Billing and Coding: GlycoMark® Testing for Glycemic Control

This billing and coding guidance directs that GlycoMark® testing is billed using CPT 84378 (or 84999 where appropriate) and emphasizes correct use of ABN-related modifiers (-GA, -GX, -GZ, -GY) depending on the reason for anticipated denial. Claims must include a valid ICD-10-CM code, required referring/ordering provider information (name and NPI when applicable), and supporting medical record documentation (assessment, relevant history, test results, and signed dated visit/operative reports); Part A MAC claims with a GA ABN must include occurrence code 32 and the ABN date.

"Bill GlycoMark® testing using CPT code 84378 or, if appropriate, CPT 84999."

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