CMS SOM App. H, Tag V194

5.2.5 Carbon adsorption: (Iodine #900/replacement)

When granular activated carbon is used as the media, it shall have a minimum iodine

number of 900. Other forms of carbon should not be used unless there is performance data

to demonstrate that each adsorption bed has the capacity to reduce the chloramine

concentration in the feed water to less than 0.1 mg/L when operating at the maximum

anticipated flow rate for the maximum time interval between scheduled testing of the

product water for chloramines.

Regenerated carbon shall not be used for hemodialysis applications.

Refer to RD62:2001, 4.3.9 Carbon adsorption media: Exhausted carbon adsorption media

shall be discarded and replaced with new media according to a replacement schedule

determined by regular monitoring.

Interpretive Guidelines §494.40(a)

ANSI/AAMI RD62:2001

4.3.9 Carbon adsorption media

For example, when testing between the beds shows that the first bed is exhausted, the second bed

should be moved into the first position, the second bed replaced with a new bed, and the

exhausted bed discarded.

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Other forms of carbon should not be used unless there is performance data to demonstrate that

each adsorption bed has the capacity to reduce the chloramine concentration in the feed water to

less than 0.1 mg/L when operating at the maximum anticipated flow rate for the maximum time

interval between scheduled testing of the product water for chloramines.

ANSI/AAMI RD52

5.2.5 Carbon adsorption

Some granular activated carbon contains aluminum, which can elute from the carbon and add to

the burden of aluminum to be removed by reverse osmosis or ion exchange. The use of acid-washed carbon minimizes this source of aluminum in the water.

Additional Guidance:

Facilities using an exchange tank system should establish a schedule for replacing the exhausted

carbon adsorption media based on their experience with these tanks to prevent interruptions to

patient services. The date of exchange of tanks should be documented on the tank and in the

appropriate log. Facilities using back-washable carbon systems should establish a schedule for

back-washing the tanks and document the system's function. Back-washing does NOT regenerate

the carbon; it rearranges the carbon in the tank, exposing sites that have not yet been used to

adsorb chlorine or chloramine. Back-washable systems do exhaust; the responsible staff member

should be able to describe how they will replace the carbon when indicated. A “schedule” could

refer to “every X months” rather than a specific date or month and should be based on past

experience at the facility. Carbon in the tanks can be removed and replaced (“rebedding”) on

site when the tanks are offline.

Granulated activated carbon (GAC) with a minimum iodine number of 900 must be specified

when replacement carbon is ordered. Acid-washed carbon is recommended, as it will protect the

RO from exposure to excess aluminum, but is not required as the RO would still protect the

patient.