![]() ![]() #Reason 5 license number generator codeMedicare claims for the monthly supplies for non-adjunctive CGMs are submitted using HCPCS code K0553.Įffective for claims with dates of service from Februthrough March 31, 2022, suppliers should use HCPCS code E1399 (Durable medical equipment, miscellaneous) to submit claims for adjunctive CGM receivers and HCPCS code A9999 (Miscellaneous DME supply or accessory, not otherwise specified) to submit claims for the monthly supplies for adjunctive CGMs. Medicare claims for non-adjunctive CGM receivers are submitted using code K0554 in the Healthcare Common Procedure Coding System (HCPCS). Non-adjunctive CGM receivers, which are DME that displays and monitors the continuous glucose readings and trends, replace a blood glucose monitor for use in making diabetes treatment decisions. ![]() CGMs that do not replace a blood glucose monitor are referred to as adjunctive CGMs because they can be used as an adjunct to the blood glucose monitor by showing trends in glucose levels and alerting the patient about potentially dangerous levels, even while they sleep, that then must be verified by use of a separate blood glucose monitor. The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule that takes effect on Februand classifies non-implantable continuous glucose monitors (CGMs) as durable medical equipment (DME) regardless of whether the CGM has been approved or cleared by the Food and Drug Administration (FDA) to replace a blood glucose monitor for use in making diabetes treatment decisions. Information Regarding Implementation of Recent Rulemaking Addressing Classification of Adjunctive Continuous Glucose Monitors as Durable Medical Equipment (Revised) ![]()
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