Glucometer replacement billing: pseudo-DINs, groups, serial numbers, and strip compatibility
How manufacturer-sponsored meter replacement claims are structured and why the strip family matters.
Bill a manufacturer-sponsored meter through TELUS eSampling using Carrier 80, the manufacturer's Group, the meter serial number and Issue 01. Enter the program's total reimbursement in Drug Cost, with no dispensing fee. The meter's pseudo-DIN does not bill its test strips.
The most important practical detail is often strip compatibility. The meter handed to the patient determines which strips they will buy or refill later. Replacing a meter without checking the strip family can create future claim and counselling problems even if the replacement itself adjudicates.
Pseudo-DINs identify the program item
Pseudo-DINs are used when the item is not billed as an ordinary commercial DIN. They allow the adjudicator to identify the sponsored item or service. A pseudo-DIN for a training fee, a replacement meter, or a specific meter model should not be substituted with a similar-looking number unless the current program list supports it.
The certificate field is not optional decoration
Manufacturer programs often require a serial number or certificate number from the meter, box, or warranty card. The expected format can differ by manufacturer. Truncating the wrong digits or including spaces that the program does not expect can cause a rejection that looks like an eligibility problem but is actually a formatting problem.
- Confirm the exact meter model.
- Confirm which test strip family is compatible.
- Use the manufacturer group assigned to that program.
- Enter the pseudo-DIN associated with that model or fee.
- Record the serial or certificate number on the prescription record for audit support.
Meter claims and test strips
The FRx tables list meter pseudo-DINs and reimbursement amounts. Each table names the compatible strips separately. A strip refill is a separate product claim, not a Carrier 80 meter claim.
CONTOUR NEXT: meter or training only?
The Ascensia bulletin effective August 1, 2023 lists $45 total for NEXT GEN, NEXT ONE and NEXT EZ: $33 meter MSRP plus $12 training. Enter the full $45 in Drug Cost. The purchase of CONTOUR NEXT test strips is required.
For a meter supplied as a free sample, pseudo-DIN 55555557 pays $12 for training only. It is not an extra $12 on top of the $45 meter-and-training claim.