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CodeMap® 10/15/2004 Coding Glucose Tests CodeMap®-10/15/2004 Coding Glucose Tests Archive

CodeMap Compliance Briefing: 10/15/04


Editor's Welcome

Although the codes for Glucose tests are not new, they continue to generate questions regarding how the results from central laboratory and point-of-care devices are coded and paid for by Medicare. Because most hospitals perform high volumes of this type of testing, it is very important, from a compliance viewpoint, to code these tests properly. As always, feel free to email us your compliance questions and suggestions.

Sincerely,

Charles B. Root, Ph.D.

Glucose Testing Codes

Depending on the method employed, providers should use the following three CPT codes to report glucose testing:

  • 82947   Glucose; quantitative, blood (except reagent strip)
  • 82948   Glucose; blood, reagent strip
  • 82962   Glucose; blood by glucose monitoring device(s) cleared by the FDA specifically for home use

CPT code 82947 is used to report most quantitative fasting glucose determinations performed on either automated or single test devices.
 
Blood glucose measured by reagent strip (82948) is reported when a drop of blood is placed on a glucose oxidase strip and the resulting color is compared against a color chart to obtain a qualitative result, usually expressed as a range of values.

Code 82962 is reported when whole blood is obtained (usually by finger stick) and assayed using a glucose meter designed for home blood glucose monitoring. These devices are typically used in physician offices, patient's homes, and in nursing homes. Providers should report testing by other point-of-care devices, that are not approved for home use, by using CPT code 82947.

When providers perform waived tests, they must use the -QW modifier with CPT codes 82947, 82948, 82950, 82951 and 82952. CPT code 82962 is one of the original eight CLIA waived tests published in the CPT and does not require the -QW modifier.

Glucose Tolerance Tests

Glucose tolerance testing is reported using the following codes:

  • 82950   Glucose; post glucose dose (includes glucose)
  • 82951   Glucose; tolerance test (GTT), three specimens (includes glucose)
  • 82952   Glucose; tolerance test, each additional beyond three specimens

The term, "includes glucose," refers to the glucose dose (Glucola).  If a quantitative glucose is performed prior to the "post glucose dose" determination described by CPT code 82950, 82947 would also be reported.

A glucose tolerance test typically includes an initial quantitative (pre-glucose dose) test and subsequent quantitative tests at 1 and 2 hours after glucose administration.  Additional tests are submitted separately using CPT code 82952.  This code may only be used as an "add-on code" to 82951.

For example: A physician performs a glucose tolerance test by obtaining five blood specimens (initial, 1 Hr., 2Hr., 3Hr., and 4 Hr.).
 
The physician should use the following codes:

  • 82951   Glucose tolerance test (GTT), three specimens (includes glucose)
  • 82952 X 2   Glucose tolerance test, each additional beyond three specimens

Providers should report only one venipuncture procedure for glucose tolerance tests even though multiple blood draws are performed.  Modifier -91 (repeat clinical diagnostic laboratory test) is not required when reporting 82952 more than once on the same date of service.

Medicare Reimbursement for Glucose Tests

The 2004 Medicare National Limitation Amounts for glucose tests are:

  • 82947   Glucose, quantitative: $5.48
  • 82948   Glucose; reagent strip: $4.43
  • 82962   Glucose, by home use device: $3.27
  • 82950   Glucose; post glucose dose: $6.44
  • 82951   Glucose tolerance test (GTT), three specimens: $17.99
  • 82952   Glucose tolerance test, each additional specimen: $5.48

Since reimbursement for 82962 is significantly less than 82947, it is important to code point-of-care or single-use glucose tests correctly to avoid false claims problems.  If a glucose meter cleared by FDA for home use is employed, results must be reported using 82962.

Since 82950 includes the cost of glucose administration, it should not be used for postprandial glucose tests. CPT code 82947 should be used to report postprandial tests.

Also, remember that glucose is classified as an automated test by Medicare and subject to reduced payment when reported on the same date of service with other automated tests.


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02/27/2004 Medicare Payment for ReferredTests
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10/31/2003 Specimen Collection
10/24/2003 Coding Qualitative Drugs-of-Abuse Tests
10/17/2003 The OIG's Work Plan, Medicare CDs, Recent Enforcement Actions.
10/10/2003 ESRD Composite Rate Lab Tests
10/03/2003 End Stage Renal Disease (ESRD) Reimbursement for Automated Tests
09/26/2003 Proposed Rules from the OIG
09/12/2003 Category III (Tracking) CPT Codes
09/05/2003 New Proposed Rules for Flow Cytometry
08/15/2003 Thyroid Testing
08/01/2003 CMS Lab Reimbursement Meeting
07/25/2003 NCD Misconceptions
07/18/2003 The -GZ Modifier
07/11/2003 Screening Mammogram Codes
06/27/2003 Correct Coding Edits II
06/20/2003 Correct Coding Edits I
06/13/2003 Diagnosis Coding Rules II
06/06/2003 Diagnosis Coding Rules I
05/23/2003 Revised Medicare Appeals Provisions II
05/16/2003 Revised Medicare Appeals Provisions I
05/09/2003 Business Associates Agreements
05/02/2003 Pathologist Interpretation of Clinical Lab Tests
04/25/2003 TC Billing of Pathology Services
04/18/2003 Medicare Reimbursement for Pathology Services
04/11/2003 How to Respond to a Search Warrant
03/28/2003 How to Respond to Subpoenas
03/21/2003 How to Respond to Investigators
03/14/2003 Mandatory Claim Submission
03/07/2003: Who Can Order Diagnostic Tests?
02/28/2003 Changes in 2003 Physician Fee Schedule
02/21/2003 Medical Necessity Requirements for Chemistry Panels, Part II
02/14/2003 Medical Necessity Requirements for Chemistry Panels I
02/07/2003: ABNs and Client Cooperation
01/31/2003: Patient Ordered and/or Performed Testing
01/24/2003: The Beneficiary Anti-Kickback Statute
01/17/2003: Significant Changes in 2003 Medicare Reimbursement
01/10/2003: 2003 Medicare Lab and Physician Fee Schedules
12/13/2002: More National Coverage Policies
12/06/2002: How Medicare Sets Fees for New CPT Codes
11/22/2002: Critical Year End Dates
11/15/2002: 2003 Medicare Laboratory Fee Schedule
11/08/2002: Stark Self-Referral Prohibitions
11/01/2002: Using Modifiers -59 and -91
10/25/2002: Introduction to Privacy Regulations
10/18/2002: New Codes for Obstetrical Ultrasound
10/11/2002: National Coverage Determinations (NCDs)
10/04/2002: Implementing a Radiology Compliance Program
09/27/2002: New 2003 Lab CPT Codes
09/20/2002: Automated Order Entry
09/13/2002: National Coverage Policy for Lipids
09/06/2002: The Anti-Kickback Statute
08/23/2002: Using the New ABN Forms
08/16/2002: Advance Beneficiary Notices
08/09/2002: Medicare Coverage for PET Scans
08/02/2002: Reflex Testing
07/26/2002: 2003 Hematology CPT Code Changes II
07/19/2002: 2003 Hematology CPT Code Changes I
07/12/2002: Direct Billing Rules II
06/28/2002: Direct Billing Rules I
06/21/2002: Medicare Reimbursement for Lipid Panels
06/14/2002: Bone Density Studies
06/07/2002: CLIA Waived Testing Rules
05/31/2002: Blood Draws and the Anti-kickback Statute
05/01/2002 - CodeMap® Quarterly Reports, Volume I, No. 2
National Coverage Determination (NCD) Updates
01/15/2002 - CodeMap® Quarterly Reports, Volume I, No. 1