BC Advantage - 2022 Issue 5

Continuous Glucose Monitors (CGMs) - New Codes

New codes for continuous glucose monitors (CGMs) became effective on April 1, 2022. The following information is excerpted from MLN Matters MM12564 regarding CGMs. Be sure to review this information and implement policies to ensure accurate reporting/billing.Continuous Glucose Monitors (CGMs)On December 28, 2021, we published the Medicare DMEPOS final rule in the Federal Register. This addressed the classification and payment of adjunctive CGMs under the Medicare Part B benefit for DME.This rule expanded the classification of DME to a larger group of non-implantable CGMs, regardless of whether the CGMs are non-adjunctive (can alert patients when glucose levels...

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