Wiki Continuous glucose monitoring

[Triesen1]

We are just staring to place the continuous glucose monitoring systems in some of our patients and would like some guidance for billing. We will be placing the sensor on one visit and the patient will come back at 1 week for an adjustment of medications with a Diabetic educator/RN and pharmacist. Then at 2 weeks they will return to see the physician. and have sensor replacement.

1. Do we bill 95250 on the date the patient comes in to see the pharmacist and RN or do we have to wait until the sensor is removed to bill for this code?
2. Do you bill for A9276 x 14 or A9276 x 1? We will be changing the sensor at 14 days.
3. Can we bill for both 95250 and 95251 on the same visit?

Thanks!

 

[erjones147]

95250 on the date of sensor placement, and 95251 on the date of sensor read (assuming complete documentation of the read)

 

[wongs84]

I have a question on how to code for insulin pump readings and for diabetes education. I know for CGM reading is coded as 95251 but not sure what to use for insulin pump or do I use the same code. Also what would be the code for diabetes education? Is it G0108/G0109 for Medicare patients and 98960-98962 for commercial payers? Hoping someone could help. Thanks in advance!

 

[dfulton]

Anyone seeing commercial insurers use modifiers on A9276, A9277 and A9278?