82947
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- No specific documentation requirements are stated in this Clinical Policy Bulletin.
- The policy explicitly states that diagnostic measurements often used in the context of intermittent IV insulin therapy (respiratory quotient, urine urea nitrogen, arterial/venous/capillary glucose, potassium concentration) are of unproven clinical value in this context and thus are not supported by the policy; documentation of such testing does not make the therapy medically necessary per this policy.
Key Coverage Criteria
- Pregnant and considered to be at high risk for type 2 diabetes mellitus;or
- Impaired fasting glucose has been found on other testing;or
- Blood glucose testing is consideredmedically necessaryfor individuals who meet any of the following criteria (A through Q):
- Signs or symptoms of either of the following:Hypoglycemia;orHyperglycemia;or
- Hypoglycemia;or
- Hyperglycemia;or
2 Active Policies
AETNA-CPB-0742 — Intermittent Intravenous Insulin Therapy
ANTHEM-CG-LAB-30 — CG-LAB-30 Outpatient Laboratory-based Blood Glucose Testing
Related Codes
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