Glucose 82948 and 82962

[Partha]

Can we bill CPTs, 82948 reagent strip and 82962 glucose monitoring device home use, simultaneously - they have mutually exclusive relationship in CCI edits??

[Anna Weaver]

It looks like they can be modified to pass, however, it would have to be medically necessary. Here's what the NCCI has to say:

NCCI contains edits pairing each panel CPT code (column one code) with each CPT code corresponding to an individual laboratory test that is included in the panel (column two code). These edits allow use of NCCI-associated modifiers to bypass them if one or more of the individual laboratory tests are reported on the same date of service. The repeat testing must be medically reasonable and necessary. Modifier -91 may be utilized to report this repeat testing. Based on the Internet-Only Manuals(IOM), Medicare Claims Processing Manual, Publication 100-04, Chapter 16, Section 100.5.1, the repeat testing cannot be performed to “confirm initial results; due to testing problems with specimens and equipment or for any other reason when a normal, one-time, reportable result is all that is required.�

82962 is column one code, 82948 is column two code and a one is in the modifier column.

Now, having listed this, I don't really see a reason to do both tests simultaneously, so I wouldn't report both. Unless your Dr can give you a medically necessary reason to do both tests I wouldn't.

[hthompson]

I was going to ask the difference between the 82948 and 82962 and I found it in 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.

[lrodriguez1426]

Can we use 82962 to report a glucose blood test done in the office phisicians during a visit?