CPT 95251 reports the professional component of a continuous glucose monitoring service that includes reviewing and analyzing data collected for at least 72 hours and creating a written report.
What Is CPT Code 95251
CPT code 95251 reports the professional component of a continuous glucose monitoring service performed on a patient for at least 72 hours.
CPT 95251 includes reviewing and analyzing data collected during the monitoring period and creating a written report on the patient’s blood glucose levels and necessary treatment adjustments.
Continuous glucose monitoring involves using a device that measures glucose levels in interstitial fluid and provides real-time or stored data for review by a healthcare provider.
This service is often used for patients with diabetes who have difficulty regulating their blood glucose levels.
The CPT book describes CPT code 95251 as: “Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation, and report.”
CPT code 95251 represents the professional component of a service in which a patient has undergone continuous glucose monitoring (CGM) for at least 72 hours.
The provider reviews the data collected from monitoring, analyzes it, interprets it, and creates a written report.
Reports may include information such as an assessment of current treatment and necessary treatment adjustments.
CGM systems monitor and record blood glucose levels by measuring glucose levels in interstitial fluid.
The monitor either provides the data in real–time for patient response or stores it for later download and review by a provider.
Typical patients may have trouble regulating blood glucose because of type 1, 2, or gestational diabetes.
How To Use CPT 95251
You can report CPT code 95251 only one time per month.
CPT code 95251 represents only the professional component of the service. Therefore, you should not append modifier 26 or modifier TC.
You can report the technical component of this procedure with CPT code 96250.
Do not report CPT 95251 with CPT 99091.