How To Use HCPCS Code A9277

HCPCS code A9277 describes an external transmitter used with a non-durable medical equipment interstitial continuous glucose monitoring system. This code is used to identify and bill for the specific device that transmits glucose readings from the monitoring system to a separate receiver or display device. In this article, we will explore the details of HCPCS code A9277, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A9277?

HCPCS code A9277 is used to identify an external transmitter that is part of a non-durable medical equipment interstitial continuous glucose monitoring system. This code specifically refers to the device that transmits glucose readings from the monitoring system to a separate receiver or display device. It is important to note that this code is not used to identify the entire monitoring system, but only the external transmitter component.

2. Official Description

The official description of HCPCS code A9277 is “Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system.” The short description for this code is “External transmitter, cgm.”

3. Procedure

1. Ensure that the patient is using a non-durable medical equipment interstitial continuous glucose monitoring system.
2. Select the appropriate external transmitter for the specific monitoring system being used.
3. Properly attach the external transmitter to the patient’s body according to the manufacturer’s instructions.
4. Activate the transmitter and ensure that it is properly transmitting glucose readings to the receiver or display device.
5. Provide any necessary instructions to the patient regarding the use and maintenance of the external transmitter.

4. When to use HCPCS code A9277

HCPCS code A9277 should be used when billing for the external transmitter component of a non-durable medical equipment interstitial continuous glucose monitoring system. It is important to ensure that the patient meets the specific criteria for using this code, such as having a medical need for continuous glucose monitoring and using a compatible monitoring system that requires an external transmitter.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9277, healthcare providers should ensure that the following documentation is included:

• Medical records supporting the medical necessity of continuous glucose monitoring and the use of a non-durable medical equipment interstitial continuous glucose monitoring system.
• Documentation of the specific monitoring system being used and the need for an external transmitter.
• Proof of purchase or lease agreement for the external transmitter.

Providers should follow the appropriate billing guidelines and submit the claim with the necessary supporting documentation to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code A9277 was added to the Healthcare Common Procedure Coding System on January 01, 2008. As of the effective date of January 01, 2023, this code has no maintenance actions, indicated by the action code N, which means no maintenance for this code. It is important to stay updated on any future changes or revisions to this code.

7. Medicare and Insurance Coverage

HCPCS code A9277 is classified as non-covered by Medicare statute, indicated by the coverage code S. This means that Medicare does not provide reimbursement for this specific code. It is important to check with individual insurance providers to determine coverage and reimbursement policies for HCPCS code A9277.

8. Examples

Here are five examples of when HCPCS code A9277 should be billed:

1. A patient with diabetes who requires continuous glucose monitoring and uses a non-durable medical equipment interstitial continuous glucose monitoring system with an external transmitter.
2. A healthcare provider prescribing a non-durable medical equipment interstitial continuous glucose monitoring system with an external transmitter for a patient with gestational diabetes.
3. A patient with type 1 diabetes who is transitioning from traditional fingerstick glucose monitoring to a non-durable medical equipment interstitial continuous glucose monitoring system with an external transmitter.
4. A patient with type 2 diabetes who experiences frequent hypoglycemic episodes and requires continuous glucose monitoring using a non-durable medical equipment interstitial continuous glucose monitoring system with an external transmitter.
5. A healthcare provider recommending a non-durable medical equipment interstitial continuous glucose monitoring system with an external transmitter for a patient with impaired vision who has difficulty reading traditional glucose meters.