Wiki CGM Supply Coding

[JillMedicalBiller]

Hello all!
Let me start by saying, Thank You, for the amazing support of those that share opinions and guidance on this forum! I'm still quite new and learning a lot about billing and y'all have been so helpful!

Now to the question. I'm working on resolving some Medicare billing issues for patients that are still using a BGM along with their CGM. Since a Non-Adj. CGM does replace the home BGM, my understanding is from the LCD (quote and link below) that a patient can still receive blood strips for the BGM if necessary.

"Non-adjunctive CGM devices replace standard home BGMs (HCPCS codes E0607, E2100, E2101) and related supplies (HCPCS codes A4233, A4234, A4235, A4236, A4244, A4245, A4246, A4247, A4250, A4253, A4255, A4256, A4257, A4258, A4259). Claims for a BGM and related supplies, billed in addition to a non-adjunctive CGM device (code E2103) and associated supply allowance (code A4239), will be denied."

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33822&ver=55&keyword=dexcom 6&keywordType=starts&areaId=s18&docType=NCA,CAL,NCD,MEDCAC,TA,MCD,6,3,5,1,F,P&contractOption=all&sortBy=relevance&bc=1

So my questions is, would you bill the CGM supply code A4239 for blood strips? That code seems to be used for lancets, not strips!
Or would I still code the A4253 for strips but be sure and add the required narrative that the patient has a CGM on file?

Thank you for any thoughts on this!

 

[CBLENNIE]

Now to the question. I'm working on resolving some Medicare billing issues for patients that are still using a BGM along with their CGM. Since a Non-Adj. CGM does replace the home BGM, my understanding is from the LCD (quote and link below) that a patient can still receive blood strips for the BGM if necessary.

"Non-adjunctive CGM devices replace standard home BGMs (HCPCS codes E0607, E2100, E2101) and related supplies (HCPCS codes A4233, A4234, A4235, A4236, A4244, A4245, A4246, A4247, A4250, A4253, A4255, A4256, A4257, A4258, A4259). Claims for a BGM and related supplies, billed in addition to a non-adjunctive CGM device (code E2103) and associated supply allowance (code A4239), will be denied."

So my questions is, would you bill the CGM supply code A4239 for blood strips? That code seems to be used for lancets, not strips!
Or would I still code the A4253 for strips but be sure and add the required narrative that the patient has a CGM on file?

I'm confused by your question because a BGM & supplies are not covered when a patient has a non-adjunctive CGM, so you cannot bill for lancets or test strips and expect them to be covered by Medicare. Am I missing something in your question?