Table of content for "Glucose monitor platforms" (HCPCS A4255)
General information on the “A4255” code
HCPCS Code: A4255
Long Description: Platforms for home blood glucose monitor, 50 per box
Short Description: Glucose monitor platforms
Original information is taken from A4255 page
Pricing indicators
Pricing Indicator Code 1: 34 – DME supplies (price subject to floors and ceilings). Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings.
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage Issues Manual Reference Section Number 1: 60-11
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): D1E – Other DME
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 19970101
Code Effective Date: 20020101
Action Code: N – No maintenance for this code