There are no adequate and well-controlled studies in pregnant women. Cathflo Activase should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Blaney M, Shen V, Kerner JA, et al; for CAPS Investigators. Alteplase for the treatment of central venous catheter occlusion in children: results of a prospective, open-label, single-arm study (the Cathflo Activase Pediatric Study). J Vasc Interv Radiol. 2006;17(11, pt 1):1745-1751.

Certain causes of catheter dysfunction should be considered before treatment with Cathflo Activase (e.g. catheter malposition, mechanical failure, constriction by a suture and lipid deposits or drug precipitates within the catheter lumen). These types of conditions should be considered before treatment with Cathflo Activase.

Richardson D. Vascular access nursing: standards of care, and strategies in the prevention of infection: a primer on central venous catheters (part 2 of a 3-part series). JAVA. 2007;12(1):19-27.

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Cummings-Winfield C, Mushani-Kanji T. Restoring patency to central venous access devices. Clin J Oncol Nurs. 2008;12(6):925-934.

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Cathflo Activase should be used with caution in the presence of known or suspected infection in the catheter. Using Cathflo Activase in patients with infected catheters may release a localized infection into the systemic circulation. As with all catheterization procedures, care should be used to maintain aseptic technique.

Visit our Resource Center for a list of downloadable forms, interactive files, and other documents designed to facilitate successful claim submissions. Examples of claim forms that you may use when billing for Cathflo are included.

Mohiaddin RH, Wann SL, Underwood R, Firmin DN, Rees S, Longmore DB. Vena caval flow: assessment with cine MR velocity mapping. Radiology. 1990;177(2):537-541.

The submission and completion of reimbursement- or coverage-related documentation are the responsibility of the patient and healthcare provider. Genentech, Inc. and its affiliates make no representations or guarantees concerning reimbursement for any service or item.

aPlease contact other payers as needed to clarify their reimbursement guidelines for Cathflo. bCurrent Procedural Terminology (CPT) is a registered trademark of the American Medical Association. CPT is copyright 2010 American Medical Association. All rights reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. cAll CPT 5-digit numeric codes, descriptions, numeric modifiers, instructions, guidelines, and other materials included in this webpage are copyright 2010 American Medical Association. All rights reserved.

Frey AM. Intravenous therapy in children. In: Hankins J, Lonsway RAW, Hedrick C, Perdue M, eds. Infusion Therapy in Clinical Practice. 2nd ed. WB Saunders; 2001:561-591.

Blaney M, Shen V, Kerner JA, et al; for CAPS Investigators. Alteplase for the treatment of central venous catheter occlusion in children: results of a prospective, open-label, single-arm study (the Cathflo Activase Pediatric Study). J Vasc Interv Radiol. 2006;17(11, pt 1):1745-1751.

Should serious bleeding in a critical location (e.g., intracranial, gastrointestinal, retroperitoneal, pericardial) occur, treatment with Cathflo Activase should be stopped and the drug should be withdrawn from the catheter.

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Richardson D. Vascular access nursing: standards of care, and strategies in the prevention of infection: a primer on central venous catheters (part 2 of a 3-part series). JAVA. 2007;12(1):19-27.

The link you have selected will take you away from this site to one that is not owned or controlled by Genentech, Inc. Genentech, Inc. makes no representation as to the accuracy of the information contained on sites we do not own or control. Genentech does not recommend and does not endorse the content on any third-party websites. Your use of third-party websites is at your own risk and subject to the terms and conditions of use for such sites.

Ponec D, Irwin D, Haire WD, et al. Recombinant tissue plasminogen activator (alteplase) for restoration of flow in occluded central venous access devices: a double-blind placebo-controlled trial—the cardiovascular thrombolytic to open occluded lines (COOL) efficacy trial. J Vasc Inter Radiol. 2001;12(8):951-955.

Cummings-Winfield C, Mushani-Kanji T. Restoring patency to central venous access devices. Clin J Oncol Nurs. 2008;12(6):925-934.

Frey AM. Intravenous therapy in children. In: Hankins J, Lonsway RAW, Hedrick C, Perdue M, eds. Infusion Therapy in Clinical Practice. 2nd ed. WB Saunders; 2001:561-591.

McKnight S. Nurse's guide to understanding and treating thrombotic occlusion of central venous access devices. Medsurg Nurs. 2004;13(6):377-382.

Deitcher SR, Fesen MR, Kiproff PM, et al; for the Cardiovascular Thrombolytic to Open Occluded Lines-2 Investigators. Safety and efficacy of alteplase for restoring function in occluded central venous catheters: results of the Cardiovascular Thrombolytic to Open Occluded Lines trial. J Clin Oncol. 2002;20(1):317-324.

Please select the appropriate billing code when filing all claims. Billing codes should be based on diagnosis and the services provided. The codes most commonly associated with the billing and reimbursement of Cathflo are given below. We cannot guarantee that use of the following billing codes will result in reimbursement.c

McKnight S. Nurse's guide to understanding and treating thrombotic occlusion of central venous access devices. Medsurg Nurs. 2004;13(6):377-382.

Private payers may employ different reimbursement methodologies that may or may not allow for the separate reimbursement of Cathflo when administered in the inpatient setting. Some payers may require additional coding and patient-specific clinical information to determine coverage and payment for the inpatient stay. Please contact individual private payers as needed to clarify their specific reimbursement policies for Cathflo.

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Deitcher SR, Fesen MR, Kiproff PM, et al; for the Cardiovascular Thrombolytic to Open Occluded Lines-2 Investigators. Safety and efficacy of alteplase for restoring function in occluded central venous catheters: results of the Cardiovascular Thrombolytic to Open Occluded Lines trial. J Clin Oncol. 2002;20(1):317-324.

Reimbursement for all services, drugs, and supplies administered to Medicare beneficiaries during a single inpatient hospitalization is bundled into a single prospective payment amount. This payment amount is determined by the Medicare Severity Diagnosis Related Group (MS-DRG) system, which classifies patients into clinically cohesive groups that have similar hospital resource use and length of stay. The MS-DRG assignment for each case is based on the combination of ICD-10-CM diagnosis and procedure codes reported on the hospital claim form, the Unified Bill 2004 (UB-04) (see description of coding systems below).

On claim forms, hospitals use the International Classification of Diseases (ICD) code sets to report medical diagnoses and Healthcare Common Procedural Coding System (HCPCS) Level II codes and American Medical Association (AMA) Current Procedural Terminology (CPT®b) to report items and procedures provided during outpatient encounters. As of October 1, 2015, all claims need to use the tenth revision of the ICD diagnosis codes to report medical diagnoses (ICD-10-CM) in order to receive reimbursement. All codes should be reported on the claim form to the highest level of specificity. Medicare may require additional coding and patient-specific clinical information to determine coverage and payment for the outpatient visit. CPT codes are 5-digit number codes created by the AMA to designate specific procedures performed. Certain supplies, services, procedures, and drugs administered to Medicare beneficiaries in the outpatient setting may be reimbursed separately. Reimbursement for Cathflo administered in the outpatient setting is set at Average Sales Price (ASP) plus 6% (except 340B hospitals; ASP published quarterly by the Centers for Medicare and Medicaid Services). To bill Medicare for the services provided and supplies furnished to patients, outpatient hospitals use the UB-04 claim form. The form must be completed with revenue codes, Healthcare Common Procedure Coding System (HCPCS) codes, and ICD-10-CM diagnosis codes (see description of coding systems below). Hospitals should be as thorough as possible in coding to ensure appropriate reimbursement. View an illustrative chart to guide you through the billing process applicable for outpatients.

Hospitals use the International Classification of Diseases (ICD) code sets to report medical diagnoses and procedures associated with inpatient stays. As of October 1, 2015, the tenth revision of these codes (ICD-10) replaced the previous ninth revision (ICD-9) codes.

In clinical trials, the most serious adverse events reported after treatment were sepsis, gastrointestinal bleeding, and venous thrombosis.

The interaction of Cathflo Activase with other drugs has not been formally studied. Concomitant use of drugs affecting coagulation and/or platelet function has not been studied.

Kaler W, Chinn R. Successful disinfection of needleless access ports: a matter of time and friction. JAVA. 2007;12(3):140-142.

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Cathflo Activase should not be administered to patients with known hypersensitivity to alteplase or any component of the formulation.

Genentech cannot guarantee the exact amount of money, if any, your facility will receive. If you need further assistance regarding Medicare or Medicaid reimbursement policies or procedures, please contact your local carrier directly.

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Camp-Sorrell D, Matey L, ed. Access Device Standards of Practice for Oncology Nursing. 4th ed. Oncology Nursing Society; 2017.

If the steels have a cobalt content of 5% or 8%, then these steels form their own alloy group, which is designated by the abbreviation HSS-E. Both the spellings ...

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

Haire WD, Herbst SF. Consensus conference on the use of alteplase (t-PA) for the management of thrombotic catheter dysfunction. J Vasc Access Devices. 2000;5(2):28-36.

Haire WD, Herbst SF. Consensus conference on the use of alteplase (t-PA) for the management of thrombotic catheter dysfunction. J Vasc Access Devices. 2000;5(2):28-36.

Stephens LC, Haire WD, Kotulak GD. Are clinical signs accurate indicators of the cause of central venous catheter occlusion? J Parenter Enteral Nutr. 1995;19(1):75-79.

Siegel JD, Rhinehart E, Jackson M, Chiarello L; Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. 2007:1-226.

Three-digit codes that providers (physicians, freestanding clinics, hospitals) use to categorize provided services. When completing the UB-04, providers must describe the services related to the revenue code used.

Doellman D, Buckner JK, Garrett JH Jr, et al. Best practice guidelines in the care and maintenance of pediatric central venous catheters. 2015. http://www.ivas.online/newstyle/wp-content/uploads/2019/06/AVA-Pediatric-Guidelines-2nd-edition_web.pdf

This section provides general coding information related to the use of Cathflo and is intended for informational purposes only. Please consult the Centers for Medicare & Medicaid Services (CMS) for specific information and requirements.

The most frequent adverse reaction associated with all thrombolytics in all approved indications is bleeding. Cathflo Activase has not been studied in patients known to be at risk for bleeding events that may be associated with the use of thrombolytics. Caution should be exercised with patients who have any condition for which bleeding constitutes a significant hazard.

Siegel JD, Rhinehart E, Jackson M, Chiarello L; Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. 2007:1-226.

The form must be completed with Healthcare Common Procedure Coding System (HCPCS) codes and ICD-10-CM diagnosis codes (see description of coding systems below). Physician providers must also list a doctor's order and medical justification (diagnosis) in the patient's chart for the services provided. An illustrative chart to guide you through the billing process applicable to a physician's office or a freestanding clinic.

Cathflo® Activase® (alteplase) is indicated for the restoration of function to central venous access devices as assessed by the ability to withdraw blood.

Kaler W, Chinn R. Successful disinfection of needleless access ports: a matter of time and friction. JAVA. 2007;12(3):140-142.

Under the MS-DRG system, Cathflo is not separately reimbursable when administered to Medicare beneficiaries in the inpatient setting. Instead, its cost is intended to be covered by the single MS-DRG payment. To ensure appropriate reimbursement, be sure to accurately code for all patient diagnoses and procedures performed.

Ponec D, Irwin D, Haire WD, et al. Recombinant tissue plasminogen activator (alteplase) for restoration of flow in occluded central venous access devices: a double-blind placebo-controlled trial—the cardiovascular thrombolytic to open occluded lines (COOL) efficacy trial. J Vasc Inter Radiol. 2001;12(8):951-955.

Stephens LC, Haire WD, Kotulak GD. Are clinical signs accurate indicators of the cause of central venous catheter occlusion? J Parenter Enteral Nutr. 1995;19(1):75-79.

Hill DR, et al. GibN (cyanoglobin) is a peripheral membrane protein that is restricted to certain Nostoc spp.. J. Bacteriol. 178: 6587-6598, 1996.

Doellman D, Buckner JK, Garrett JH Jr, et al. Best practice guidelines in the care and maintenance of pediatric central venous catheters. 2015. http://www.ivas.online/newstyle/wp-content/uploads/2019/06/AVA-Pediatric-Guidelines-2nd-edition_web.pdf

With this fits, The parts with great clearances with having great tolerances. ... All data given in bold in the chart below are in accordance with ABC agreements.

Hypersensitivity, including urticaria, angioedema and anaphylaxis, has been reported in association with use of Cathflo Activase. Monitor patients treated with Cathflo Activase for signs of hypersensitivity and treat appropriately if necessary.

Mohiaddin RH, Wann SL, Underwood R, Firmin DN, Rees S, Longmore DB. Vena caval flow: assessment with cine MR velocity mapping. Radiology. 1990;177(2):537-541.

Camp-Sorrell D, Matey L, ed. Access Device Standards of Practice for Oncology Nursing. 4th ed. Oncology Nursing Society; 2017.

Excessive pressure should be avoided when Cathflo Activase is instilled into the catheter. Such force could cause rupture of the catheter or expulsion of the clot into the circulation.

Depending on the setting of care, certain code systems are used on the patient's claim form to describe the services provided during the healthcare visit.

Reimbursement for Cathflo administered in a physician's office or freestanding clinic (ie, a clinic that is not operated as part of a hospital) is set at Average Sales Price (ASP) plus 6% (ASP published quarterly by the Centers for Medicare and Medicaid Services). Both physicians’ offices and freestanding clinics bill Medicare using the CMS-1500 claim form.