Local Coverage Determination · DME MAC
L33822
Glucose Monitors
Version 70. CMS effective date 10/01/2024. CMS updated 10/09/2024. Read from the CMS Coverage API on 2026-10-13. Contractors on the report: CGS Administrators (DME MAC) and Noridian Healthcare Solutions (DME MAC).
CMS coverage policy citation. CMS Pub. 100-03, (Medicare National Coverage Determinations Manual), Chapter 1, Section 40.2
Coverage indication
In addition to the “reasonable and necessary” criteria contained in this LCD there are other payment rules, which are discussed in the following documents, that must also be met prior to Medicare reimbursement: The LCD-related Standard Documentation Requirements Article, located at the bottom of this policy under the Related Local Coverage Documents section. The LCD-related Policy Article, located at the bottom of this policy under the Related Local Coverage Documents section. Refer to the Supplier Manual for additional information on documentation requirements. Refer to the DME MAC web sites for additional bulletin articles and other publications related to this LCD. For the items addressed in this LCD, the “reasonable and necessary” criteria, based on Social Security Act § 1862(a)(1)(A) provisions, are defined by the following coverage indications, limitations and/or medical necessity. HOME BLOOD GLUCOSE MONITORS (BGM) To be eligible for coverage of home blood glucose monitors and related accessories and supplies, the beneficiary must meet both of the following basic criteria (1)-(2): The beneficiary has diabetes (Refer to the ICD-10 code list in the LCD-related Policy Article for applicable diagnoses); and, The beneficiary’s treating practitioner has concluded that the beneficiary (or the beneficiary’s caregiver) has sufficient training using the particular device prescribed as evidenced by providing a prescription for the appropriate supplies and frequency of blood glucose testing.
Excerpt from the LCD indication. Full text on CMS.
Documentation requirements
Items covered in this LCD have additional policy-specific requirements that must be met prior to Medicare reimbursement. Refer to the LCD-related Policy article, located at the bottom of this policy under the Related Local Coverage Documents section for additional information.
Related articles
- A59330 · Response to Comments: Glucose Monitors – DL33822
- A52464 · Glucose Monitor - Policy Article
- A55426 · Standard Documentation Requirements for All Claims Submitted to DME MACs
Related NCDs
- NCD 40.2 · Home Blood Glucose Monitors (version 2)
- NCD 280.1 · Durable Medical Equipment Reference List (version 4)
HCPCS codes on this LCD
29 other Level II codes are on the LCD and are not given a page in this set: E0607, E0620, E1399, E2100, E2101, E2102, E2103, E2104, A4233, A4234, A4235, A4236, A4238, A4239, A4244, A4245, A4246, A4247, A4250, A4255, A4256, A4257, A4258, A4259, A4271, A9275, A9276, A9277, A9278.
Questions
What does LCD L33822 cover?
L33822 is Glucose Monitors. It is a current final DME MAC local coverage determination, version 70.
Where is the CMS source for L33822?
The Medicare Coverage Database page for LCD L33822 version 70.
Get the signed answer via API
The signed answer is the receipt for this code on a date of service: the rule that was in force, with a hash you can replay. The call needs an API key. The source archive and as-of resolution are public.
curl -H "X-API-Key: $VERZI_API_KEY" \
"https://api.verzi.health/v1/rules/warrant?hcpcs=A4253&as_of=2024-01-15&npi=1234567890&state=UT"