Gastroenterology Coding Alert

Question: One of our patients mentioned to a nurse that he was receiving continuing glucose monitoring (CGM) supplies from both Medicare and the Veterans Administration (VA). He is covered by both, but I’m not sure it’s OK for him to get double the supplies by going through both programs? He says he won’t try to get supplies from both anymore, but, out of curiosity, is this something the Centers for Medicare & Medicaid Services (CMS) and the VA allow?

Washington, D.C. Subscriber

Answer: In the Medicare Learning Network (MLN) booklet “Items and Services Not Covered by Medicare,” CMS says it doesn’t provide coverage for items or services authorized or provided by another government entity.

Specifically, on page 17 of the MLN booklet, CMS states, “We normally don’t pay for these items and services authorized or paid for by a federal, state, or local government entity: Those provided by a government or non-government provider or other individual at public expense authorized by a federal agency, like the Veterans Administration (VA).”

So, for future reference, beneficiaries of government entities like Medicare and the VA should not double dip on their items or services.