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    Where to get pristeen in California

    Hi All,

    I was wondering where to go about getting Peristeen? I have no issues with getting a prescription but I can't find any resellers. Also, during my searches , I've noticed that people were saying you need to be trained? I can find no information on who is doing this training or where I am to find a lit of certified people to train. This might be a good solution fo rme and it's dam near impossible to find anything. Please help!

    E
    T7 Incomplete from 1989

    #2
    The outpatient clinic RN at Sharp Rehabilitation Center in San Diego is a certified Peristeen trainer. You will need a physician's order for the training and the supplies.

    You can also contact Coloplast through their website and they will get back to you with information on other training centers:
    https://www.coloplast.us/Bladder-and...wel-solutions/

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


      #3
      Again, emanshiu, I highly suggest the IryPump S. It is far less invasive and far less expensive in the long run than Peristeen. Unless it's covered by insurance (didn't think it was last time I checked), there is literally no reason in my mind to buy the Peristeen.

      Why shove a single use plastic catheter in your anus (aren't they $10 a unit?), have tubing running everywhere, have balloons burst, and have to manually pump water in?

      The IryPump S is a small soft 6-month reusable cone you put in the end of the anus and the shape creates a seal. There's a single tube that goes to a battery powered unit that is smaller than the Peristeen. You turn a single knob and it instills water into your colon.

      To each his/her own, but I'm honestly suggesting you go the route of the IryPump S. Far less parts, far less work, and far less money in the long run for the same effect.

      Comment


        #4
        Originally posted by paraparajumper View Post
        Again, emanshiu, I highly suggest the IryPump S. It is far less invasive and far less expensive in the long run than Peristeen. Unless it's covered by insurance (didn't think it was last time I checked), there is literally no reason in my mind to buy the Peristeen.

        Why shove a single use plastic catheter in your anus (aren't they $10 a unit?), have tubing running everywhere, have balloons burst, and have to manually pump water in?

        The IryPump S is a small soft 6-month reusable cone you put in the end of the anus and the shape creates a seal. There's a single tube that goes to a battery powered unit that is smaller than the Peristeen. You turn a single knob and it instills water into your colon.

        To each his/her own, but I'm honestly suggesting you go the route of the IryPump S. Far less parts, far less work, and far less money in the long run for the same effect.

        I will look into this then. I didn't even know about it. Thank you!
        T7 Incomplete from 1989

        Comment


          #5
          I am an old paraplegic, 51 years in the chair, but new colon irrigator. There is information on the IryPump S on my DIY Pulse Irrigation post from a few days ago. As described there I am doing it with a simple hand pump and minimal expense. Day 5, so I am very new, but so far it has been a life changer. Should have done it years ago.

          I know the Sharp nurse, and she is great. We talked about Peristeen, but it is not covered by my insurance, and it is outrageously expensive out of pocket.
          T4 complete, 150 ft fall, 1966. Completely fused hips, partially fused knees and spine, heterotopic ossification. Unsuccessful DREZ surgery about 1990. Successful bladder augmentation using small intestine about 1992. Normal SCI IC UTI problems culminating in a hospital stay in 2001. No antibiotics or doctor visits for UTI since 2001: d-mannose. Your mileage may vary.

          Comment


            #6
            Many people reuse the Peristeen catheters, and it is covered by many insurances now.

            (KLD)
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

            Comment


              #7
              Like KLD says, the Peristeen catheters are reusable. I would love to see the IryPump with the Peristeen catheter. That would be the perfect solution for me.

              Comment


                #8
                Originally posted by SCI-Nurse View Post
                The outpatient clinic RN at Sharp Rehabilitation Center in San Diego is a certified Peristeen trainer. You will need a physician's order for the training and the supplies.

                You can also contact Coloplast through their website and they will get back to you with information on other training centers:
                https://www.coloplast.us/Bladder-and...wel-solutions/

                (KLD)

                thank you for that, I've called them and waiting for a call back. I live in the bay area and wonder if ther4e's anything here.
                T7 Incomplete from 1989

                Comment


                  #9
                  Originally posted by SCI-Nurse View Post
                  The outpatient clinic RN at Sharp Rehabilitation Center in San Diego is a certified Peristeen trainer. You will need a physician's order for the training and the supplies.

                  You can also contact Coloplast through their website and they will get back to you with information on other training centers:
                  https://www.coloplast.us/Bladder-and...wel-solutions/

                  (KLD)
                  Originally posted by emanshiu View Post
                  thank you for that, I've called them and waiting for a call back. I live in the bay area and wonder if ther4e's anything here.
                  I filled out the contact form at the Coloplast site and am awaiting a return call as well. I too am in the San Francisco Bay area. I suspect training centers will be University of California San Francisco, Rehab center at Santa Clara and/or Stanford University Medical Center.

                  Is Peristeen covered by Medicare?
                  Last edited by gjnl; 29 Sep 2017, 7:42 PM.

                  Comment


                    #10
                    let me know if you hear back and I'll do the same
                    T7 Incomplete from 1989

                    Comment


                      #11
                      How many uses do you get out of the Peristeen catheters?

                      If it's covered by insurance, than obviously go with it. They probably won't give you the unit unless they trained you, but I "trained" myself. You're just putting water in your colon. As long as you don't try and instill 5 gallons or something like radiator fluid it's not really rocket science

                      Comment


                        #12
                        I found the answer to Medicare coverage here: https://www.carecure.net/forum/showt...n-System/page2

                        The thread dates back to 2014-16 and Medicare and Veterans Administration both cover Peristeen now.

                        Possibly dating back to my rehab days, I remember a device called pulsed irrigation evacuation (PIE). At the time, I don't think the system had FDA approval and my gastroenterologist was worried about washing away the natural mucous of the colon. Is this a concern with either the PIE or Peristeen systems?

                        Is the PIE system being used today? Pro and Con of PIE over Peristeen type systems?

                        I read in the thread above that the PIE system required administration by an attendant while the patient is in bed, where as the Peristeen system can be used independently, if user is capable, and is administered while sitting on a toilet or commode chair. Have there been changes to these uses and administration?

                        Comment


                          #13
                          Originally posted by gjnl View Post
                          I filled out the contact form at the Coloplast site and am awaiting a return call as well. I too am in the San Francisco Bay area. I suspect training centers will be University of San Francisco, Rehab center at Santa Clara and/or Stanford University Medical Center.

                          Is Peristeen covered by Medicare?
                          I was told a couple of weeks ago by the SCI nurse at Sharp San Diego that Peristeen is not covered by Medicare.
                          T4 complete, 150 ft fall, 1966. Completely fused hips, partially fused knees and spine, heterotopic ossification. Unsuccessful DREZ surgery about 1990. Successful bladder augmentation using small intestine about 1992. Normal SCI IC UTI problems culminating in a hospital stay in 2001. No antibiotics or doctor visits for UTI since 2001: d-mannose. Your mileage may vary.

                          Comment


                            #14
                            Originally posted by gac3rd View Post
                            I was told a couple of weeks ago by the SCI nurse at Sharp San Diego that Peristeen is not covered by Medicare.
                            Originally posted by SCI-Nurse View Post
                            No. I just had a meeting with our rep, and it still not VA approved, but it is finally Medicare approved, so you could ask you VA provider to prescribe product through you Medicare & then request the training through Fee-Basis. Coloplast will only supply after you have been trained by one of their certified RNs. They are busy training outpatient & inpatient RNs at larger non-VA rehab centers now.

                            (KLD)
                            Post Number 3 by SCI Nurse KLD
                            Thread: https://www.carecure.net/forum/showt...n-System/page2
                            Date: 12/03/2014

                            Originally posted by SCI-Nurse View Post
                            They are now on VA contract, but are pretty slow in rolling out to VA facilities, including SCI Centers. There is still a requirement (from the FDA) that they only be prescribed by providers who, and training provided by nurses who, have completed the Coloplast training program on the Peristeen. So not just any VA provider can order them for you...

                            (KLD)
                            Post Number 12 by SCI Nurse KLD
                            Thread: https://www.carecure.net/forum/showt...n-System/page2
                            11/22/16

                            From article in New Mobility, April 1, 2014, http://www.newmobility.com/2014/04/p...el-management/Para/Medic: Peristeen: New Option for Bowel Management

                            Most important now is getting insurance companies to understand the importance of the system so they will reimburse it, says Martini. Coloplast has applied for a Medicare HCPCS code for Peristeen. Approval is expected by November. When the code is granted, approval from other insurers will be much easier. At present the system is being approved in quite a few states through Medicaid and more are being added. Various private insurance companies are paying for it, but it may take a few appeal processes. As always, it is important to get documentation on why you need the system and get prior authorization. Coloplast is working with suppliers to help educate insurance companies on the importance of the system.

                            I did an internet search to find a code. https://www.dmepdac.com/resources/articles/2015/02_18_15.html

                            It appears that the system as initially provided with pump, balloon, catheter and accessories is initially covered, but refills for additional disposable supplies is not covered by Medicare.Correct Coding and Coverage – Peristeen? Transanal Irrigation (PAI) System

                            Joint DME MAC Publication

                            The Peristeen transanal irrigation (PAI) system is a device used to empty the lower bowel and to prevent chronic constipation and fecal incontinence or simply as a method of bowel management. The system consists of an enema bag, a rectal catheter with an inflatable balloon and a hand pump. Effective for claims with dates of service on or after January 1, 2015 the correct code to bill is:
                            A4459 – MANUAL PUMP ENEMA SYSTEM, INCLUDES BALLOON, CATHETER AND ALL ACCESSORIES, REUSABLE, ANY TYPE
                            There is no Medicare benefit for this device; therefore, claims for code A4459 will be denied as non-covered (no Medicare benefit).
                            Code A4459 is an all-inclusive code at initial issue. Separate billing of any of the individual components is not allowed. The code is established as a single code to include all parts including the disposable supplies at initial issue. For refills of disposable supplies such as rectal catheters, HCPCS code A9270 (Noncovered item or service) should be used.
                            For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form.
                            Last edited by gjnl; 29 Sep 2017, 2:14 PM.

                            Comment


                              #15
                              Originally posted by gjnl View Post
                              I found the answer to Medicare coverage here: https://www.carecure.net/forum/showt...n-System/page2

                              The thread dates back to 2014-16 and Medicare and Veterans Administration both cover Peristeen now.

                              Possibly dating back to my rehab days, I remember a device called pulsed irrigation evacuation (PIE). At the time, I don't think the system had FDA approval and my gastroenterologist was worried about washing away the natural mucous of the colon. Is this a concern with either the PIE or Peristeen systems?

                              Is the PIE system being used today? Pro and Con of PIE over Peristeen type systems?

                              I read in the thread above that the PIE system required administration by an attendant while the patient is in bed, where as the Peristeen system can be used independently, if user is capable, and is administered while sitting on a toilet or commode chair. Have there been changes to these uses and administration?
                              Check insurance coverage first, but after that I'd really consider lifestyle as well. That PIE system looks massive, like a radiator you have to keep in your bathroom. You want to lug this with you on vacation?

                              Comment

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