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Medicare Compliance & Reimbursement

Reader Question:

Submit 95250, Then 95251 for Glucose Monitoring

Published on Sat Nov 19, 2011

Question: What is the best way to bill for continuous glucose monitoring? Do we bill for the initial visit and when the patient returns to the office after five days of monitoring, or report only one visit? Answer: You can bill for both dates of service related to continuous glucose monitoring (CGM). The codes are: 95250 -- Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and printout of recording 95251 -- Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; interpretation and report. Initial day: Report 95250 for the initial placement of the CGM and related patient training. If a significant, separately identifiable E/M service is provided at the same encounter, you may also submit the appropriate E/M code, such as 99211 [...]
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