Action Alerts

Blood Glucose Testing
April 2008

An article was recently posted to the National Government Services website regarding blood glucose testing. It states that the CERT denial rates for CPT code 82962 (Glucose, blood by glucose monitoring device cleared by the FDA specifically for home use) has continued to rise. The primary denial reason is that the documentation did not support the medical necessity of the test.

Medicare will pay for the service if:

• The blood glucose test has been ordered by a physician. The physician must be promptly notified of the results in order to provide active medical care to treat the patient.
• The blood glucose test is medically necessary. The physician must certify that the test is medically necessary. A standing order by the physician is not sufficient to order a series of blood glucose tests.

The use of sliding scale insulin administration in a diabetic does not support a Medicare covered blood glucose test.

This policy applies to services rendered in the hospital, renal dialysis facility and nursing home.

Is your facility in compliance?