Wiki Glucose Test 82962 vs 82947

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stephne_smth

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Per The AMA and Ingenix CPT books 82962 says it is specifically for home use which we are coding and every ins co is denying. If done in the office isnt 82947 a more appropriate code with QW modifier per Medicare LCD
 
So, I'm looking for the same kind of answer.

For anyone who bills Medicaid, do you bill 82962 or 82947 for your fingerstick glucose? Can you add "why"?

Thanks in advance!!
 
Since I found my answer, I guess I'll share it with you :)

CPT Assistant
Year: 1999

Issue: January

Pages: 10

Title: Pathology and Laboratory, 82948, 82962 (Q&A)

Body: Coding Consultation

Question

What are the differences between codes 82948, Glucose; blood, reagent strip and code 82962, Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use?

AMA Comment

From a CPT coding perspective, code 82948 describes a blood glucose level that is determined by a reagent strip method. The blood is obtained and a drop of blood is placed on a glucose oxidase strip. The strip is blotted at a prescribed interval and the color of the strip (after it has been allowed to react with the blood) is visually compared against a color chart on the side of the vial that contains the unused reagent strips.

CPT code 82962 describes the method when whole blood is obtained (usually by finger stick device) and assayed by glucose oxidase, hexokinase, or electrochemical methods and spectrophotometry using a small portable device designed for home blood glucose monitoring use. These devices may also be used in physician offices, during home visits or in clinics.
 
Hi Heidi,

I was just looking at the code 82962 and was going to question whether the monitoring device could be used in a Providers office. Your answer was exactly what I was looking for. I know you posted this over 3 years ago but thank you!

Bonnie Bleacher, CPC
 
glucose monitoring

I asked the manufacturer of the glucose monitor that some of my physicians currently use in the hospital and was told the correct CPT code was 82947 -Glucose; quantitative, blood (except reagent strip) Not 82962
CPT 82948 is not CLIA waived and can only be done in a lab.


hthompson said:
Since I found my answer, I guess I'll share it with you :)

CPT Assistant
Year: 1999

Issue: January

Pages: 10

Title: Pathology and Laboratory, 82948, 82962 (Q&A)

Body: Coding Consultation

Question

What are the differences between codes 82948, Glucose; blood, reagent strip and code 82962, Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use?

AMA Comment

From a CPT coding perspective, code 82948 describes a blood glucose level that is determined by a reagent strip method. The blood is obtained and a drop of blood is placed on a glucose oxidase strip. The strip is blotted at a prescribed interval and the color of the strip (after it has been allowed to react with the blood) is visually compared against a color chart on the side of the vial that contains the unused reagent strips.

CPT code 82962 describes the method when whole blood is obtained (usually by finger stick device) and assayed by glucose oxidase, hexokinase, or electrochemical methods and spectrophotometry using a small portable device designed for home blood glucose monitoring use. These devices may also be used in physician offices, during home visits or in clinics.
Click to expand...
 
I'm having a denial issue with 82947 Glucose; quantitative, blood (except reagent strip). The denial states N95 - Pvdr type may not bill this svc, and after researching the cpt code 82947 Codify shows:

X (Statutory Exclusion - not defined by CMS as a "physician service" for Fee Schedule purpose. No RVU's or payment amounts) Non-Physician Service (so meaning it's done only in the lab).

My Patients presents for his Hyperbaric Oxygen therapy (HBO) treatment and have to have his glucose check every visit.

Please help LOL
 
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