0064002021 08714729342090 OpenTip 6 70 - bx20M0064002031 08714729342106 OpenTip 7 70 - bx20M0064002041 08714729342113 OpenTip 8 70 - bx20M0064002111 08714729342168 Cone Tip 5 70 8 bx20M0064002121 08714729342175 Cone Tip 6 70 10 bx20M0064002131 08714729342182 Cone Tip 7 70 12 bx20M0064002141 08714729342199 Cone Tip 8 70 14 bx20M0064002301 08714729302506 OliveTip 4 70 - bx20M0064002311 08714729302513 OliveTip 5 70 - bx20M0064002361 08714729268918 Spiral Tip 5 70 - bx20M0064002371 08714729268925 Spiral Tip 6 70 - bx20M0064002411 08714729302544 WedgeTip 5 70 14 bx20

EachCatheterSuppliedwithInjectionHubApplicableMedicareC-codes:C1758-catheter,ureteral

Ureteral Catheters: Angled Tip Ureteral Catheters (Sets with .035" PTFE Bentson Tip Guidewire)

OrderNumber


Catheter O.D. Size (Fr)

Working Length(cm)

Tip O.D. Size(Fr) Unit

M0064002510 08714729256830 AngledTipSet 5 70 - eaM0064002520 08714729256847 AngledTipSet 6 70 - ea

SetIncludes:AngledTipCatheter,.035"PTFEBentsonTipGuidewireandInjectionHubApplicableMedicareC-codes:C1758-catheter,ureteral

TORQUEABLE CATHETERS (Continued)


47

URETERAL CATHETERS

Lock

Axxcess™ Catheter: Open End Ureteral Catheter

OrderNumber

GTINNumber

Catheter O.D. Size(Fr)


M0064001161 08714729191971 6 70 bx10


C-Flex™ Ureteral Catheters: Flexible Tip Open End Ureteral Catheter Sets

OrderNumber

GTINNumber

O.D. Size(Fr)


M0064001400 08714729011088 6 70 eaM0064001410 08714729011071 7 70 ea

SetIncludes:C-FlexFlexibleTipCatheter,.038"StainlessSteelGuidewireand(2)LuerLockCatheterAdaptorsApplicableMedicareC-codes:C1758-catheter,ureteral



48

C-Flex™ Ureteral Catheters: Open End Ureteral Catheter Sets

OrderNumber

GTINNumber

O.D. Size(Fr)


M0064001500 08714729005162 4.8 70 ea M0064001510 08714729005179 6 70 eaM0064001520 08714729700517 7 70 eaM0064001530 08714729005193 8 70 ea

SetIncludes:FirmC-FlexCatheter,.038"StainlessSteelGuidewireandTwo(2)LuerLockCatheterAdaptorsApplicableMedicareC-codes:C1758-catheter,ureteral

C-Flex Ureteral Catheters: Pigtail Ureteral Catheter Sets

OrderNumber

GTINNumber

O.D. Size(Fr)

Increments of Side Ports(cm)


M0064001700* 08714729011224 4.8 5 70 eaM0064001710 08714729011231 6 5 70 eaM0064001720 08714729011248 7 5 70 eaM0064001730 08714729011255 8 5 70 ea

*SetIncludes:FirmC-FlexPigtailCatheter,.038"Lubriglide™CoatedGuidewireandTwo(2)LuerLockCatheterAdaptors SetIncludes:FirmC-FlexPigtailCatheter,.038"PTFECoatedGuidewireandTwo(2)LuerLockCatheterAdaptorsApplicableMedicareC-codes:C1758-catheter,ureteral

URETERAL CATHETERS



49

NOTES


50

NOTES

NEPH

ROSTOMY

PRODUCTS

NEP

HRO

STOM

YPR

ODU

CTS


51


PERCUTANEOUS KITSLingeman Percutaneous Tract Kit with ZIPwire™ Guidewire contains

LATEX

OrderNumber


M0064501150 08714729789536 LingemanPercutaneousTractKitwithZIPwire Guidewire ea

KitIncludes:.035inx150cmxStraightTipZIPwireGuidewire,.035inx150cmx“J”TipPTFECoatedMoveableCoreGuidewire, .035inx150cmxStraightTipPTFECoatedMoveableCoreGuidewire,.035inx145cmxStraightTipAmplatzSuperStiff™PTFECoatedGuidewire,7FOccluder™OcclusionBalloonCatheter,18gax20cmPercutaneousAccessNeedle,8/10Dilator/SheathSet,8FAmplatzTypeRenalDilator,NephroMax™NephrostomyBalloonCatheterKit(KitIncludes:NephroMaxHighPressureNephrostomyBalloonCatheter, 30FIDAmplatzTypeRenalSheath,HighPressureStopcock,20mlEncore™26InflatorwithPressureGauge),UroLok™IIScopeAdaptor, 20FRe-Entry™MalecotNephrostomyCatheterSetApplicableMedicareC-codes:C1769-guidewire;C2628-catheter,occlusion;C1726-catheter,balloondilatation,non-vascular; C1729-catheter,drainage

Percutaneous Tract Kit with ZIPwire Guidewire containsLATEX

OrderNumber


M0064501140 08714729784432 Percutaneous Tract Kit with ZIPwire Guidewire ea

KitIncludes:.038inx150cmxStraightTipZIPwireGuidewire,.038inx150cmxStraightTipStiffBodiedPTFECoatedGuidewire, .038inx150cmxAngledTipZebra™Guidewire,.038inx145cmx“J”TipAmplatzSuperStiffPTFECoatedGuidewire,7FOccluderOcclusionBalloonCatheter,18gax20cmPercutaneousAccessNeedle,8/10Dilator/SheathSet,8FAmplatzTypeRenalDilator,NephroMaxNephrostomyBalloonCatheterKit(KitIncludes:NephroMaxHighPressureNephrostomyBalloonCatheter,30FIDAmplatzTypeRenalSheath,HighPressureStopcock,20mlEncore26InflatorwithPressureGauge),24FRe-EntryMalecotNephrostomy Catheter Set ApplicableMedicareC-codes:C1769-guidewire;C2628-catheter,occlusion;C1726-catheter,balloondilatation,non-vascular; C1729-catheter,drainage


52


PERCUTANEOUS KITS (Continued)

Percutaneous Access Set

OrderNumber


M0064201100 08714729012702 Percutaneous Access Set ea

KitIncludes:21gaTrocarPointNeedle,19gaTrocarPointNeedlewith5FPTFESheath,SixFascialDilators(6F-16FEvenFrenchsizes), CatheterRetentionDevice,.038inx150cmx“J”TipStiffBodiedPTFECoatedGuidewire,ConnectingTubeWithRemovableStopcock, #11DisposableScalpelApplicableMedicareC-codes:C1769-guidewire

Percutaneous Access Sets – Pigtail Catheter

OrderNumber

GTINNumber

O.D. Size(Fr)


M0064201110 08714729009733 8 30 eaM0064201120* 08714729009740 10 30 ea

KitIncludes:C-Flex™PigtailCatheter,21gaTrocarPointNeedle,19gaTrocarPointNeedlewith5FPTFESheath,FascialDilators(6F-10FEvenSizes),CatheterRetentionDevice,.038inx150cmx“J”TipStiffBodiedPTFECoatedGuidewire,ConnectingTubeWithRemovableStopcock,#11DisposableScalpel*Also Includes: 12Fr Fascial DilatorApplicableMedicareC-codes:C1729-catheter,drainage;C1769-guidewire

TLA Introducer Needle and Sheath Set

OrderNumber

GTINNumber Description Gauge Length (cm) Unit

M0067001200 08714729005209 TLA Introducer Needle and Sheath Set 19 20 ea


INTRODUCER SETS

NaviGuide™ Percutaneous Access Needle

OrderNumber

GTINNumber Description Gauge Length (cm) Unit

M0067001310 08714729953364 NaviGuide Percutaneous Access Needle 18 12 ea





53


BALLOON DILATION CATHETERS

NephroMax™ High Pressure Nephrostomy Balloon Catheters

OrderNumber

GTINNumber


BalloonLength

(cm)


(cm)

Sheath Type

Unit(Fr) (mm) (Fr) (mm) (Fr) (cm)

M0062101170 08714729012641 30 10 12 7 2.3 55 30 17PTFE ea

M0062101400 08714729826484 24 8 12 7 2.3 55 24 17PTFE ea

M0062101420 08714729826491 30 10 12 7 2.3 55 30 17Clear ea

M0062101440 08714729826507 30 10 15 7 2.3 55 30 20 PTFE ea

SuppliedWith:HighPressureStopcockandRenalSheathApplicableMedicareC-codes:C1726-catheter,balloondilatation,non-vascular

INFLATION DEVICES


OrderNumber


M0067101131 08714729761815 20mlEncore26InflatorwithPressureGauge bx5

M0067101140 08714729755814 20mlEncore26InflatorwithPressureGauge ea


NephroMax High Pressure Nephrostomy Balloon Catheters (Kits)

OrderNumber

GTINNumber


BalloonLength

(cm)


(cm)

Sheath Type

Unit(Fr) (mm) (Fr) (mm) (Fr) (cm)

M0062101180 08714729077589 30 10 12 7 2.3 55 30 17PTFE ea

M0062101600 08714729834540 24 8 12 7 2.3 55 24 17PTFE ea

M0062101620 08714729834526 30 10 12 7 2.3 55 30 17Clear ea

M0062101640 08714729834533 30 10 15 7 2.3 55 30 20 PTFE ea

KitIncludes:NephroMaxHighPressureNephrostomyBalloonCatheter,RenalSheath,HighPressureStopcockand20mlEncore26InflatorwithPressureGaugeApplicableMedicareC-codes:C1726-catheter,balloondilatation,non-vascular


54

DILATORS AND SHEATHS

Clear Renal Sheath

OrderNumber

GTINNumber

O.D. Size I.D. Size Total Length(cm) Unit(Fr) (mm) (Fr) (mm)

M0062601600 08714729341727 34 11.3 30 10.0 17 ea


8Fr Dilator

Amplatz Type Renal Dilators (Individual Components)

OrderNumber

GTINNumber

O.D. Size I.D. Size Total Length(cm) Unit(Fr) (mm) (Fr) (mm)

M0062601010 08714729005438 8 2.7 3 1.0 35 eaM0062601020 08714729005445 10 3.4 3 1.0 35 eaM0062601030 08714729005452 12 4.1 3 1.0 35 eaM0062601040 08714729005469 14 4.7 8 2.7 35 eaM0062601050 08714729005476 16 5.4 8 2.7 35 eaM0062601060 08714729005483 18 6.1 8 2.7 35 eaM0062601070 08714729005490 20 6.8 8 2.7 35 eaM0062601080 08714729005506 22 7.4 8 2.7 35 eaM0062601090 08714729005513 24 8.1 8 2.7 35 eaM0062601100 08714729005520 26 8.7 8 2.7 35 ea M0062601110 08714729005537 28 9.4 8 2.7 35 eaM0062601120 08714729005544 30 10.1 8 2.7 35 ea


Amplatz Type Renal Dilator/Sheath Set

OrderNumber


M0062602500 08714729137122 AmplatzTypeRenalDilator/SheathSet ea

SetIncludes:TwelveDilators(8F-30FEvenSizes),FourAmplatzTypeRenalSheaths(24F-30FEvenSizes),8/10Dilator/SheathSetApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.

Amplatz Type Graduated Renal Dilation Set

OrderNumber


M0062601000 08714729005421 Amplatz Type Graduated Renal Dilator Set ea

SetIncludes:TwelveDilators(8F-30FEvenSizes),8/10Dilator/SheathSetApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.



55


DILATORS AND SHEATHS (Continued)

24Fr I.D., 17cm Length




Amplatz Type Renal Sheath (Set)

OrderNumber


M0062601500 08714729005568 Amplatz Type Renal Sheath Set ea

SetIncludes:FourRadiopaquePTFESheaths,24through30FrenchI.D.,17cmLengthApplicableMedicareC-codes:C1894-introducer/sheath,otherthanguiding,otherthanintracardiacelectrophysiological,non-laser

8Fr Stylet8Fr Stylet

10Fr PTFE Sheath

8/10 Dilator/Sheath Set

OrderNumber


M0062601200 08714729005551 8FrenchStyletwith10FrenchO.D.SafetyWireIntroducerSheath ea


Amplatz Type Renal Sheaths (Individual Components)

OrderNumber

GTINNumber

I.D. Size Total Length(cm) Unit(Fr) (mm)

M0062601450 08714729430056 14 4.7 17 ea

M0062601460 08714729430070 16 5.3 17 ea

M0062601470 08714729430094 18 6.1 17 ea

M0062601480 08714729430117 20 6.7 17 ea

M0062601490 08714729430131 22 7.4 17 ea

M0062601510 08714729005575 24 8.1 17 ea

M0062601520 08714729005582 26 8.8 17 ea

M0062601530 08714729005599 28 9.4 17 ea

M0062601540 08714729005605 30 10.1 17 ea

M0069001230 08714729431671 30 10.1 20 ea



56


TORQUEABLE CATHETERS

Imager™ II Urology Torque Catheters

OrderNumber

GTINNumber Description O.D. Size (Fr) Working Length (cm) Unit

M0064003001 08714729430261 C1 5 65 bx5

M0064003011 08714729430278 C2 5 65 bx5

M0064003021 08714729430285 Straight 5 65 bx5

M0064003031 08714729430292 Bern 5 65 bx5

M0064003041 08714729430308 JB1 5 65 bx5

M0064004021 08714729430315 Straight 5 100 bx5

M0064004031 08714729430322 Bern 5 100 bx5

M0064004041 08714729430339 JB1 5 100 bx5

M0064005031 08714729430346 Bern 5 40 bx5


OCCLUSION BALLOON CATHETERS

Occluder™ Occlusion Balloon Catheters

OrderNumber

GTINNumber

Balloon Inflated O.D Catheter Size Usable Length(cm) Unit(Fr) (mm) (Fr) (mm)

M0062201070 08714729191988 26 8.5 5 1.7 65 ea M0062201080 08714729191995 26 8.5 5 1.7 100 eaM0062201090 08714729192008 34 11.5 7 2.3 65 eaM0062201100 08714729161691 34 11.5 7 2.3 100 ea

SetIncludes:OcclusionBalloonCatheter,Two-WayStopcockandSyringeApplicableMedicareC-codes:C2628-catheter,occlusion


57


DRAINAGE CATHETERS

Luer Lock Connector

Flexible Stylet

.038"EndHole

C-Flex™ Malecot Catheter

Malecot Nephrostomy Catheters

OrderNumber

GTINNumber

O.D. Size(Fr)


M0064101020 08714729005285 20 35 ea

M0064101030 08714729005292 24 35 ea

SetIncludes:C-FlexMalecotCatheter,TwoFlexibleStyletsandDrainageBagConnectingTubeApplicableMedicareC-codes:C1729-catheter,drainage

Re-Entry™ Malecot Nephrostomy Catheter Sets

OrderNumber

GTINNumber

CatheterO.D. Size

(Fr)

CatheterWorking Length

(cm)

Re-Entry TipO.D. Size

(Fr)

Re-Entry TipTip Length

(cm) Unit

M0064101060 08714729005308 20 35 8 18 ea

M0064101070 08714729005315 24 35 8 18 ea

SetIncludes:C-FlexRe-EntryMalecotCatheter,TwoFlexibleStyletsandDrainageBagConnectingTubeApplicableMedicareC-codes:C1729-catheter,drainage

Percuflex™ Locking Loop All Purpose Drainage Catheters with Fader Tip™

OrderNumber

GTINNumber

O.D. Size(Fr)


M0064102020 08714729079767 8.3 19 ea

M0064102030 08714729079774 10.3 19 ea

SetIncludes:PercuflexCatheterwithFaderTipandLockingPigtail,TrocarStyletandStiffeningCannulaApplicableMedicareC-codes:C1729-catheter,drainage


58

DRAINAGE CATHETERS (Continued)

Percuflex™ Locking Loop Nephrostomy Catheters with Fader Tip

OrderNumber

GTINNumber

O.D. Size(Fr)


M0064102040 08714729192299 8.3 26 ea

M0064102050 08714729192305 10.3 27.6 ea

M0064102060 08714729192312 12 27 ea

SuppliedWith:MetalStiffeningCannula,FlexibleStiffeningCannulaandSeptumCapApplicableMedicareC-codes:C1729-catheter,drainage


Percuflex Combination Stent/Nephrostomy Catheter

OrderNumber

GTINNumber

O.D. Size(Fr)

Working Length FromHub to Loop

(cm)

Length FromLoop to Tip

(cm) Unit

M0064101260 08714729005254 8.3 25 24 ea

Includes:StiffeningCannula,SeptumCapApplicableMedicareC-codes:C1729-catheter,drainage

Percuflex Locking Loop Nephrostomy Catheters

OrderNumber

GTINNumber

WorkingO.D. Size

(Fr)Length

(cm) Unit

M0064101110 08714729005223 8.3 26.5 ea

M0064101120 08714729005230 10.3 28.3 ea

Includes:MetalStiffeningCannulawithEchogenicTip,FlexibleStiffeningCannula,SeptumCapApplicableMedicareC-codes:C1729-catheter,drainage


59

NOTES


60

NOTES

LITHOTRIPSY

PRODUCTS

LITH

OTRI

PSY

PROD

UCT

S


61


LASER SYSTEMSLumenis™ Laser Systems


M0068408300 NA Lumenis Pulse™ 120 H Holmium Laser eaGA-0006801 NA LumenisPulse120HLaserwithMoses eaM0068408100 NA Lumenis Pulse 100 H Laser eaM0068408290 08714729430636 Lumenis VersaPulse™ PowerSuite™100WattHolmiumLaser eaM0068408280 NA Lumenis80/100WattHolmiumLaser eaM0068408270 08714729470380 LumenisVersaPulsePowerSuite60WattHolmiumLaser eaGA-1008946 NA LumenisPulse50HLaser eaGA-2000435 NA LumenisPulse30HLaser eaSA-20037840 NA LumenisPulse30HCart eaAC-2004192 NA LumenisPulse30HArm ea


Flexiva High Power Single-Use Laser Fibers (Forusewithnon-RFIDLumenisHo:YAGandNd:YAGLasers)


M0068403910 08714729808145 Flexiva200HighPowerSingle-UseHolmiumLaserFiber eaM0068403920 08714729808183 Flexiva365HighPowerSingle-UseHolmiumLaserFiber eaM0068403930 08714729808206 Flexiva550HighPowerSingle-UseHolmiumLaserFiber eaM0068403940 08714729808121 Flexiva1000HighPowerSingle-UseHolmiumLaserFiber eaM0068403911 08714729808152 Flexiva200HighPowerSingle-UseHolmiumLaserFiber bx5M0068403921 08714729808190 Flexiva365HighPowerSingle-UseHolmiumLaserFiber bx5M0068403931 08714729808213 Flexiva550HighPowerSingle-UseHolmiumLaserFiber bx5M0068403941 08714729808138 Flexiva1000HighPowerSingle-UseHolmiumLaserFiber bx5


Flexiva ID TracTip High Power Single-Use Laser Fibers (ForusewithRFIDLumenisHo:YAGandNd:YAGLasers)


M006R8403960 08714729963837 FlexivaIDTracTip200LaserFiberSingle eaM006R8403961 08714729963844 FlexivaIDTracTip200LaserFiberBox5 bx5

Applicable Medicare C-codes: There are no applicable Medicare C-codes for the above products.

LASER FIBERSFlexiva™ TracTip™ High Power Single-Use Laser Fibers (Forusewithnon-RFIDLumenisHo:YAGandNd:YAGLasers)


M0068403960 08714729808169 FlexivaTracTip200HighPowerSingle-UseHolmiumLaserFiber eaM0068403961 08714729808176 FlexivaTracTip200HighPowerSingle-UseHolmiumLaserFiber bx5

Applicable Medicare C-codes: There are no applicable Medicare C-codes for the above products.

Lumenis Pulse™ 120H Moses Upgrade


SPMO-0006800 NA LumenisPulse120HMosesUpgrade ea



62


LASER FIBERS (Continued)

AccuTrac™ Single-Use Holmium Laser Fibers (ForusewithDornier(H20)andNewStarLaserswithSMA-905connectors)

OrderNumber


M0068404110 08714729802716 AccuTrac200Single-UseHolmiumLaserFiber eaM0068404112 08714729802709 AccuTrac200Single-UseHolmiumLaserFiber bx5


AccuMax™ Single-Use Holmium Laser Fibers (ForusewithDornier(H20)andNewStarLaserswithSMA-905connectors)

OrderNumber


M0068404010 08714729784586 AccuMax200Single-UseHolmiumLaserFiber eaM0068404020 08714729784593 AccuMax365Single-UseHolmiumLaserFiber eaM0068404030 08714729784609 AccuMax550Single-UseHolmiumLaserFiber eaM0068404040 08714729784616 AccuMax1000Single-UseHolmiumLaserFiber eaM0068404012 08714729784623 AccuMax200Single-UseHolmiumLaserFiber bx5M0068404022 08714729784630 AccuMax365Single-UseHolmiumLaserFiber bx5M0068404032 08714729784647 AccuMax550Single-UseHolmiumLaserFiber bx5M0068404042 08714729784654 AccuMax1000Single-UseHolmiumLaserFiber bx5


Flexiva™ ID High Power Single-Use Laser Fibers (ForusewithRFIDLumenisHo:YAGandNd:YAGLasers)

OrderNumber


M006R8403910 08714729963752 FlexivaID200LaserFiberSingle eaM006R8403920 08714729963776 FlexivaID365LaserFiberSingle eaM006R8403930 08714729963790 FlexivaID550LaserFiberSingle eaM006R8403940 08714729963813 FlexivaID1000LaserFiberSingle eaM006R8403911 08714729963769 FlexivaID200LaserFiberBox5 bx5M006R8403921 08714729963783 FlexivaID365LaserFiberBox5 bx5M006R8403931 08714729963806 FlexivaID550LaserFiberBox5 bx5M006R8403941 08714729963820 FlexivaID1000LaserFiberBox5 bx5


Moses™ Laser Fibers NEW

OrderNumber


AC-10030100 NA Moses200D/F/LLaserFiber–Max2J,80Hz,60W ea

AC-10030110 NA Moses365D/F/LLaserFiber–Max6J,80Hz,120W ea

AC-10030120 NA Moses550D/F/LLaserFiber-Max6J,80Hz,120W ea



63


LASER FIBERS (Continued)

LASER ACCESSORIESAccessories for Lumenis Brand Holmium and Dual Wavelength Laser Systems

OrderNumber


M0068408570 NA LaserRadiationWarningSign ea

M0068408580 NA Holmium Laser Safety Glasses ea

M0068408590 NA HolmiumLaserSafetyGoggles ea

M0068408800 NA 200MicronFiberStripper(Forreusablefibersonly) ea

M0068408820 NA 365MicronFiberStripper(ForLumenisFibers) ea



M0068408850 NA SlimLine Steam Sterilization Tray ea

M0068408860 NA CuttingScissors ea

M0068408870 NA CleavingTool ea

M0068408880 NA FiberInspectionMicroscope ea


SlimLine™ EZ SIS Single-Use Laser Fibers (For use with all Lumenis Lasers)

OrderNumber


AC-1001635 07290109140261 SlimLine200DFLFiber(SmoothTip) ea

M0068409201 07290109140193 SlimLineEZ200SISSingle-UseLaserFiber bx3




SlimLine SIS Reusable Laser Fibers (For use with all Lumenis Lasers)

OrderNumber


M0068409230 07290109140223 SlimLine200SISReusableLaserFiber ea






64


DUAL-ENERGY LITHOTRIPTER SYSTEMS

Swiss LithoClast™ Trilogy System Kit

OrderNumber


M006840200K0 761335312399 SwissLithoClastTrilogySystemKit ea

Included in Kit:

M0068402010 7613353125707 SwissLithoClastTrilogyConsole ea

M0068402030 7613353125776 SwissLithoClastTrilogyHandpieceKit ea

M0068402050 7613353125806 SwissLithoClastTrilogyFootSwitch ea

M0068403590 7613353133351 TrilogyReusableTorqueWrench ea

M0068401810 7613353125820 Stone Catcher Holder ea

M0068401800 7613353125769 HDMI-VDICable(10m) ea

M0068401820 7613353125837 FillingBottle ea

M0068401830 7613353125844 BottleofDemineralizedWater(2.5l) ea

M0068401850 7613353125721 PowerCord(US-6m) ea

M0068401860 7613353140175 SwissLithoClastTrilogySystemIFU ea

M0068401890 7613353140199 QuickGuide ea

M0068401620 7613353125851 CleaningRodforTrilogyProbes(3.4mmand3.9mm) ea


Swiss LithoClast Trilogy Single-Use Probe Kits*

OrderNumber


M0068403550 7613353123703 3.9mmx440mmTrilogyProbeKitBlue ea

M0068403540 7613353123697 3.9mmx350mmTrilogyProbeKitBlue ea

M0068403530 7613353123727 3.4mmx445mmTrilogyProbeKitGreen ea

M0068403520 7613353123710 3.4mmx340mmTrilogyProbeKitGreen ea

M0068403510 7613353123734 1.9mmx341mmTrilogyProbeKitYellow ea

M0068403490 7613353123772 1.1mmx625mmTrilogyProbeKitRed ea



*Single-UseProbeKitsincludeaprobeandStoneCatcher.ApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.


65


DUAL-ENERGY LITHOTRIPTER SYSTEMS (Continued)

Swiss LithoClast™ Trilogy System Accessories

OrderNumber


M0068402030 7613353125776 SwissLithoClastTrilogyHandpieceKit* ea

M0068402050 7613353125806 SwissLithoClastTrilogyFootSwitch ea

M0068403590 7613353133351 TrilogyReusableTorqueWrench ea

M0068401610 7613353125790 CleaningRodforTrilogyHandpiece ea


M0068401800 7613353125769 HDMI-VDICable(10m) ea

M0068401820 7613353125837 FillingBottle ea

M0068401830 7613353125844 BottleofDemineralizedWater(2.5l) ea

M0068401850 7613353125721 PowerCord(US-6m) ea

M0068401860 7613353140175 SwissLithoClastTrilogySystemIFU ea

M0068401890 7613353140199 QuickGuide ea

M0068401620 7613353125851 CleaningRodforTrilogyProbes(3.4mmand3.9mm) ea

M0068401630 7613353125868 CleaningRodforTrilogyProbes(1.9mm) ea

M0068401790 7613353125899 TrilogyHandpieceSuctionConnector ea

*SwissLithoClastTrilogyHandpieceKitincludesaTrilogyReusableTorqueWrench,shippedseparately.ApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.

Swiss LithoClast Trilogy Single-Use Accessories (Optional)

OrderNumber


M0068402981 7613353126384 StoneCatcherforTrilogy bx5

M0068402061 7613353132118 DoubleSuctionBags bx5

M0068402071 7613353133931 SuctionBag5l bx10


Swiss LithoClast Trilogy Cart

OrderNumber


M0068401760 7613353125912 SwissLithoClastTrilogyCart ea



66



Ultrasound Probe

Swiss LithoClast Ultrasound Probes (Not compatible with Swiss LithoClast Standard Probe)

OrderNumber


M0068407140 08714729470236 3.3mmx330mmSwissLithoClastUltrasoundProbe ea




ForuseonlywithSwissLithoClastSelectSystemModelno.840-300k,SwissLithoClastUltraSystemModelno.840-700k,orUpgradedSystemModelno.840-701U.ApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.

Swiss LithoClast™ Select Accessories

OrderNumber


M0068403020 08714729820123 Swiss LithoClast Select Directions for Use ea

M0068403030 08714729820130 SwissLithoClastSelectErrorMessageLaminate N/C

M0068403040 08714729820413 Vario Ultrasound Handpiece Kit ea

M0068407030 08714729520016 Foot Pedal ea


M0068407070 08714729520030 CompressedAirTube-3m ea

M0068407080 08714729520047 Power Cord ea

M0068407090 08714729520054 Spare Fuses ea

M0068407200 08714729520092 Pneumatic Handpiece Kit ea

M0068403180 08714729820383 VarioUltrasoundHandpiece5mmWrench ea

M0068403050 08714729820390 VarioUltrasoundHandpiece8mmWrench ea

M0068407280 08714729520108 PneumaticHandpieceTubewithQ-connect(3M) ea

M0068407290 08714729520115 PneumaticHandpieceShippingCase ea

M0068407501 08714729520139 StoneCatcherwithTubingandAdapter(5/box) ea

M0068403060 08714729802877 AngledSuctionConnector-StoneCatcher ea

M0068403070 08714729820079 StraightSuctionConnector-StoneCatcher ea

M0068403220 08714729820451 VarioUltrasoundHandpieceShippingCase ea

M0068403160 08714729802884 AngledSuctionConnector-SuctionTubing ea

M0068403170 08714729820086 StraightSuctionConnector-SuctionTubing ea

M0068403240 08714729809982 Hose Sterilization Cap ea

M0068403190 08714729820376 Vario Ultrasound Distal Protective Cap ea

M0068403200 08714729820420 VarioUltrasoundHandpieceO-Ring ea

M0068403210 08714729820062 StraightSuctionConnectorO-Ring ea

M0068403110 08714729820437 VarioUltrasoundHandpieceQuickTable ea



67


Swiss LithoClast™ Pneumatic Probes

OrderNumber


M0068407310 08714729516620 0.8mmx668mmDisposablePneumaticProbe ea

M0068407320 08714729470250 1.0mmx497mmDisposablePneumaticProbe* ea

M0068407330 08714729516637 1.0mmx570mmDisposablePneumaticProbe** ea



M0068407390 08714729430599 0.89mmx940mmFlexibleUreteroscopyProbeforSwissLithoClastSystem ea

*DesignedforusewithUltrasoundprobes840-714&840-715 **DesignedforusewithUltrasoundprobes840-716&840-717ApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.



68

NOTES

PROSTATEH

EALTH

PROS

TATE

HEA

LTH


69

PROSTATE HEALTH

BPH LASER SYSTEMS

Rezūm™ Water Vapor Therapy

OrderNumber


G2200-003 NA RezūmGenerator ea

D2200-5 NA RezūmDeliveryDeviceKitforBPH bx5


Holmium Laser Therapy (vaporization and enucleation)

OrderNumber


M0068408100 NA Lumenis Pulse™ 100 H Laser ea

M0068408300 NA Lumenis Pulse 120 H Laser ea

GA-0006801 NA LumenisPulse120HLaserwithMoses ea

AC-1000729 07290109140278 Xpeeda™550DSLFiber,SideFiringFiber ea


GreenLight™ Laser Therapy

OrderNumber Description Unit

Lasers0010-0210S-G0 GreenLightXPS™ Laser System ea

Fibers0010-2400 AngledDeliveryDevice,GreenLightXPS MoXy™ ea0010-2090 AngledDeliveryDevice,GreenLightHPS ea0010-2092 AngledDeliveryDevice,GreenLightHPSEA ea

Accessories (Protective Filters)0010-0721 VideoCameraGoldFilterforRigidEndoscope1.25"diameter ea0010-0722 VideoCameraGoldFilterforRigidEndoscope.095”diameter ea0010-0725 VideoCameraBlueFilterforRigidEndoscope1.25"diameter ea0010-0726 VideoCameraBlueFilterforRigidEndoscope.095"diameter ea0010-0728 VideoCameraGreenFilterforRigidEndoscope1.23"diameter ea

Accessories (Protective Eyewear)0010-0010 GreenLightPhysicianProtectiveEyewear ea0010-0011 GreenLightPhysicianEyewearOTG ea0010-7031 GreenLightSpectatorEyewear ea

Accessories (Other)0010-0231 GreenLightXPSLaserinUseSign(setof2) ea0010-0068 GreenLightXPSOperator'sManual ea



70

PROSTATE HEALTH

RESECTION DEVICES FOR USE WITH VARIOUS RESECTOSCOPESCompatible for Use with Circon / ACMI Brand USA Elite System™/USA Series™ Resectoscope

OrderNumber

GTINNumber Description Sheath O.D. (Fr) Unit

M0068802131 08714729160489 CuttingLoop 24 bx10

M0068802141 08714729160496 CuttingLoop 26 bx10

M0068802191 08714729516675 CuttingLoop 28 bx10

M0068802151 08714729160502 3mmRollerballElectrode 24 bx10




M0068802111 08714729160472 Powerball™ Electrode 24 bx5

M0068802171 08714729160526 TUIP Knife 24 bx10

M0068805111 08714729520641 Incision Blade 24 bx10


Compatible for Use with Circon / ACMI Brand Classic Series™ Resectoscope

OrderNumber


M0068802531 08714729516712 CuttingLoop 24 bx10

M0068802541 08714729516729 CuttingLoop 26 bx10

M0068802581 08714729516774 CuttingLoop 28 bx10





M0068802511 08714729516705 PowerballElectrode 24 bx5

M0068802571 08714729516767 TUIP Knife 24 bx10



Compatible for Use with Storz Brand Single Stem Resectoscope

OrderNumber


M0068802031 08714729160427 CuttingLoop 24 bx10

M0068802041 08714729160434 CuttingLoop 27 bx10





M0068802011 08714729160410 PowerballElectrode 24 bx10

M0068802071 08714729160465 TUIP Knife 24 bx10




71

PROSTATE HEALTH

RESECTION DEVICES FOR USE WITH VARIOUS RESECTOSCOPES (Continued)

Compatible for Use with Storz Brand Double Stem Resectoscope

Order Number GTIN Number Description Sheath O.D. (Fr) Unit

M0068802231 08714729160540 CuttingLoop 24 bx10M0068802241 08714729160557 CuttingLoop 27 bx10M0068802251 08714729160564 3mmRollerballElectrode 24 bx10M0068802261 08714729160571 3mmRollerballElectrode 27 bx10M0068804211 08714729258308 5mmRollerballElectrode 24 bx10M0068804221 08714729258315 5mmRollerballElectrode 27 bx10M0068802211 08714729160533 Powerball™ Electrode 24 bx5M0068802271 08714729160588 TUIP Knife 24 bx10M0068805211 08714729258377 Incision Blade 24 bx10


Compatible for Use with Olympus Brand OES™ Single Stem Resectoscope


M0068802331 08714729160601 CuttingLoop 24 bx10M0068802341 08714729160618 CuttingLoop 26 bx10M0068802391 08714729516682 CuttingLoop 28 bx10M0068802351 08714729160625 3mmRollerballElectrode 24 bx10M0068802361 08714729160632 3mmRollerballElectrode 26 bx10M0068804311 08714729258322 5mmRollerballElectrode 24 bx10M0068804321 08714729258339 5mmRollerballElectrode 26 bx10M0068802311 08714729160595 PowerballElectrode 24 bx5M0068802371 08714729191056 TUIP Knife 24 bx10M0068805311 08714729258384 Incision Blade 24 bx10


Compatible for Use with Wolf Brand E-line Series Resectoscope


M0068802431 08714729191063 CuttingLoop 24 bx10M0068802441 08714729191070 CuttingLoop 26 bx10M0068802491 08714729516699 CuttingLoop 28 bx10M0068802451 08714729191087 3mmRollerballElectrode 24 bx10M0068802461 08714729191094 3mmRollerballElectrode 26 bx10M0068804411 08714729258346 5mmRollerballElectrode 24 bx10M0068804421 08714729258353 5mmRollerballElectrode 26 bx10M0068802411 08714729160656 PowerballElectrode 24 bx5M0068802471 08714729191100 TUIP Knife 24 bx10M0068805411 08714729258391 Incision Blade 24 bx10


Compatible for Use with Olympus Brand OES Pro Series Resectoscope


M0068802611 08714729773672 CuttingLoop 24 bx10M0068802621 08714729775157 CuttingLoop 26 bx10M0068802631 08714729813637 CuttingLoop 28 bx10M0068802641 08714729773849 3mmRollerball 24 bx10M0068802651 08714729775140 5mmRollerball 24 bx10M0068802661 08714729813644 PowerballElectrode 24 bx5M0068802671 08714729775171 TUIP Knife 24 bx10M0068802681 08714729775164 Incision Blade 24 bx10



72

PROSTATE HEALTH

BLADDER TUMOR RESECTION LOOPS

Bladder Tumor Resection (TURBT) Loops

OrderNumber


M0065051611 08714729802723 Bladder Tumor Resection Loop forUsew/ACMIUSAEliteSystem™ and USA Series™ Resectoscope 24 bx10

M0065051621 08714729813620 Bladder Tumor Resection Loop forUsew/OlympusBrandOES™ Resectoscope 26 bx10

M0065051631 08714729820055 Bladder Tumor Resection Loop forUsew/StorzBrandSingleStemResectoscope 28 bx10

M0065051641 08714729820048 Bladder Tumor Resection Loop orUsew/StorzBrandDoubleStemResectoscope 24 bx10

M0065051691 08714729813613 Bladder Tumor Resection Loop forUsew/OlympusOESProSeriesResectoscope 26 bx10



73

PROSTATE HEALTH

SUTURE CAPTURING DEVICES

Capio™ RP Suturing Devices for Radical Prostatectomy

OrderNumber

GTINNumber Description Size Unit

M0068321010 08714729470212 CapioRPSutureCapturingDeviceforanopenradicalprostatectomy ea

M0068331351 08714729799030 Absorbable,monofilamentPOLYGLYTONE™Suture,withaTCtaperpointneedle(dart)andaT26mm1/2circletaperneedle,36" 2.0 bx12

M0068331361 08714729646334 Bondek™Absorbable,braidedcoatedPGAsuture,withaTCtaperpoint needle(dart)andaT26mm1/2circletaperneedle,36" 2.0 bx12


FORCEPS

Piranha™ 3 French Ureteroscopic Biopsy Forcep

OrderNumber

GTINNumber

Jaw O.D.(mm)

Length(cm)

RecommendedWorking Channel

(mm) Unit

M0065051600 08714729302599 1.0 115 1.1 ea



74

Aura XP™ Laser Therapy


Fibers0010-0612 EndoStat™Fiber,0.6mmx12’(KTP/YAG) ea0010-0622 EndoStatFiber,0.4mmx12’(KTP/YAG) ea0010-0632 EndoStatFiber,0.3mmx12’(KTP/YAG) ea0010-6122 EndoStatFiber,0.2mmx12’(Aura/Orion) ea0010-0613 EndoStatFiber,0.6mmx18’(KTP/YAG) ea0010-0952 EndoStatFiber,0.2mm(KTP/YAG) ea0010-2221 CoaxialEndoStatFiber,0.6mmx12’ ea0010-6110 AccuStat™,singlefiber(Aura/Orion) ea

Accessories (Protective Filters)0010-6211 ZeissMicroscopeFixedEyeProtectionFilter(Aura/Orion) ea0010-6212 Wild/LeicaMicroscopeFixedEyeProtectionFilter(Aura/Orion) ea0010-0045 ZeissMicroscopeAutomaticEyeProtectionFilter(Aura) ea0010-0046 StorzMicroscopeAutomaticEyeProtectionFilter(Aura) ea0010-0047 Wild/LeicaMicroscopeAutomaticEyeProtectionFilter(Aura) ea

Accessories (Protective Eyewear)0010-0010 GreenLightPhysicianProtectiveEyewear ea0010-0011 GreenLightPhysicianEyewearOTG ea0010-7031 GreenLightSpectatorEyewear ea

Accessories (Micromanipulator)0010-6133 MicrobeamCablesforMicrobeam250(setof2) ea

Accessories (Other)0124-3680 ShippingCase(Aura/Lyra) ea0010-8310 Aura XP Laser Cart ea


LASER DEVICES

PROSTATE HEALTH


75

Aura XP™ Laser Therapy (Continued)


Accessories (Specialized Handpieces)0010-0851 AngledMicroStats(setof2) ea0010-0831 BayonetMicroStats(setof3) ea0010-0446 BayonetMicroStat,withSuction,7.5cm ea0010-0441 BayonetMicroStat,withSuction,11.5cm ea0010-0444 BayonetMicroStat,withSuction,23cm ea0010-0811 CurvedMicroStats(setof3) ea0010-0813 CurvedMicroStat5cm ea0010-0832 CurvedMicroStat6cm ea

0010-0462 Endo-SuctionSinusSet(setof8)Includes8SinusMicroStatslistedbelow (ortoorderindividually,refertopartnumberslistedbelow) ea

0010-0991 –SinusMicroStat,Straight ea0010-0992 –SinusMicroStat,15ºRightBend ea0010-0993 –SinusMicroStat,30ºRightBend ea0010-0994 –SinusMicroStat,15ºLeftBend ea0010-0995 –SinusMicroStat,30ºLeftBend ea0010-0996 –SinusMicroStat,30ºUpBend ea0010-0997 –SinusMicroStat,90ºRightBend ea0010-0998 –SinusMicroStat,90ºLeftBend ea


Other Laser System Accessories

Model Number Description Unit

Fibers0010-3032 AccuStat™,singlefiber(800) ea0010-2074 ADDStat™,1.8mmdiameter,35.5mmcannula(KTP/YAG) ea

Accessories (Protective Filters)0010-0041 ZeissMicroscopeAutomaticEyeProtectionFilter(800) ea

Accessories (Other)0124-3680 ShippingCase(AuraXP/Lyra) ea


LASER DEVICES (Continued)

PROSTATE HEALTH


76

NOTES

PROCEDURE

ACCESSORIES

PROC

EDU

REAC

CESS

ORIE

S


77


INFLATION DEVICE


OrderNumber


M0067101131 08714729761815 20mLEncore26InflatorwithPressureGauge bx5

M0067101140 08714729755814 20mLEncore26InflatorwithPressureGauge ea


BLADDER EVACUATION DEVICE

Urovac™ Bladder Evacuator containsLATEX

OrderNumber


M0067301251 08714729033769 Urovac Bladder Evacuator bx10


IRRIGATION DEVICES AND ACCESSORIES

From IrrigationFluid Reservoir

Irrigation to Scope

SAPS™ Single Action Pumping System

OrderNumber


M0067201001 08714729045069 SingleActionPumpingSystem bx5

SystemIncludes:10mLVacuumSyringe,CheckValvewithAdjustableLengthConnectingTubesApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.


78


IRRIGATION DEVICES AND ACCESSORIES (Continued)

"T" Fitting

Roller Clamp

10cc Syringe

SAPS™ CF Continuous Flow Single Action Pumping System

OrderNumber


M0067201011 08714729045076 SingleActionPumpingSystemCF bx5

SystemIncludes:10mLVacuumSyringe,ContinuousFlowAdjustableLengthTubingSystemwithDual-CheckValveandRollerClampApplicableMedicareC-codes:TherearenoapplicableMedicareC-codesfortheaboveproducts.

OTHER

UroLok™ II Scope Adaptor

OrderNumber


M0067301401 08714729066569 UroLokIIScopeAdaptor bx10


ESP™ Radiation Reduction Examination Gloves containsLATEX

OrderNumber

GTINNumber Description Size Unit

M0067051021 08714729044963 ESPRadiationReductionExaminationGloves 7 bx3pairs

M0067051031 08714729191117 ESPRadiationReductionExaminationGloves 71/2 bx3pairs


M0067051051 08714729044994 ESPRadiationReductionExaminationGloves 81/2 bx3pairs




79


OTHER (Continued)

Connecting Tubes

OrderNumber


M0067401000 08714729010944 30cmConnectingTubefor3through6FrCatheters ea

M0067401010 08714729012832 30cmConnectingTubefor7through10FrCatheters ea

M0067401020 08714729010951 30cm“Y”ConnectingTubeforTwo3through6FrCatheters ea


Ureteral Catheter Connectors

OrderNumber


M0067401100 08714729010982 Connectionfor3through6FrCatheterswithLuerLockFitting ea

M0067401110 08714729010975 Connectionfor7through10FrCatheterswithLuerLockFitting ea


Drainage Bag Connectors

OrderNumber


M0067401200 08714729010999 ConnectionforFemaleLuerLockFittingtoDrainageBag ea

M0067401220 08714729011002 Connectionfor3through6FrUreteralCatheterstoDrainageBag ea


Gateway™ Advantage Y-Adapter

OrderNumber


M0067301501 08714729845331 GatewayAdvantageY-Adapter bx10



80

NOTES

PELVIC FLOORPRODU

CTS

PELV

IC F

LOOR

PROD

UCT

S


81


MID-URETHRAL SLING SYSTEMS

Advantage Fit™ System (Transvaginal)

OrderNumber


M0068502110 08714729772880 AdvantageFitSystem(singleunit) ea

M0068502120 08714729961925 AdvantageFitBlueSystem ea

EachSystemincludesOne(1)DeliveryDeviceandOne(1)MeshAssemblyApplicableMedicareC-codes:C1771-repairdevice,urinary,incontinence,withslinggraft

Curved Needle Tip

Advantage™ System (Transvaginal)

OrderNumber


M0068502000 08714729470274 AdvantageSystem(singleunit) ea

M0068502050 08714729961918 AdvantageBlueSystem ea


Curved Needle Tip

Lynx™ System (Suprapubic)

OrderNumber


M0068503000 08714729718949 LynxSystem(singleunit) ea

M0068503010 08714729961932 LynxBlueSystem ea

Two(2)DeliveryDevicesandOne(1)MeshAssemblyApplicableMedicareC-codes:C1771-repairdevice,urinary,incontinence,withslinggraft


82


MID-URETHRAL SLING SYSTEMS (Continued)

Curved Halo

Obtryx™ II System with PrecisionBlue™ Design Halo or Curved (Transobturator)

OrderNumber


M0068504110 08714729839255 ObtryxIISystem-Curved(singleunit) ea

M0068505110 08714729837565 ObtryxIISystem-Halo(singleunit) ea

EachSystemincludesTwo(2)DeliveryDevicesandOne(1)MeshAssemblyApplicableMedicareC-codes:C1771-repairdevice,urinary,incontinence,withslinggraft

Obtryx System Halo or Curved (Transobturator)

OrderNumber


M0068504000 08714729718963 ObtryxSystem-Curved(singleunit) ea

M0068505000 08714729718987 ObtryxSystem-Halo(singleunit) ea

EachSystemincludesTwo(2)DeliveryDevicesandOne(1)MeshAssemblyApplicableMedicareC-codes:C1771-repairdevice,urinary,incontinence,withslinggraft

Deployment Mechanism

Mid-line Marker

Delivery Tip

Solyx™ SIS System (Single Incision)

OrderNumber


M0068507000 08714729774044 SolyxSISSystem(singleunit) ea

M0068507010 08714729961901 SolyxBlueSISSystem(singleunit) ea



83


INJECTABLE IMPLANTCoaptite™ Injectable Implant

OrderNumber


M0068903000 08714729804796 1mlSyringe ea

M0068903040 08714729819530 Sidekick™RigidNeedle ea

ApplicableMedicareC-codes:L8606-Injectablebulkingagent,syntheticimplant,urinarytract,1mlsyringe,includesshippingandnecessarysupplies


84


SUTURING SYSTEMS

Capio CL Transvaginal Suture Capturing Device

OrderNumber


M0068311350 08714729516545 CapioCLTransvaginalSutureCapturingDevice ea

ApplicableMedicareC-codes:C2631-repairdevice,urinary,incontinence,withoutslinggraft

Capio™ SLIM Suture Capturing Device

OrderNumber


M0068318250 08714729838005 Capio SLIMSutureCapturingDevice ea

M0068318261 08714729842224 Capio SLIMSutureCapturingDevice bx5


Capio Suture Capturing Devices

OrderNumber


Size(mm) x (cm) Unit

M0068311251 08714729257615 OpenAccess-forsensory/directvisualcontrolwhereatrocarisnotemployed,i.e.,MiniIncisionBurch,SacrospinousFixationorVaginalParavaginalRepair

25cmlength bx4

M0068312321 08714729257622 Standard-fordirectvisionendoscopic,openortransvaginaluse 12mmx32cm bx4


Dart Carrier


85


SUTURING SYSTEMS (Continued)

Capio™ Sutures

OrderNumber

GTINNumber Description Size Closest Equivalent Unit

M0068331231 08714729257660Non-absorbable,polypropylenemonofilament, doublearmedwithtwoTCtapercutneedles(darts),48"

0 Surgilene™Sutures/ Prolene™ Sutures bx12

M0068331241 08714729257677Non-absorbable,polypropylenemonofilament,doublearmedwithaTCtapercutneedle(dart)andaT26mm1/2circletaperneedle,36"

0 SurgileneSutures/ Prolene Sutures bx12

M0068331131 08714729257646 Non-absorbable,coatedbraidedpolyester,doublearmedwithtwoTCtapercutneedles(darts),48" 0 TI-CRON™Sutures/

Ethibond™ Sutures bx12

M0068331141 08714729257653

Non-absorbable,coatedbraidedpolyester,doublearmedwithaTCtapercutneedle(dart)andaT26mm1/2circletaperneedle,36"

0 TI-CRONSutures/ EthibondSutures bx12

M0068331371 08714729761822Monodek™Absorbable,monofilamentPDO,doublearmedwithaTCtapercutneedle(dart)andaT26mm1/2circletaperneedle,48"

0 PDS™ Sutures bx12

M0068332131 08714729298205Bondek™Suture,absorbable,coatedbraidedPGA,doublearmedwithtwoTCtapercutneedles(darts),48"

0 Dexon™IIMesh/ Vicryl™Mesh bx12



86


Uphold™ LITE Vaginal Support System with Capio™ SLIM Suture Capturing Device

OrderNumber


M0068318170 08714729839200 UpholdLITESystemwithCapioSLIMSutureCapturingDevice ea

Systemincludes:One(1)CapioSlimOpenAccessDeviceandOne(1)MeshAssemblyApplicableMedicareC-codes:C1763-connectivetissue,non-human(includessynthetic)

Polyform™ Synthetic Mesh

OrderNumber


Size(cm) Unit

M0068402580 08714729839224 PolyformSyntheticMesh 10x15 ea

M0068402590 08714729845256 PolyformSyntheticMesh 15x20 ea

ApplicableMedicareC-codes:C1763-connectivetissue,non-human(includessynthetic)

SACROCOLPOPEXYUPsylon™ Y-Mesh

OrderNumber


M0068318200 08714729839217 UPsylonY-Mesh ea

M0068318210 08714729848097 Colpassist™VaginalPositioningDevice ea

M0068318220 08714729848103 UPsylonY-MeshandColpassistVaginalPositioningDeviceKit ea


PELVIC FLOOR RECONSTRUCTION SYNTHETIC MESH KIT


87


BIOLOGIC GRAFT MATERIALSXenform™ Soft Tissue Repair Matrix

OrderNumber


Size(cm) Unit

M0068302410 08714729775133 XenformSoftTissueRepairMatrix 2x7 ea





Repliform™ Tissue Regeneration Matrix

OrderNumber


Size(cm) Unit

M0068202400 08714729268970 RepliformTissueRegenerationMatrix 2x4 ea







ApplicableMedicareC-codes:C1762-connectivetissue,human(includesfascialata)

PELVIC FLOOR ACCESSORIESSingle-Step™ Pelvic Drape

OrderNumber


M0068201060 08714729077329 Single-Step™ Pelvic Drape ea



88

NOTES


89

8/10Dilator/SheathSet............................................. 55

Accessories for Lumenis Brand Holmium and Dual WavelengthLaserSystems...................................63

AccuMax™Single-UseHolmiumLaserFibers............62

AccuTrac™Single-UseHolmiumLaserFibers............62

Advantage™System(Transvaginal)........................... 81

AdvantageFit™System(Transvaginal)...................... 81

AmplatzSuperStiff™ Coated Guidewires.................. 10

Amplatz Type Graduated Renal Dilation Set.............54

AmplatzTypeRenalDilator/SheathSet....................54

Amplatz Type Renal Dilators (IndividualComponents)......................................54

AmplatzTypeRenalSheath(Set).............................. 55

Amplatz Type Renal Sheaths (IndividualComponents)...................................... 55

Aura XP™ Laser Therapy............................................. 74

Axxcess™Catheter:OpenEndUreteralCatheter....... 47

Bagley™HelicalStoneRetrievalBaskets....................20

BladderTumorResection(TURBT)Loops.................. 72

C-Flex™ Ureteral Catheters ................................... 47–48

Capio™CLTransvaginalSutureCapturingDevice......84

CapioRPSuturingDevicesforRadicalProstatectomy 73

CapioSLIMSutureCapturingDevice.........................84

CapioSutureCapturingDevices................................84

Capio Sutures.............................................................85

Clear Renal Sheath.....................................................54

Coaptite™InjectableImplant......................................83

CompatibleforUsewithCircon/ACMIBrand Classic Series™ Resectoscope................................ 70

CompatibleforUsewithCircon/ACMIBrand USA Elite System™/USASeries™ Resectoscope.... 70

CompatibleforUsewithOlympusBrand OES™ Pro Series Resectoscope...............................71

CompatibleforUsewithOlympusBrand OESSingleStemResectoscope.............................71

CompatibleforUsewithStorzBrand DoubleStemResectoscope...................................71

CompatibleforUsewithStorzBrand SingleStemResectoscope.................................... 70

CompatibleforUsewithWolfBrandE-lineSeries Resectoscope.........................................................71

ConnectingTubes...................................................... 79

Contour™InjectionStentSets.................................... 37

Contour Ureteral Stent Sets.................................. 33–35

Contour VL™InjectionStentSets..............................38

Contour VL Ureteral Stents ........................................36

Dakota™ Nitinol Stone Retrieval Devices................... 19

DrainageBagConnectors.......................................... 79

Dual Lumen Ureteral Catheter...................................45

Encore™26Inflator...........................................15,53,77

Escape™NitinolStoneRetrievalBaskets.................... 19

ESP™RadiationReductionExaminationGloves........ 78

Flexiva™HighPowerSingle-UseLaserFibers............61

FlexivaIDHighPowerSingle-UseLaserFibers........62

FlexivaIDTracTip™HighPowerSingle-Use LaserFibers...........................................................61

FlexivaTracTipHighPowerSingle-UseLaserFibers..61

Gateway™AdvantageY-Adapter............................... 79

Gemini™PairedWireHelical StoneRetrievalBaskets.........................................21

Graspit™ Nitinol Stone Retrieval Forceps...................20

GreenLight™ Laser Therapy.......................................69

Holmium Laser Therapy............................................69

Imager™IIUrologyTorqueCatheters................... 45,56

Leslie Parachute™Multi-WireStone SweepingDevices................................................. 23

LingemanPercutaneousTractKit with ZIPwire Guidewire.........................................51

LithoCatch™ImmobilizationDevice........................... 23

LithoVue Empower™ Retrieval Deployment Device.... 5

LithoVue™Single-UseDigitalOnly.............................. 5

LithoVueSystemWorkstation..................................... 5

LithoVuewithImageandVideoCapture.................... 5

Lubriglide™ Coated Guidewires.................................. 11

Lumenis™ Laser Systems............................................61

Lynx™System(Suprapubic)........................................ 81

MalecotNephrostomyCatheters............................... 57

MardisSoftUreteralStentSets.................................39

Moses™LaserFibers.................................................62

Navigator™ HD Ureteral Access Sheath Sets...............13

NavigatorUreteralAccessSheathSets.......................13

NaviGuide™ Percutaneous Access Needle................. 52

Product Index


90

NephroMax™HighPressureNephrostomy Balloon Catheters.................................................. 53

NephroMaxHighPressureNephrostomy BalloonCatheters(Kits)......................................... 53

NottinghamOne-StepHydrogelCoated Ureteral Dilators.................................................... 16

Obtryx™ System Halo or Curved (Transobturator)....................................................82

ObtryxIISystemwithPrecisionBlue™Design HaloorCurved(Transobturator)...........................82

Occluder™OcclusionBalloonCatheters.....................56

OptiFlex™NitinolStoneRetrievalBaskets.................20

OtherLaserSystemAccessories................................ 75

Passport™ Balloon Dilatation Catheters......................15

Percuflex™CombinationStent/Nephrostomy Catheter ................................................................58

PercuflexLockingLoopAllPurposeDrainage Catheters with Fader Tip™..................................... 57

PercuflexLockingLoopNephrostomyCatheters......59

PercuflexLockingLoopNephrostomyCatheters with Fader Tip ......................................................58

PercuflexPlusUreteralStentSets.........................29–31

PercuflexUreteralStent............................................. 32

PercuflexUrinaryDiversionStentSets................41–42

Percutaneous Access Set............................................ 52

PercutaneousAccessSets–PigtailCatheter............. 52

Percutaneous Tract Kit with ZIPwire™ Guidewire.......51

Piranha™3FrenchUreteroscopicBiopsyForcep........ 73

Polaris™ Ultra Ureteral Stent Sets ........................ 25–26

Polaris Loop Ureteral Stent Sets............................27–28

Polyform™SyntheticMesh.........................................86

PTFE Coated Guidewires ........................................9–10

Re-Entry™MalecotNephrostomyCatheterSets........58

Repliform™TissueRegenerationMatrix.................... 87

Retromax™ Plus Endopyelotomy Stents.................... 41

Rezūm™WaterVaporTherapy.................................69

SAPS™CFContinuousFlowSingleAction PumpingSystem................................................... 78

SAPSSingleActionPumpingSystem........................ 77

SeguraHemisphere™StoneRetrievalBaskets.......... 22

Sensor™ Nitinol Guidewires......................................... 7

Single-Step™ Pelvic Drape.......................................... 87

SlimLineEZSISSingle-UseLaserFibers....................63

SlimLineSISReusableLaserFibers...........................63

Solyx™SISSystem(SingleIncision)............................82

Stone Cone™NitinolUrologicalRetrievalCoils.......... 23

Stretch™VLFlexima™ Ureteral Stent Sets ..................40

Swiss LithoClast™PneumaticProbes......................... 67

Swiss LithoClast Select Accessories...........................66

SwissLithoClastTrilogyCart......................................65

SwissLithoClastTrilogySingle-UseAccessories (Optional)..............................................................65

SwissLithoClastTrilogySingle-UseProbeKits..........64

SwissLithoClast™TrilogySystemAccessories..........65

SwissLithoClastTrilogySystemKit............................64

SwissLithoClastUltrasoundProbes..........................66

TLA Introducer Needle and Sheath Set..................... 52

Tricep™Hooked-ProngGraspingForceps.................. 22

Uphold™LITEVaginalSupportSystemwith Capio™SLIMSutureCapturingDevice..................86

UPsylon™Y-Mesh.......................................................86

Ureteral Catheter Connectors..................................... 79

UreteralCatheters:AngledTipUreteralCatheters....46

UreteralCatheters:OpenEndUreteralCatheters......46

Ureteral Dilatation Set................................................ 16

Ureteral Dilator System with Procedural Sheath Set................................... 16

Ureteral Dilators......................................................... 16

Ureteral Stent Positioners..........................................42

UroLok™ II Scope Adaptor.......................................... 78

UroMaxUltra™ Balloon Dilatation Catheters.............. 14

Urovac™ Bladder Evacuator........................................ 77

Xenform™SoftTissueRepairMatrix.......................... 87

Zebra™ Guidewires.......................................................9

Zero Tip™NitinolStoneRetrievalBaskets.................. 19

ZIPwire Guidewires...................................................7-8

Product Index (continued)


91

C-CODE CROSS-REFERENCE TO BOSTON SCIENTIFIC PRODUCTS

BACKGROUND

C-codesarerequiredbyMedicareonclaimswhereproceduresarebilledundertheOutpatientProspectivePaymentSystem(OPPS).Theyareusedtotrack

thetypesofdevicesusedduringapplicableoutpatientproceduresandtoensurethatbothproceduresanddevicesareappropriatelybilled.Claimscanbe

returnediftheprimarydevicerequiredfortheprocedureisnotincludedonthesameclaim.SeparatedevicereimbursementisnotdrivenbyC-codeuse.

Itisimportanttochargeappropriatelyfordevice-relatedproceduresbecausehospital’schargingpracticeswilldetermineadequacyoffutureMedicare

hospitaloutpatientrates.Medicaresetsnewhospitaloutpatientratesusinghospitalclaimsandcostdatafromprioryears.

Whenhospitalsfailtoincludeappropriatedevicechargesontheclaim,thisreducesfuturepaymentratesbecausethedevice-relatedcostsarenot

capturedforthatservice.Asaresult,itisimportantforhospitalstoaccuratelyreflectallprocedurecostsininsuranceclaimscharges,includingdevicecost,

usingtheappropriateC-code,whereapplicableinconjunctionwithrevenuecode278Medical/SurgicalSuppliesandDevices-OtherImplant.

Medicare does not have a C-Code category for every Boston Scientific Urology and Women’s Health product.

MEDICARE HOSPITAL OUTPATIENT AMBULATORY PAYMENT CLASSIFICATIONS (APCS)

APCsreferstothegroupingsofprocedurecodesunderthehospitaloutpatientpaymentsystemthatwasmadeeffectiveonAugust1,2000.Thissystem,

mandatedbyfederallawtoreplacetheformerretrospectivecost-basedreimbursementsystem,utilizespre-set,uniformpaymentsforeachprocedure

groupedwithinagivenAPC.APCsclusteroutpatientproceduresintogroupsbasedoncomparableresourceuseandclinicalsimilarities.APCspertainto

MedicareoutpatientservicesonlyandhavenobearingonMedicareinpatientorphysicianreimbursement.

IMPORTANT - PLEASE NOTE

HealtheconomicandreimbursementinformationprovidedbyBostonScientificCorporationisgatheredfromthird-partysourcesandissubjecttochange

withoutnoticeasaresultofcomplexandfrequentlychanginglaws,regulations,rulesandpolicies.Thisinformationispresentedforillustrativepurposes

onlyanddoesnotconstitutereimbursementorlegaladvice.BostonScientificencouragesproviderstosubmitaccurateandappropriateclaimsfor

services.Itisalwaystheprovider’sresponsibilitytodeterminemedicalnecessity,thepropersitefordeliveryofanyservicesandtosubmitappropriate

codes,charges,andmodifiersforservicesthatarerendered.BostonScientificrecommendsthatyouconsultwithyourpayers,reimbursementspecialists

and/orlegalcounselregardingcoding,coverageandreimbursementmatters.BostonScientificdoesnotpromotetheuseofitsproductsoutsidetheir

FDA-approvedlabel.

CPTCopyright2015AmericanMedicalAssociation.Allrightsreserved.CPTisaregisteredtrademarkoftheAmericanMedicalAssociation.ApplicableFARS/DFARSRestrictionsApplytoGovernmentUse.Feeschedules,relativevalueunits,conversionfactorsand/orrelatedcomponentsarenotassignedbytheAMA,arenotpartofCPT,andtheAMAisnotrecommendingtheiruse.TheAMAdoesnotdirectlyorindirectlypracticemedicineordispensemedicalservices.TheAMAassumesnoliabilityfordatacontainedornotcontainedherein.


92

C-CODE RESOURCE LIST

CMS MANDATES SELECT C-CODES

FederalRegister,November15,2004,Vol.69No.219:FinalRuleMedicareHospitalOutpatientPaymentSystem.Pleasemonitorforquarterlyupdates.

SELECT CMS (FORMERLY HCFA) PROGRAM MEMORANDA ADDRESSING PASS-THROUGH ITEMS

WeencourageyoutoretainforyourrecordsallProgramMemorandarelatedtochangestoC-codesonthePass-ThroughListtokeeptrackofhistoricalchanges.RefertotheCMSwebsitetoaccessProgramMemoranda.(http://www.cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp)

• November20,2005,ConsolidatedDeviceEdits;HospitalOutpatientProspectivePaymentSystem(OPPS)RelatedInformation.

• December17,2004,January2005UpdateoftheHospitalOutpatientProspectivePaymentSystem(OPPS);Transmittal403;Pub.100-04; CentersforMedicare&MedicaidServices(CMS)

• June4,2004,SummaryofChanges;Transmittal195;Pub100-04;CentersforMedicare&MedicaidServices(CMS)

• July2003UpdateoftheHospitalOutpatientProspectivePaymentSystem(OPPS);TransmittalNo.A-03-051, CentersforMedicare&MedicaidServices(CMS)

• CodingInformationforHospitalOutpatientProspectivePaymentSystem(OPPS),TransmittalNo.A-00-42, HealthCareFinancingAdministration,July26,2000.(EffectiveAugust1,2000;discardafterOctober1,2001.)

• Update1—CodingInformationforHospitalOutpatientProspectivePaymentSystem(OPPS),TransmittalNo.A-00-61, HealthCareFinancingAdministration,September6,2000.(EffectiveOctober1,2000;discardafterOctober1,2001.)

• TechnicalCorrectionstoCodingInformationforHospitalOutpatientProspectivePaymentSystem(OPPS),TransmittalNo.A-00-72, HealthCareFinancingAdministration,October3,2000.(EffectiveOctober1,2000;discardafterOctober1,2001.)

• January2001Update:CodingInformationforHospitalOutpatientProspectivePaymentSystem(OPPS),TransmittalNo.A-00-82, HealthCareFinancingAdministration,November3,2000.(EffectiveJanuary1,2001;discardafterJanuary1,2002.)

• ImpactoftheBenefitsImprovementandProtectionActonDevicesEligibleforTransitionalPass-ThroughPaymentsUnderthe HospitalOutpatientProspectivePaymentSystem,TransmittalNo.A-01-17,HealthCareFinancingAdministration,January31,2001. (EffectiveJanuary20,2001;discardafterJanuary20,2002.)

• AdditionalInformationonTransitionalPass-ThroughDevicesandDrugs,TransmittalNo.A-01-40,HealthCareFinancingAdministration, March22,2001.(EffectiveApril1,2001;discardafterApril1,2002.)

• CategoriesforUseinCodingDevicesEligibleforTransitionalPass-ThroughPaymentsUndertheHospitalOutpatientProspectivePaymentSystem,TransmittalA-01-41,HealthCareFinancingAdministration,March22,2001.(EffectiveApril1,2001;discardafterApril1,2002.)

• July2001UpdatetotheHospitalOutpatientProspectivePaymentSystem,TransmittalA-01-73,HealthCareFinancingAdministration,June1,2001. (Effectivedatesvary;discardafterJuly1,2002.)

• TechnicalCorrectionsUndertheHospitalOutpatientProspectivePaymentSystem(OPPS),TransmittalA-01-97,CentersforMedicare&MedicaidServices(CMS),August8,2001.(Effectivedatesvary;discardafterApril1,2002.)

• MedicareProgram;ProspectivePaymentSystemforHospitalOutpatientServices;InterimFinalRule,November13,2000. http://www.access.gpo.gov/su_docs/fedreg/a001113c.html

• OfficeoftheInspectorGeneral;MedicareProgram;ProspectivePaymentSystemforHospitalOutpatientServices:RevisionstoCriteriatoDefineNew orInnovativeMedicalDevices,Drugs,andBiologicalsEligibleforPass-ThroughPaymentsandCorrectionstotheCriteriafortheGrandfatherProvision forCertainFederallyQualifiedHealthCenters;InterimFinalRule,August3,2000.http://www.access.gpo.gov/su_docs/fedreg/a000803c.html


93

TERMS AND CONDITIONS

Ordering Information

AllordersshouldbeplaceddirectlywithCustomerServicebymailortelephoneto:

Boston Scientific CorporationAttn: Customer Service

500 Commander Shea Blvd.Quincy, MA 02171

For Phone Orders Call Customer Service at 1.888.272.1001For Fax Orders 1.888.272.9444

PleasenotethattheaboveaddressisourCustomerServicemailingaddressonly.

Thetoll-freenumberisavailablebetweenthehoursof8:30amand9:30pm(EasternTime)weekdaysexcludingnationalholidays.

Foryourconvenience,BostonScientificacceptsordersbyFAX.Thetoll-freeFAXnumberis1.888.272.9444.

STANDING ORDERSBostonScientificacceptsstandingordersonallproducts.Thisconvenienceprovidesyouwithscheduledshipmentsusingasinglepurchaseorder. ContactCustomerDatabaseDepartmentat1.888.325.1060fordetails. ContactCustomerServicefordetailsonordering,pricing,anddelivery.

TERMSTermsareNet30Days.AllshipmentsareF.O.B.Quincy,Massachusetts.Pricesaresubjecttochangewithoutnotice. RETURNED GOODSPermissiontoreturnmerchandiseisrequiredforallreturnsandmaybewithheldinthesolediscretionofBostonScientific. ForauthorizationpleasecontacttheCustomerServiceReturnsDepartmentforaReturnGoodsAuthorization(RGA)numberat1.800.862.1284.

Therequestforauthorizationmustinclude: –Reasonforthereturn –Ordernumber,lotnumber,quantity –Purchaseordernumber,BostonScientificinvoicenumber,dateofinvoice

AcopyofthepackingsliporinvoicemustaccompanyallmerchandisereturnedtoBostonScientific.TheReturnedGoodsAuthorization(RGA)numbermustbeclearlymarkedontheshippingcontainer.MerchandisereturnedwithoutanRGAnumberwillnotbeacceptedorconsideredreturnedforpurposesofthewarranty.

–MerchandiseprocessedinerrorbyBostonScientificwillreceivefullcreditifreturnedwithin30daysofinvoicedateinsaleablecondition –Othermerchandisereturnedwithin30daysofinvoicedateinsaleableconditionwillreceivefullcreditlessa10%RestockingCharge –Merchandisereturnedpast31daysinsaleableconditionwillreceivefullcreditlessa30%RestockingCharge –Materialthatisopened,damaged,expiredortamperedwithisnotreturnableforcreditnorisproductwithlessthansixmonthsofshelfliferemaining –ProductsmanufacturedasSpecialsorCustomproductsarenotreturnableforcredit

Productreturnsshouldbeshippedto:BostonScientificCorporation,CustomerServiceReturnsDepartment, 500CommanderSheaBlvd.,Quincy,MA021711.800.862.1284

SPECIFICATION CHANGESAswearecontinuallyimprovingourproducts,theequipmentsuppliedmaynotagreeinalldetailswiththedescriptionandspecificationsshowninthecatalogand/orpricelist.Allpricesandspecificationsaresubjecttochangewithoutnotice.

BostonScientificCorporationmakesnowarranties,expressorimplied,includingbutnotlimitedto,anyimpliedwarrantyofmerchantabilityorfitnessforaparticularpurpose,exceptasspecificallysetforthintheproductlabelingsuppliedwitheachdevice.

REGULATORYBostonScientificdistributesproductsincompliancewithrelevantregulations.

CAUTION: Accordinglyformedicaldevices:Federal(USA)lawrestrictsthesedevicestosalebyorontheorderofaphysician.PleaserefertopackageinsertprovidedwiththeproductforcompleteIndicationsforUse,Contraindications,Warnings,Precautions,AdverseEventsandInstructions. RepliformTissueRegenerationMatrixcomplieswithU.S.Regulationsin21CFRpart1271HumanTissueIntendedforTransplantation.

WARNING REGARDING SINGLE USE DEVICES Productsmarkedas“singleuse”areforsingleuseonly.Donotreuse,reprocessorresterilizesingle-useproducts.Reuse,reprocessingorresterilizationmaycompromisethestructuralintegrityofthedeviceand/orleadtodevicefailurewhichinturnmayresultinpatientinjury,illnessordeath.Reuse,reprocessingorresterilizationmayalsocreateariskofcontaminationofthedeviceand/orcausepatientinfectionorcross-infection,including,butnotlimitedto,thetransmissionofinfectiousdisease(s)fromonepatienttoanother.Contaminationofthedevicemayleadtoinjury,illnessordeathofthepatient.BostonScientificCorporationassumesnoliabilitywithrespecttoinstrumentsreused,reprocessedorresterilizedandmakesnowarranties,expressorimplied,including,butnotlimitedto,anyimpliedwarrantiesofmerchantabilityorfitnessforaparticularpurpose,withrespecttoanysuchinstrument.

Boston Scientific Corporation300 Boston Scientific Way Marlborough, MA 01752www.bostonscientific.com

Ordering Information 1.888.272.1001

© 2019 Boston Scientific Corporation or its affiliates. All rights reserved.

UROPH-439105-AC JAN 2019Alltrademarksarethepropertyoftheirrespectiveowners.

2019PRODUCT CATALOG AND ORDERING INFORMATION...M0066703061 08714729302667 .035 150 Angled 3cm...

Documents

Transcript of 2019PRODUCT CATALOG AND ORDERING INFORMATION...M0066703061 08714729302667 .035 150 Angled 3cm...