Billing and Coding: Blood Glucose Monitoring in a Skilled Nursing Facility (SNF) (A56591)


Related Local Coverage Determination (LCD)
L34834-Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)


Contractor NameContract NumberStates
Novitas Solutions, Inc. 04111 - A and B MAC Colorado
04112 - A and B MAC Colorado
04211 - A and B MAC New Mexico
04212 - A and B MAC New Mexico
04311 - A and B MAC Oklahoma
04312 - A and B MAC Oklahoma
04411 - A and B MAC Texas
04412 - A and B MAC Texas
04911 - A and B MAC Colorado
New Mexico
Oklahoma
Texas
07101 - A and B MAC Arkansas
07102 - A and B MAC Arkansas
07201 - A and B MAC Louisiana
07202 - A and B MAC Louisiana
07301 - A and B MAC Mississippi
07302 - A and B MAC Mississippi
12101 - A and B MAC Delaware
12102 - A and B MAC Delaware
12201 - A and B MAC District of Columbia
12202 - A and B MAC District of Columbia
12301 - A and B MAC Maryland
12302 - A and B MAC Maryland
12401 - A and B MAC New Jersey
12402 - A and B MAC New Jersey
12501 - A and B MAC Pennsylvania
12502 - A and B MAC Pennsylvania
12901 - A and B MAC Delaware
District of Columbia
Maryland
New Jersey
Pennsylvania

Article Information

Article ID Number: A56591 Status: A-Approved

Article Title: Billing and Coding: Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)

Original Article Effective Date: 06/13/2019

Revision Effective Date: 11/07/2019

Article Text:

Refer to the Novitas Local Coverage Determination (LCD) L34834, Blood Glucose Monitoring in a Skilled Nursing Facility (SNF), for reasonable and necessary requirements.


The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code(s) may be subject to National Correct Coding Initiative (NCCI) edits. This information does not take precedence over NCCI edits. Please refer to NCCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare.


Coding Information


The material for examination may be from any source unless otherwise specified in the code descriptor. When an analyte is measured in multiple specimens from different sources or in specimens that are obtained at different times, the analyte is reported separately for each source and for each specimen.

Coding Information
Bill Type Codes:

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

22Skilled Nursing - Inpatient (Medicare Part B only)
23Skilled Nursing - Outpatient

Revenue Codes:

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

0300 Laboratory - General Classification
0301 Laboratory - Chemistry
0302 Laboratory - Immunology
0303 Laboratory - Renal Patient (Home)
0304 Laboratory - Non-Routine Dialysis
0305 Laboratory - Hematology
0306 Laboratory - Bacteriology & Microbiology
0307 Laboratory - Urology
0309 Laboratory - Other Laboratory

CPT/HCPCS Codes:

Group 1 Paragraph:

Note: Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book.



Group 1 CPT Codes:
82947 GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP)
82948 GLUCOSE; BLOOD, REAGENT STRIP
82962 GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY THE FDA SPECIFICALLY FOR HOME USE


ICD-10 Codes That Are Covered

It is the provider's responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

ICD-10-CM codes that support medical necessity are per the National Coverage Determination for Blood Glucose Testing which can be accessed in the CMS Internet-Only Manual (IOM), Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 3, Section 190.20, Blood Glucose Testing.

or via the CMS Coverage Center at:

http://www.cms.gov/center/coverage.asp

XX000 Not Applicable
ICD-10 Codes That Are Not Covered

XX000


Revision History Information
Revision History DateRevision History NumberRevision History Explanation
11/07/2019
R1

Article revised and published on 11/07/2019. System changes have been made to our articles in response to CMS Change Request 10901. The Coding Section has been reordered and new sections for CPT/HCPCS Modifiers and Other Coding Information have been added.