Question 1

What is HCPCS code E0787?

Accepted Answer

HCPCS code E0787 is "Cgs dose adj insulin inf pmp". External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing

Question 2

What category is E0787 in?

Accepted Answer

E0787 belongs to HCPCS Category E (Durable Medical Equipment (DME)).

Question 3

When should I use HCPCS code E0787?

Accepted Answer

Use E0787 when billing for cgs dose adj insulin inf pmp. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is E0787 covered by Medicare?

Accepted Answer

Coverage for E0787 (Cgs dose adj insulin inf pmp) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for E0787?

Accepted Answer

Documentation for E0787 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).