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Official Description

Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
Short Descr Adju cgm supply allowance
Coverage Carrier Priced
Pricing Indicator(s) 34 – Supplies And Surgical Dressings - DME supplies (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
BETOS D1E – Other DME
TOS Code(s) 9 – Other medical items or services
Added Date 4/1/2022
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 3
MUE 3
OTS Orthotic No
KF Item designated by fda as class iii device
KX Requirements specified in the medical policy have been met
CG Policy criteria applied
GA Waiver of liability statement issued as required by payer policy, individual case
KS Glucose monitor supply for diabetic beneficiary not treated with insulin
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
CR Catastrophe/disaster related
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GS Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
GZ Item or service expected to be denied as not reasonable and necessary
SC Medically necessary service or supply
Date
Action
Notes
2023-01-01 Changed Long Description Change
2022-04-01 Added Code added.
Code
Description
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