How To Use HCPCS Code A9276

HCPCS code A9276 describes a disposable sensor that is used with a non-durable medical equipment interstitial continuous glucose monitoring system. This code represents a one-day supply of the sensor, which is invasive and typically placed subcutaneously. It is important for medical coders to understand the specific details and usage guidelines for this code in order to accurately document and bill for the services provided.

1. What is HCPCS A9276?

HCPCS code A9276 is used to identify a disposable sensor that is used in conjunction with a non-durable medical equipment interstitial continuous glucose monitoring system. This sensor is typically placed subcutaneously and provides continuous monitoring of glucose levels in patients with diabetes. It is important to note that this code represents a one-day supply of the sensor.

2. Official Description

The official description of HCPCS code A9276 is as follows: “Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply.” This description accurately reflects the purpose and usage of the code.

3. Procedure

1. The provider will prepare the patient for sensor placement, ensuring that the area is clean and sterile.
2. The disposable sensor will be inserted subcutaneously, typically in the abdomen or upper arm.
3. The sensor will be connected to the non-durable medical equipment interstitial continuous glucose monitoring system.
4. The system will begin monitoring the patient’s glucose levels continuously.
5. The patient will be instructed on how to interpret the glucose readings and take appropriate action, such as adjusting insulin dosages or making dietary changes.
6. After one day, the disposable sensor will be removed and replaced with a new one.

4. When to use HCPCS code A9276

HCPCS code A9276 should be used when documenting and billing for the use of a disposable sensor in a non-durable medical equipment interstitial continuous glucose monitoring system. This code is specific to the sensor itself and does not cover other components or services associated with glucose monitoring. It is important to ensure that the patient meets the criteria for continuous glucose monitoring and that the sensor is used as intended.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9276, healthcare providers should ensure that the following documentation is included:

• Documentation of the medical necessity for continuous glucose monitoring and the use of the disposable sensor
• Date of service and duration of sensor use
• Any relevant patient information, such as diagnosis codes or medical history
• Provider information, including NPI and billing information

Providers should follow the appropriate billing guidelines and submit claims using the correct coding and modifier information to ensure accurate reimbursement for the services provided.

6. Historical Information and Code Maintenance

HCPCS code A9276 was added to the Healthcare Common Procedure Coding System on January 01, 2008. As of January 01, 2023, this code is non-covered by Medicare statute. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The pricing indicator code for A9276 is 00, which means that the service is not separately priced by Part B and may be bundled or not covered by Medicare.

7. Medicare and Insurance Coverage

HCPCS code A9276 is classified as non-covered by Medicare statute, meaning that it is not eligible for reimbursement under Medicare. The multiple pricing indicator code for this code is 9, indicating that it is not applicable as HCPCS is not priced separately by Part B or the value is not established. It is important for healthcare providers to verify coverage and reimbursement policies with other insurance providers to determine if this code is eligible for reimbursement.

8. Examples

Here are five examples of when HCPCS code A9276 should be billed:

1. A patient with diabetes is prescribed a non-durable medical equipment interstitial continuous glucose monitoring system and uses a disposable sensor for one day.
2. A healthcare provider performs a glucose tolerance test using a non-durable medical equipment interstitial continuous glucose monitoring system with a disposable sensor for one day.
3. A patient with diabetes is admitted to the hospital and requires continuous glucose monitoring using a non-durable medical equipment interstitial continuous glucose monitoring system with a disposable sensor for one day.
4. A healthcare provider conducts a research study on glucose levels in patients with diabetes and utilizes a non-durable medical equipment interstitial continuous glucose monitoring system with a disposable sensor for one day.
5. A patient with diabetes is enrolled in a clinical trial and uses a non-durable medical equipment interstitial continuous glucose monitoring system with a disposable sensor for one day as part of the trial protocol.