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CMS makes changes to CGM supply billing

CMS announced that, effective January 1, 2024, suppliers will be able to bill CGM supplies in 90 day increments.  According to change request CR13397, the purpose of this Change Request (CR) is to instruct Medicare  Administrative Contractors...

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Audit Alert: UPICs focus on CGM and supplies

The van Halem Group has identified an increase in UPIC audit requests for CGM and supplies for both pandemic and current dates of service. The UPICs are auditing providers on both a prepayment and postpayment basis. CMS recently indicated that they wanted...

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Final Continuous Glucose Monitor (CGM) policy released

Medicare released the final draft of the new Glucose Monitor LCD and Policy Article with an effective date of 4/16/2023. The change was completed after a response to comments for the LCD. This new policy revamps the current CGM coverage criteria with...

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CGM coding changes for 2023

Effective January 1, 2023, claims submitted to Medicare for continuous glucose monitor (CGM) receivers, supplies and accessories using codes K0553 and K0554 will be rejected. These codes are discontinued on 12/31/2022. Suppliers that provide CGM devices...

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Updates to Glucose Monitor LCD and Policy Article
Updates to Glucose Monitor LCD and Policy Article

The FUTURE Local Coverage Article: Glucose Monitor - Policy Article (A52464) and FUTURE Local Coverage Determination (LCD): Glucose Monitors (L33822) are now available for viewing on the CMS website. While most of the edits are minor changes to verbiage,...

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