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March 27, 2018

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OIVIT Remains Noncovered for Medicare Patients

April 6, 2010:

In a recent transmittal, the Centers for Medicare and Medicaid Services indicated that there is no evidence supporting the conclusion that outpatient intravenous insulin treatment (OIVIT) improves health outcomes in Medicare patients. For this reason, CMS has determined that OIVIT is not reasonable and necessary and is a noncovered service.

HCPCS code G9147, which becomes effective with the April I Outpatient Code Editor (OCE) and Medicare Physician Fee Schedule Database (MPFSDB) updates, should be used on claims with dates of service on or after December 23, 2009, when billing for noncovered OIVIT and any services making up an OIVIT regimen.

CPT code 99199 or 94681(with or without diabetes-related conditions 250.00-250.93) are not to be used on claims billing for noncovered OIVIT and any services making up an OIVIT regimen when furnished pursuant to an OIVIT regimen. Claims billing for HCPCS codes 99199 and 94681 for noncovered OIVIT are to be returned to provider/returned as unprocessable.


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