How To Use HCPCS Code E2101

HCPCS code E2101 describes a blood glucose monitor with integrated lancing/blood sample. This code is used to identify a specific type of medical device that is used for monitoring blood glucose levels in patients with diabetes. It is important for medical coders to understand the meaning and usage of this code in order to accurately document and bill for the services provided.

1. What is HCPCS E2101?

HCPCS code E2101 is used to identify a blood glucose monitor with integrated lancing/blood sample. This device is commonly used by individuals with diabetes to monitor their blood glucose levels on a regular basis. It consists of a monitor that displays the blood glucose reading and an integrated lancing device that is used to obtain a blood sample for testing.

2. Official Description

The official description of HCPCS code E2101 is “Blood glucose monitor with integrated lancing/blood sample.” The short description for this code is “Enteral supp not otherwise c.” This description accurately reflects the purpose and function of the device.

3. Procedure

1. Prepare the blood glucose monitor by ensuring that it is clean and in proper working condition.
2. Prepare the patient by cleaning the area where the blood sample will be obtained.
3. Use the integrated lancing device to prick the patient’s finger and obtain a small blood sample.
4. Apply the blood sample to the designated area on the monitor.
5. Wait for the monitor to display the blood glucose reading.
6. Record the blood glucose reading in the patient’s medical record.

4. When to use HCPCS code E2101

HCPCS code E2101 should be used when documenting and billing for the use of a blood glucose monitor with integrated lancing/blood sample. This code is typically used in the context of managing diabetes and monitoring blood glucose levels. It is important to ensure that the device meets the specific criteria outlined in the code description in order to accurately use this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2101, healthcare providers should ensure that the necessary documentation is in place to support the use of this code. This may include the patient’s medical record, which should include information on the diagnosis of diabetes and the medical necessity for using a blood glucose monitor. Additionally, providers should follow the specific billing guidelines outlined by Medicare or other insurance carriers to ensure proper reimbursement for the service or supply.

6. Historical Information and Code Maintenance

HCPCS code E2101 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has remained unchanged since its addition to the system.

7. Medicare and Insurance Coverage

HCPCS code E2101 is eligible for coverage by Medicare and other insurance carriers. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means that it is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines on billing and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code E2101 should be billed:

1. A patient with diabetes visits their healthcare provider for a routine check-up. The provider uses a blood glucose monitor with integrated lancing/blood sample to measure the patient’s blood glucose levels.
2. A home healthcare nurse visits a patient with diabetes to provide education on blood glucose monitoring. The nurse uses a blood glucose monitor with integrated lancing/blood sample to demonstrate the process to the patient.
3. A patient with diabetes purchases a blood glucose monitor with integrated lancing/blood sample from a medical supply store to use at home for self-monitoring of blood glucose levels.
4. A patient with diabetes is admitted to the hospital for a surgical procedure. The healthcare team uses a blood glucose monitor with integrated lancing/blood sample to monitor the patient’s blood glucose levels during their hospital stay.
5. A healthcare provider prescribes a blood glucose monitor with integrated lancing/blood sample for a patient with diabetes who is newly diagnosed. The patient obtains the device from a durable medical equipment supplier and uses it for ongoing blood glucose monitoring.