S5518 Hit cath repair kitHome infusion therapy, all supplies necessary for catheter repair
Status I: not valid for Medicare (Medicare uses another code).
1 of 1 payer prior-auth lists that name S5518 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross and Blue Shield of Texas | Texas PA exemption (gold card), outpatient, fully insured | TX | prior auth required | Gold-card exemption available | Jan 1, 2026 | BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) |
S5518 appears in 14 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Infusion Pumps (0161) | covered if criteria are met | Mar 31, 2026 | payer document |
| Aetna | Nutritional Support (0061) Enteral lactoferrin supplementation | covered if criteria are met | Jan 15, 2026 | payer document |
| Aetna | Skilled Home Private Duty Nursing Care (0136) | listed, no stance (range S5517-S5523) | Apr 7, 2026 | payer document |
| Anthem | Home Health (CG-MED-23) | covered if criteria are met (range S5497-S5523) | Nov 6, 2025 | payer document |
| Blue Cross & Blue Shield of Mississippi | Parenteral Pen And Enteral En Nutrition Support In The Home (L.1.01.404) | covered if criteria are met | payer document | |
| UnitedHealthcare | Home Health Care Services (for Kentucky Only) (CS137KY.12) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (MP.022.28) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (CS137.X) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Idaho Only) (CS137ID.D) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Kansas Only) (CS137KS.04) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Nebraska Only) (CS137NE.V) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for New Mexico Only) (CS137NM.D) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Ohio Only) (CS137OH.E) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Home Health, Skilled, and Custodial Care Services (for Tennessee Only) (CS137TN1.J) | listed, no stance | Jan 1, 2026 | payer document |
Prior authorization required or conditional in IN, VA.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.