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Issue Number - Name
0014 - Automated Glucose Monitor When Billed With Same Date of Services as Glucose Monitor Supplies (Unbundling)
Review Type
Complex
Claim Type
DME by Supplier, DME by Physician
Region and State
RAC 5
All States
Date Approved
2017-02-01

Description

HCPCS codes A4233, A4234, A4235, and A4236, which describe glucose monitor supplies, will be denied when billed with the same date of service as glucose monitor HCPCS codes E0607, E2100 or E2101.

Affected Codes

  • Reference Codes: E0607,  E2100, E2101
  • Target Codes: A4233, A4234, A4235, A4236

Applicable Policy References 

  • Title XVIII of the Social Security Act, Section 1862(a)(1)(A)
  • Title XVIII of the Social Security Act, Section 1833(e)
  • Title XVIII of the Social Security Act, Section 1833(e)
  • LCDs, L11520, L27231, L11530, L196, L33822
  • LCDs, L11520, L27231, L11530, L196 for services performed on or after 10/1/15
  • LCD, L33822, for services performed on or after 7/1/16