CPT for a home monitor

[wcasey5]

What is the procedure code, or CPT, for getting a home monitor. My insurance wants to know to get this thing started. TIA

 

[ALCapshaw2]

Are you planning on purchasing through QAS?

They have people who handle the Insurance filings and can send you the necessary forms to fill out and info you need from your doc.

'AL Capshaw'

 

[Ross]

Perhaps this will help?

http://www.hemosense.com/docs/5500207_ReimbGuide_RevF_web.pdf

 

[wcasey5]

Thanks guys, sorry for the late reply. This is very very helpful!

I will say, getting through this and dealing with the health insurance company is exhausting. I have United Health Care and I've talked with 5 different customer service people and found, burried in their covered items, that they actually do pay for a home tester. I had to ask the same question over and over, but modified it slightly every time to zoom in on the answer. Very frustrating.

 

[Ross]

I know it is. I think they play stupid intentionally in hopes that you'll give up and go away.

 

[catwoman]

Thanks guys, sorry for the late reply. This is very very helpful!

I will say, getting through this and dealing with the health insurance company is exhausting. I have United Health Care and I've talked with 5 different customer service people and found, burried in their covered items, that they actually do pay for a home tester. I had to ask the same question over and over, but modified it slightly every time to zoom in on the answer. Very frustrating.

Casey:

UHC bought my first monitor in 2003. It's under DME (durable medical equipment). I thought it was an E code -- E1399. That's what I put on paperwork when I filed for reimbursement with Aetna for my 2nd unit, along with V43.3 for the valve.
Whether UHC covers your testing materials is another story. It would NOT cover mine. When QAS was in network, it submitted testing strips as E1399. I had to switch to another provider when it was no longer in network, and it used a different code, which UHC would not cover. My company's policy with UHC covered testing supplies only for diabetics. My guess is INR home testing is so new that no one at our parent company ever thought of covering testing supplies.
I buy my testing supplies out of pocket and use my FSA plan for reimbursement.

Now, if you get a tester through a company and you have to call in your results to that company, that's another animal.

 

[wcasey5]

Thank You! That is some excellent information!

 

[wcasey5]

This is GREAT! I contacted QAS and everything looks great so far. Thanks everyone for this information!

 

[Ross]

Hope your soon a happy pricker too!