I need a bit of help. My providers give insulin to pt's when they come in with extremely high diabetes 300 +. According to Cigna Medicare in North Carolina, they will not reimburse for J1815 or J1817 stating that those 2 codes have exclusion dates of 01/01/2003. What should I do at this point. Should we have the patient's sign ABN forms so that they would pay for the insulin that we purchased in our office? Please help. Now I am desparate.