Laboratory Question for the Week of July 10, 2017

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.

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.