95250,95251

bkreed

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Is it correct to bill CPT 95250 and 95251 on the same day of service if a patient wears a continuous glucose sensor and returns the monitor for download three days later? Medtronic insulin pumps users can also wear a continuous sensor and load pump info onto Medtronic's Carelink site for the doctor's review from the office. Their initial training is billed as 95250. Is it correct to bill 95251, physician interp and report, on the same day?
 

bkreed

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After thoughtful consideration, may I answer my own question? One cannot bill for services not performed. The download and interp are performed three days later for CGMS. A solution is to hold the claim until the CGMS monitor is returned for download. This delay sets off a red flag in our group practice admin office but gains revenue for services performed as 95251 is not missed. As for the real time sensor starts, the upload and interp may be many days later. The provider's interp time should be reimbursed in this case also. I'll give this more thought. I appreciate the many who have read my posting. Thank you for letting me "think out loud".
 
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