Reimbursable

Professionals - Reimbursement Information

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This information is intended to provide general background information to help physicians understand key elements about the reimbursement process. In order to obtain reimbursement, physicians need to determine the appropriate ICD-9 and E & M codes associated with the reason for the patient’s visit. Physicians also determine the appropriate CPT code associated with any test or procedure performed during the office visit. The information defines codes and describes general reimbursement information. For private insurance information, please contact the private insurer directly.

The test is billable to CPT code 83037.

Use QW modifier (83037QW) when coding for Medicare and Medicaid beneficiaries.

National Average for private insurance is $18.00

Medicare payment is $14.17

Real-time results. Better outcomes.

The ADA recommends that healthcare professionals use A1C point-of-care testing for timely decisions on therapy changes [2]
Giving diabetes patients on-the- spot feedback on their A1C number may result in a 1% point reduction in their A1C [3]
A 1% point reduction lowers the risk of serious complications by 40% [1]

Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2002. Atlanta, GA:
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2003.
Standards of Medical Care in Diabetes - 2008. Diabetes Care, Volume 31, Supplement 1, January 2008.
Daniels, E. et al, Point of Care Testing to Improve Glycemic Control.Intl J or Health Care Quality Assurance 2008; 21 (3): pp. 325-335.
Data on file; Evaluation of the A1CNow SELFCHECK with lay-users. August 2008.
* Study results with healthcare professionals showed that the accuracy of A1CNow+ with fingerstick samples was, on average, 99%. This means that, on average, a true 7.0% A1C could read approximately 6.9%A1C. An individual A1CNow+ result may differ by as much as -1.0% A1C to +0.8% A1C from the true result. This represents the 95% confidence limits of a Bland-Altman plot.
Miller CD et al., Rapid A1C availability improves clinical decision-making in an urban primary care clinic. Diabetes Care 2003; 26:1158-1163.
Cagliero E et al., Immediate feedback of HbA1C levels improves glycemic control in type 1 and insulin-treated type 2 diabetic patients.
Diabetes Care 1999; 22: 1785-1789.