What is CPT code for fingerstick glucose?

Synonyms:

What is the difference between CPT 82947 and 82948?

82947 Glucose; quantitative, blood (except reagent strip) 82948 Glucose; blood, reagent strip. 82962 Glucose; blood by glucose monitoring device(s) cleared by the FDA specifically for home use.

Is CPT 82962 covered by Medicare?

Code 82962 is defined in the 2004 HCPCS as a test for “glucose, blood by glucose monitoring device cleared by the FDA specifically for home use.” The Medicare carrier denied coverage of the blood glucose testing claimed under HCPCS code 82962 because the testing “is considered part of routine personal care and is not a …

Is CPT 82947 covered by Medicare?

CPT codes 82947 and 82948 are excluded from Duplicate Laboratory Services. — 82951: glucose, tolerance test (GTT), 3 specimens, (includes glucose). All of the above test codes are included in the Medicare Laboratory Fee Schedule. Medicare reimbursement for a glucose test is $5.48.

What is the difference between 36415 and 36416?

Code 36415 is submitted when the provider performs a venipuncture service to collect a blood specimen(s). As opposed to a venipuncture, a finger/heel/ear stick (36416) is performed in order to obtain a small amount of blood for a laboratory test.

What does CPT 80050 include?

Commenters noted that HCPCS code 80050 is a bundled code that includes a comprehensive metabolic panel (HCPCS code 80053), thyroid stimulating hormone test (HCPCS code 84443), and a complete blood count (HCPCS code 85025).

What is CPT A4259?

A4259 is a valid 2021 HCPCS code for Lancets, per box of 100 or just “Lancets per box” for short, used in Lump sum purchase of DME, prosthetics, orthotics.

What is CPT code 3044F?

CPT® Code 3044F in section: Most recent hemoglobin A1c (HbA1c) level.

What is the CPT code for finger stick glucose?

CPT code 82962 describes the method when whole blood is obtained (usually by finger stick device) and assayed by glucose oxidase, hexokinase , or electrochemical methods and spectrophotometry using a small portable device designed for home blood glucose monitoring use.

What is CPT code 82962?

The definition for CPT code 82962 is (Blood – by glucose monitoring devices cleared by the FDA specifically for home use).

What is the CPT code for a glucose meter?

A CPT code 82962 is the recommended code for in-house whole blood glucose testing on a meter. Although code 82948, “glucose, quantitative blood, reagent strip,” is an acceptable code, some intermediaries have viewed this as a screening test and denied payment.

What is the CPT code for glucose tolerance test?

Medicare will cover the diabetes screening tests using CPT codes 82947 (Glucose; quantitative, blood [except reagent strip]) and 82951 (Glucose; tolerance test, three specimens [includes glucose]).

Recent evidence revealed a diurnal variation in FPG, with mean FPG higher in the morning than in the afternoon, indicating that many cases of undiagnosed diabetes would be missed in patients seen in the afternoon. Glucose concentrations decrease ex vivo with time in whole blood because of glycolysis. The rate of glycolysis, reported to average 5% to 7% [~0.6 mmol/L (10 mg/dL)] per hour, varies with the glucose concentration, temperature, white blood cell count, and other factors. Glycolysis can be attenuated by inhibition of enolase with sodium fluoride (2.5 mg fluoride/mL of blood) or, less commonly, lithium iodoacetate (0.5 mg/mL of blood). These reagents can be used alone or, more commonly, with anticoagulants such as potassium oxalate, EDTA, citrate, or lithium heparin. Although fluoride maintains long-term glucose stability, the rate of decline of glucose in the first hour after sample collection in tubes with and without fluoride is virtually identical. (Note that leukocytosis will increase glycolysis even in the presence of fluoride if the white cell count is very high). After four hours, the glucose concentration is stable in whole blood for 72 hours at room temperature in the presence of fluoride. In separated, nonhemolyzed, sterile serum without fluoride, the glucose concentration is stable for fourteen days at 25°C and 4°C.

Glucose can be measured in whole blood, serum, or plasma, but plasma is recommended for diagnosis. The molality of glucose (ie, amount of glucose per unit water mass) in whole blood and plasma is identical. Although red blood cells are essentially freely permeable to glucose (glucose is taken up by facilitated transport), the concentration of water (kg/L) in plasma is ~11% higher than that of whole blood. Therefore, glucose concentrations in plasma are ~11% higher than whole blood if the hematocrit is normal. Glucose concentrations in heparinized plasma are reported to be 5% lower than in serum. The reasons for the latter difference are not apparent but may be attributable to the shift in fluid from erythrocytes to plasma caused by anticoagulants. The glucose concentrations during an OGTT in capillary blood are significantly higher than those in venous blood [mean of 1.7 mmol/L (30 mg/dL), equivalent to 20% to 25%], but the mean difference in fasting samples is only 0.1 mmol/L (2 mg/dL).

Although methods for glucose analysis exhibit low imprecision at the diagnostic decision limits of 7.0 mmol/L [(126 mg/dL), fasting] and 11.1 mmol/L [(200 mg/dL), postglucose load], the relatively large intraindividual biological variability (CVs of ~5% to 7%) may produce classification errors. On the basis of biological variation, glucose analysis should have analytical imprecision <3.4%, bias <2.6%, and total error <8.0%.1,2

Like a fasting glucose level >125 mg/dL, a two-hour postprandial glucose >200 mg/dL is virtually diagnostic of diabetes mellitus and obviates the need for a glucose tolerance test. An oral glucose tolerance test (OGTT) is not necessary in the setting of sufficiently high fasting and two-hour postprandial results.

Other causes of high glucose (serum or plasma) include nonfasting specimen; recent or current IV infusions of glucose; stress states such as myocardial infarct,5 brain damage, CVA,6 convulsive episodes, trauma, general anesthesia; Cushing disease; acromegaly; pheochromocytoma; glucagonoma; severe liver disease; pancreatitis; drugs (thiazide and other diuretics, corticoids, many others are reported to affect glucose).

The danger of hypoglycemia (low glucose) is lack of a steady supply of glucose to the brain (neuroglycopenia).

Causes of low glucose: Excess insulin, including rare insulin autoimmune hypoglycemia, surreptitious insulin injection, and sulfonylurea use; glycolysis in specimens overheated or old; serum permitted to stand on clot in red-top tube for chemistry profile. Very prompt removal of plasma and analysis is needed in cases of marked leukocytosis. Hypoglycemia should be confirmed by specimens drawn in fluoride tubes (gray-top tubes).

With hypoglycemia, symptoms must be correlated with plasma glucose.

Three major groups of hypoglycemia are defined: reactive, fasting, and surreptitious. The reactive group includes alimentary hyperinsulinism, prediabetic, endocrine deficiency, and idiopathic functional groups.7 Postprandial hypoglycemia may occur after gastrointestinal surgery, and is described with hereditary fructose intolerance, galactosemia, and leucine sensitivity.

• Pancreatic islet cell tumors (insulinomas) − cause hypoglycemia in fasting individuals or after exercise. Measurement of simultaneous glucose, C-peptide, and insulin levels at the time of spontaneous hypoglycemia help to differentiate insulinoma from other conditions. The glucose:insulin ratio is useful in the diagnosis of insulinoma: insulin levels inappropriately increased for plasma glucose. An intravenous tolbutamide test with plasma glucose and serum insulin determinations may be used for evaluation of insulin-secreting islet cell tumors. The test is positive in approximately 75% of patients with these tumors.7 Glucagon and leucine stimulation tests are less frequently utilized.

• Extrapancreatic tumors−rare bulky fibromas, sarcomas, mesotheliomas, and carcinomas, including hepatoma and adrenal tumors

• Adrenal insufficiency (Addison disease), including congenital adrenal hyperplasia

• Hypopituitarism, isolated growth hormone or ACTH deficiency

• Starvation, malabsorption−but starvation does not cause hypoglycemia in normal persons

• Drugs including insulin (see above), oral hypoglycemic agents, and alcoholism, especially with starvation. Ethanolism is a common cause of hypoglycemia. Other drugs can depress glucose levels.

• Liver damage, including fulminant hepatic necrosis (hepatitis, toxicity), and severe congestive failure

• Tumor-induced hypoglycemia appears to be caused by increased production of an insulin-like substance (insulin-like growth factor II) by the tumor. This substance induces increased utilization of glucose by the peripheral tissues and the tumor, and impairs the counterregulatory effect of growth hormone by suppressing growth hormone secretion.8,9

Infancy and childhood: Infants with tremor, convulsions and/or respiratory distress should have stat glucose, particularly in the presence of maternal diabetes, hemolytic disease of the newborn (erythroblastosis fetalis); babies too large or small for gestational age should also have glucose level measured in the first 24 hours of life. A large number of entities relate to neonatal hypoglycemia, including glycogen storage diseases, galactosemia, hereditary fructose intolerance, ketotic hypoglycemia of infancy, fructose-1,6-diphosphatase deficiency, carnitine deficiency (a treatable disease presenting as Reye syndrome), and nesidioblastosis.