Has anyone had any luck getting insurance to reimburse you for these items? It seems like Jay may have had some luck. BCBS wants a CPT Code on my claim form. I believe there may be a general code for DME or something that I can put. Animas says it’s not covered because they don’t have a code. I know it’s not much money, but I’m interested in trying. It seems like if they pay for the pump and supplies, this ought to go right along with those things. My thoughts are sometimes wrong though, lol. Thanks.
I am surprised they are asking for a CPT code. The Current Procedural Terminology code is a code for a task or service a medical practitioner provides to a patient, and it may include medical, surgical or diagnostic services. The caps are parts of the Durable Medical Equipment and should be covered separately in the policy. Sometimes consumables are covered, sometimes not. It is similar to a formulary, where not all drugs would be covered, regardless of mdical need. I would approach this from the DME perspective, and try and move BCBS away from the CPT issue.
Carman, my insurance company paid for mine. Unfortunately, they don’t show the billing codes that were submitted on the claim form. Out of curiosity, I Googled “billing codes for pump cartridge caps” and several sites came up with E1399. I then Googled that and that code is “durable medical equipment, miscellaneous.” That could be what you are looking for.
You still need the code to bill for DME stuff. I have to have my PCP get pre-authorization for my Dex supplies and they have to have the billing code in order to do that.
Thanks Kelly, that’s exactly what I’m looking for. I encountered the rudest person at BCBS this morning over this. It’s really frustrating talking to them sometimes.
You are welcome - I hope it works! Sometimes I wonder about those people. For the most part, the people at my insurance company are very helpful, but sometimes I get one I would like to strangle!
It was such a pain in the ■■■ that I just pay for those things myself. But only the battery caps and cartridge cap. The rest o the supplies are covered. Sorry!
Are they sure? I wouldn’t think something like that would be covered; simply because it is like maintenance, apposed to “insulin” and or “reservoirs” or Infusion sets". I know my insurance doesn’t cover this…
-Yogi
Mine wouldnt either.