190.20 - Blood Glucose Testing - Health Network Labs

1 Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report ( ICD-10-CM) *January 2017 ChangesICD-10-CM Version RedNCD Fu Associates, Ltd. January 2017 1539 - Blood Glucose Testing Description This policy is intended to apply to Blood samples used to determine Glucose levels. Blood Glucose determination may be done using whole Blood , serum or plasma. It may be sampled by capillary puncture, as in the fingerstick method, or by vein puncture or arterial sampling. The method for assay may be by color comparison of an indicator stick, by meter assay of whole Blood or a filtrate of whole Blood , using a device approved for home monitoring, or by using a laboratory assay system using serum or plasma.

2 The convenience of the meter or stick color method allows a patient to have access to Blood Glucose values in less than a minute or so and has become a standard of care for control of Blood Glucose , even in the inpatient setting. HCPCS Codes (Alphanumeric, CPT AMA) Code Description 82947 Glucose ; quantitative, Blood (except reagent strip) 82948 Glucose ; Blood , reagent strip 82962 Glucose , Blood by Glucose monitoring device cleared by FDA for home use. ICD-10-CM Codes Covered by Medicare Program The ICD-10-CM codes in the table below can be viewed on CMS website as part of Downloads: Lab Code List, at Code Description Tuberculosis of lung Tuberculosis of larynx, trachea and bronchus Pulmonary anthrax Whooping cough due to Bordetella pertussis with pneumonia Whooping cough due to Bordetella parapertussis with pneumonia Whooping cough due to other Bordetella species with pneumonia Whooping cough, unspecified species with pneumonia Sepsis due to streptococcus, group A Sepsis due to streptococcus, group B Sepsis due to Streptococcus pneumoniae Other streptococcal sepsis Streptococcal sepsis, unspecified Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report ( ICD-10-CM) *January 2017 ChangesICD-10-CM Version RedNCD Fu Associates, Ltd.

3 January 2017 1540 Code Description Sepsis due to Methicillin susceptible Staphylococcus aureus Sepsis due to Methicillin resistant Staphylococcus aureus Sepsis due to other specified staphylococcus Sepsis due to unspecified staphylococcus Sepsis due to Hemophilus influenzae Sepsis due to anaerobes Gram-negative sepsis, unspecified Sepsis due to Escherichia coli [E. coli] Sepsis due to Pseudomonas Sepsis due to Serratia Other Gram-negative sepsis Sepsis due to Enterococcus Other specified sepsis Sepsis, unspecified organism Actinomycotic sepsis Legionnaires' disease Cytomegaloviral pneumonitis Cytomegaloviral pancreatitis Candidiasis of skin and nail Candidiasis of vulva and vagina Invasive pulmonary aspergillosis Other specified mycoses Ascariasis pneumonia Cutaneous strongyloidiasis Malignant neoplasm of endocrine pancreas Malignant neoplasm of retroperitoneum Benign neoplasm of endocrine pancreas Myxedema coma Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report ( ICD-10-CM)

4 *January 2017 ChangesICD-10-CM Version RedNCD Fu Associates, Ltd. January 2017 1541 Code Description Thyrotoxicosis with toxic single thyroid nodule without thyrotoxic crisis or storm Thyrotoxicosis with toxic single thyroid nodule with thyrotoxic crisis or storm Thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm Thyrotoxicosis with toxic multinodular goiter with thyrotoxic crisis or storm Thyrotoxicosis from ectopic thyroid tissue without thyrotoxic crisis or storm Thyrotoxicosis from ectopic thyroid tissue with thyrotoxic crisis or storm Thyrotoxicosis factitia without thyrotoxic crisis or storm Thyrotoxicosis factitia with thyrotoxic crisis or storm Other thyrotoxicosis without thyrotoxic crisis or storm Other thyrotoxicosis with

5 Thyrotoxic crisis or storm Thyrotoxicosis, unspecified without thyrotoxic crisis or storm Thyrotoxicosis, unspecified with thyrotoxic crisis or storm Diabetes mellitus due to underlying condition with hyperosmolarity hyperglycemic-hyperosmolar coma (NKHHC) without nonketotic Diabetes mellitus due to underlying condition with hyperosmolarity with coma Diabetes mellitus due to underlying condition with ketoacidosis without coma Diabetes mellitus due to underlying condition with ketoacidosis with coma Diabetes mellitus due to underlying condition with diabetic nephropathy Diabetes mellitus due to underlying condition with diabetic chronic kidney disease Diabetes mellitus due to underlying condition with other diabetic kidney complication Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy macular edema with Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema * *Diabetes mellitus

6 Due to retinopathy with macular underlying condition with mild nonproliferative diabetic edema, right eye * *Diabetes mellitus due to retinopathy with macular underlying condition with mild nonproliferative diabetic edema, left eye * *Diabetes mellitus due to retinopathy with macular underlying condition with mild nonproliferative diabetic edema, bilateral * *Diabetes mellitus due to retinopathy with macular underlying condition with mild nonproliferative diabetic edema, unspecified eye Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report ( ICD-10-CM) *January 2017 ChangesICD-10-CM Version RedNCD Fu Associates, Ltd. January 2017 1542 Code Description * *Diabetes mellitus due to underlying condition with mild nonproliferative diabeticretinopathy without macular edema, right eye* *Diabetes mellitus due to underlying condition with mild nonproliferative diabeticretinopathy without macular edema, left eye* *Diabetes mellitus due to underlying condition with mild nonproliferative diabeticretinopathy without macular edema, bilateral* *Diabetes mellitus due to underlying condition with mild nonproliferative diabeticretinopathy without macular edema, unspecified eye* *Diabetes mellitus due to underlying condition with moderate nonproliferativediabetic retinopathy with macular edema.

7 Right eye* *Diabetes mellitus due to underlying condition with moderate nonproliferativediabetic retinopathy with macular edema, left eye* *Diabetes mellitus due to underlying condition with moderate nonproliferativediabetic retinopathy with macular edema, bilateral* *Diabetes mellitus due to underlying condition with moderate nonproliferativediabetic retinopathy with macular edema, unspecified eye* *Diabetes mellitus due to underlying condition with moderate nonproliferativediabetic retinopathy without macular edema, right eye* *Diabetes mellitus due to underlying condition with moderate nonproliferativediabetic retinopathy without macular edema, left eye* *Diabetes mellitus due to underlying condition with moderate nonproliferativediabetic retinopathy without macular edema, bilateral* *Diabetes mellitus due to underlying condition with moderate nonproliferativediabetic retinopathy without macular edema, unspecified eye* *Diabetes mellitus due to retinopathy with macular underlying condition with severe nonproliferative diabetic edema, right eye * *Diabetes mellitus due to retinopathy with macular underlying condition with severe nonproliferative diabetic edema, left eye * *Diabetes mellitus due to retinopathy with macular underlying condition with severe nonproliferative diabetic edema.

8 Bilateral * *Diabetes mellitus due to retinopathy with macular underlying condition with severe nonproliferative diabetic edema, unspecified eye * *Diabetes mellitus due to retinopathy without macuunderlying condition with severe nonproliferative diabetic lar edema, right eye * *Diabetes mellitus due to underlying condition with severe nonproliferative diabeticretinopathy without macular edema, left eyeMedicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report ( ICD-10-CM) *January 2017 ChangesICD-10-CM Version RedNCD Fu Associates, Ltd. January 2017 1543 Code Description * *Diabetes mellitus due to underlying condition with severe nonproliferative diabeticretinopathy without macular edema, bilateral* *Diabetes mellitus due to underlying condition with severe nonproliferative diabeticretinopathy without macular edema, unspecified eye* *Diabetes mellitus due to underlying condition with proliferative diabetic with macular edema, right eyeretinopathy * *Diabetes mellitus due to underlying condition with proliferative diabetic with macular edema, left eyeretinopathy * *Diabetes mellitus due to underlying condition with proliferative diabetic with macular edema.

9 Bilateralretinopathy * *Diabetes mellitus due to underlying condition with proliferative diabetic with macular edema, unspecified eyeretinopathy * *Diabetes mellitus due to underlying condition with proliferative diabetic without macular edema, right eyeretinopathy * *Diabetes mellitus due to underlying condition with proliferative diabetic without macular edema, left eyeretinopathy * *Diabetes mellitus due to underlying condition with proliferative diabetic without macular edema, bilateralretinopathy * *Diabetes mellitus due to underlying condition with proliferative diabetic without macular edema, unspecified eyeretinopathy Diabetes mellitus due to underlying condition with diabetic cataract Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified Diabetes mellitus due to underlying condition with diabetic mononeuropathy Diabetes mellitus due to underlying condition with diabetic polyneuropathy Diabetes mellitus due to underlying condition with diabetic autonomic (poly)

10 Neuropathy Diabetes mellitus due to underlying condition with diabetic amyotrophy Diabetes mellitus due to underlying condition with other diabetic neurological complication Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy gangrene without Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy gangrene with Diabetes mellitus due to underlying condition with other circulatory complications Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report ( ICD-10-CM) *January 2017 ChangesICD-10-CM Version RedNCD Fu Associates, Ltd. January 2017 1544 Code Description Diabetes mellitus due to underlying condition with other diabetic arthropathy Diabetes mellitus due to underlying condition with diabetic dermatitis Diabetes mellitus due to underly