Laboratory Question for the Week of July 10, 2017

Laboratory Compliance Question of the Week

Question:

I am wondering if we should be charging for 82962 for hospital inpatients. All the documentation that we have found states it should not be used in a hospital setting.

Answer:

The answer to your question is separate from whether the following code is chargeable to the patient/payer for inpatient glucose monitoring for insulin administration.

82962 Glucose, blood by glucose monitoring device[s] cleared by the FDA specifically for home use)

CPT® code 82962 is accurate for most POC glucose system technology used for in-house monitoring of glucose levels. However, from a billing and payment perspective, the CPT is billable when the testing is medically indicated and diagnostic in nature (based on physician order, individual result reported to provider and medical decision-making is applied to treatment/diagnosis of the patient).  In the scenario where the POC glucose is utilized for sliding scale insulin dosing, the glucose measurement is a monitor of patient status and is inherent in the medication management of the patient. In this scenario, we would not recommend separately billing of a charge for sliding scale glucose measurement.

CPT® is a registered trademark of the American Medical Association.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.