I am fairly new to omnipod – been on it since Aug and absolutely Love it!! This question has probably been asked but I couldn’t go thru all 79 discussions out there. So, does anyone know what the CPT code is for the Omnipods? My insurance company after sending in my claims over a month ago, now needs me to get the CPT code, do most of you claim the pods as a DME or an Rx? As with all my ins. company is giving me a hard time paying or just applying to my deductible is all I asked. Any suggestions would be helpful. Thanks
Omni Pod should be handling all this for you. Mine go through as Rx just like the normal catheters were for my other pump. They get billed as pump supplies.
Empire BlueCross BlueShield calls the pods DME.
I just looked on my insurer’s website at the claim for my PDM and initial supply of pods. Here is what I found:
- EXT AMB INFUSN PUMP INSULIN for the punp
- EXT AMB INSULIN DELIVERY SYS for the pods
There are no codes, just the descriptions of the services I listed. I did not pay for my system in advance; Insulet and my CDE handled all the paperwork with my insurance company and my insurance company paid Insulet directly. For my Dexcom System 7 CGM, I had to fill out several questionaires to demonstrate need; however after that Dexcom and my CDE handled everything.
If you didn’t pay for your system, Insulet should be handling the paperwork so they get paid. If you did pay for your system, Insulet should help you fill out the paperwork for your insurance company so you get reimbursed. It is to their benefit to help you so you continue using their pump and supplies. After all, if you cannot get reimbursed, you might have to switch to MDI or another pump, wink, wink.