Cris Posted Thu 05th of May, 2011 01:10:40 AM
We check the sugar level of some of our diabetic patients using the fingerstick. Medicare always deny. We use the code '82962'. Please advise. Thanks.
SuperCoder Answered Thu 05th of May, 2011 18:39:26 PM
If home-use glucose monitoring devices are used in the hospital and nursing home settings, a glucose monitoring service must be performed in accordance with laboratory coverage criteria to qualify for separate payment under the Medicare laboratory benefit. As noted above, for a laboratory service to be reasonable and necessary, it must be ordered by the physician, the ordering physician must use the result in the management of the beneficiary's specific medical problem, and the laboratory result must be reported to the physician promptly in order for the physician to use the result and instruct continuation or modification of patient care. When a glucose monitoring service meets the criteria to be a covered laboratory service for a Part B only patient, regardless of whether the nursing home patient resides in a certified or non-certified bed, payment must be made. Denial of payment for a Part B covered laboratory service cannot be made on the basis that the service is routine care. Under Medicare, routine care determinations are applicable only for Part A nursing home services.