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Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

HCPCS code

Medical Policies and Guidelines for Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

Related policies from health plans

Diabetes Management Devices/CGMS

Similar Codes


ICD10CM codes

Z51.81 - Encounter for therapeutic drug level monitoring
Z46.81 - Encounter for fitting and adjustment of insulin pump
Z79.84 - Long term (current) use of oral hypoglycemic drugs
T85.633 - Leakage of insulin pump
T85.633A - Leakage of insulin pump, initial encounter
R73.9 - Hyperglycemia, unspecified
O24.425 - Gestational diabetes mellitus in childbirth, controlled by oral hypoglycemic drugs
O24.424 - Gestational diabetes mellitus in childbirth, insulin controlled
Z79.4 - Long term (current) use of insulin
R73 - Elevated blood glucose level

HCPCS codes

K0553 - Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accesso
A9276 - Sensor; invasive (e.g., subcutaneous), disposable, for use with interstitial continuous glucose moni
K0554 - Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system
E0443 - Portable oxygen contents, gaseous, 1 month's supply = 1 unit
S1030 - Continuous noninvasive glucose monitoring device, purchase (for physician interpretation of data, us
E0441 - Stationary oxygen contents, gaseous, 1 month's supply = 1 unit
E0444 - Portable oxygen contents, liquid, 1 month's supply = 1 unit
E0607 - Home blood glucose monitor
A4253 - Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
E0442 - Stationary oxygen contents, liquid, 1 month's supply = 1 unit

CPT4 codes

95249 - Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for
95250 - Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for
95251 - Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for
82962 - Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use
83525 - Insulin; total
99458 - Remote physiologic monitoring treatment management services, clinical staff/physician/other qualifie
99457 - Remote physiologic monitoring treatment management services, clinical staff/physician/other qualifie
99454 - Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respirato
82943 - Glucagon
82950 - Glucose; post glucose dose (includes glucose)