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US · guidance

CMS Pub. 100-03, ch. 1, § 230.5

Gravlee Jet Washer

activein force · 2026-08-25 – presentas-observed

CIM 50-4

The Gravlee Jet Washer is a sterile, disposable, diagnostic device for detecting endometrial cancer. The use

of this device is indicated where the patient exhibits clinical symptoms or signs suggestive of endometrial

disease, such as irregular or heavy vaginal bleeding.

Program payment cannot be made for the washer or the related diagnostic services when furnished in

connection with the examination of an asymptomatic patient. Payment for routine physical checkups is

precluded under the statute. (See §1862(a)(7) of the Act.)

(See the Medicare Benefit Policy Manual, Chapter 16, “General Exclusions From Coverage,” §90).

History

(Rev. 1, 10-03-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
bc327aef5caae1fb83bc82d80ce43af7465130018a7984f7ff55446a053b2deb
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