Diabetic Supplies Incorrect Billing Issues

Mar. 13, 2018

Blue Cross Blue Shield of Montana (BCBSMT) continually reviews our processes to ensure proper claims adjudication and payment in accordance with correct coding guidelines, medical policy and member benefits.

In a recent review of Durable Medical Equipment (DME) claims for diabetic supplies, billing errors were identified related to the number of billed units.

Certain HCSPCS codes, such as S8490 and A4772, include units as part of the code description. Claims billed with these types of codes will be reviewed if additional units are included on the claim.

Please consult with a certified professional coder for help with CPT/HCSPCS coding and guidelines.