Published on CGMS Central (http://cgmscentral.com)
CMS (Medicare) HCPCS Codes Are Out for CGMS Claims in 2008
By kevin
Created 11/05/2007 - 09:50

According to a filing with the SEC by DexCom and reported by Edgar Online [1], CMS published the codes this past Friday for submitting cgms claims. There are codes for the sensor, the transmitter and the receiver. See details as filed in the original request for the codes: HCPCS 2008 Request Pending for creating reimbursement codes [2].

Here's the catch.

For some reason everybody thinks that if you have dedicated codes that it will improve reimbursement for the new technology.

Wrong.

It simply isolates these claims and makes it easier for the insurance carriers to more efficiently deny claims for cgms. Eventually we will use these codes to process hundreds of millions of dollars worth of medically necessary kit. However in the meantime, be prepared for a step backward in the fight to secure reimbursement. We will just have to fight harder, be more persistent and with dogged determination to make our insurance carriers understand that cgms is a requirement and not an option for people with diabetes.


Source URL: http://cgmscentral.com/node/75

Links:
[1] http://cgmscentral.com/wiki/http%253A%252F%252Fus.rd.yahoo.com%252Ffinance%252Fnews%252Frss%252Fstory%252F%252Ahttp%253A%252F%252Fbiz.yahoo.com%252Fe%252F071105%252Fdxcm8-k.html
[2] http://cgmscentral.com/wiki/HCPCS_2008_Request_Pending_for_creating_reimbursement_codes