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Sticky Issues ​​​​

Medicare generally audits home healthcare providers with regard to diabetic supplies, making it important for providers to ensure that they have the necessary documentation and that patient files are complete, says CareCentric Vice President Jane Bunch. Insulin-dependent and non-insulin dependent patients only qualify for home glucose monitors and supplies if they have been diagnosed with the disease and are being treated by a physician who has ordered the equipment.

Additionally, Medicare requires that patients and caregivers receive training on the use of the monitors and supplies--which must be intended for home use--and have the ability to properly interpret the results. Instead of a 3x5 prescription, home healthcare providers must have a Physician's Order detailing how long the monitors and supplies are needed, how often tests must be performed, the type of monitor and whether the patient knows how to use it, and how many supplies are needed, among other things. 

Medicare covers the costs of 100 strips and 100 lancets every month for insulin-dependent patients, requiring a KX claims modifier, and every three months for non-insulin-dependent patients, requiring a KS modifier. While Medicare covers lancet device replacement every six months, the device must not be under warranty. Furthermore, the patient's file must contain the delivery ticket; and testing logs must be provided every six months if tests must be conducted more often than permitted by Medicare.

HomeCare (12/07) Bunch, Jane ​​​

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