MedicaidBilling CodesMedium impact
Therapeutic Continuous Glucose Monitors Auditing pdf
Connecticut Medicaid (HUSKY Health)·CT · Endocrinology·Provider Bulletin
Effective date
Apr 1, 2020
We identified it
Jun 20, 2026
Summary
DSS has implemented auditing rules for Therapeutic Continuous Glucose Monitors (CGMs) that prevent separate billing of 16 supply codes when billed in the same month as K0553. Starting April 1, 2020, claims will be denied with EOB code 5452 if these codes are billed together in the same calendar month.
Action Required
Before April 1, 2020: DME billing team must update billing system to prevent simultaneous billing of K0553 with codes A4233, A4234, A4235, A4236, A4244, A4245, A4246, A4247, A4250, A4253, A4255, A4256, A4258, A4259, E0607, E2101 in the same calendar month. Use web portal at www.ctdssmap.com to check Claims > Claim History for Specific Services > Med Surg Supplies and Orthotics before billing. Claims will be denied with EOB code 5452 if billed together.