HCPCS Code E2103: Non-Adjunctive, Non-Implanted Continuous Glucose Monitor (CGM) or Receiver

Get a list of the documentation and billing requirements of HCPCS code E2103 from our short guide for more accurate usage and billing.

Use Code

## **What is HCPCS code E2103?** HCPCS Code E2103 describes a non-adjunctive, non-implanted continuous glucose monitor (CGM) or receiver, classified as durable medical equipment (DME) by the Centers for Medicare & Medicaid Services (CMS). This code was created as part of HCPCS code changes to differentiate non-adjunctive CGMs from older, adjunctive continuous glucose monitor systems that required confirmatory fingerstick testing before making treatment decisions. “Non-adjunctive” indicates that the device can be used independently for insulin dosing, hypoglycemia management, and other diabetes treatment decisions without verification by a separate blood glucose meter. “Non-implanted” means the CGM receiver is external and not surgically implanted under the skin, distinguishing it from implantable CGM systems that use different codes. E2103 replaced certain existing codes that previously grouped CGM devices under miscellaneous categories, helping standardize billing and reimbursement under Medicare and Medicaid services. Providers and suppliers must ensure that any CGM billed under E2103 is listed on the PDAC Product Classification List (PCL) and meets CMS coverage criteria for insulin-treated or qualifying non-insulin-treated beneficiaries.

## **HCPCS code E2103 documentation requirements** Required documentation includes: - Standard Written Order (SWO) containing: Beneficiary’s name or Medicare Beneficiary Identifier (MBI), order date, general description of the item (HCPCS code or brand/model), quantity (if applicable), treating practitioner’s name or NPI, practitioner’s signature (must meet CMS signature requirements) - Diagnosis code(s) supporting medical necessity for glucose monitoring on each claim - Clinical records demonstrating the patient’s diabetes diagnosis and insulin use Evidence that the CGM device is intended for non-adjunctive use and aligns with coverage criteria

## **HCPCS Code E2103 billing requirements** Claims must include proper modifiers, supply codes, and documentation to avoid denials. Key billing requirements for E2103 include: - Bill E2103 with the supply allowance code A4239, reported as one unit of service per 30 days - Do not use the RR (rental) modifier, as E2103 typically represents a purchase - Ensure beneficiary-owned equipment status is documented in the medical record or listed as a claim narrative - Verify that the CGM device is listed on the Pricing, Data Analysis and Coding (PDAC) Product Classification List (PCL) - Submit claims in accordance with the most recent CMS or Medicare Administrative Contractor (MAC) policies

## **Other relevant codes** - **E2102**: Adjunctive, non-implanted continuous glucose monitor or receiver - **A4239**: Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service - **A4238**: Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

Frequently asked questions

HCPCS E2103 is for a non-adjunctive, non-implanted continuous glucose monitor or receiver in diabetes care.

E2103 codes the CGM device; A4239 codes the supply allowance for CGM sensors and accessories used monthly.

Yes, Medicare covers E2103 if the CGM meets CMS requirements and is listed on the PDAC Product Classification List.

The supply allowance for therapeutic continuous glucose monitors (CGMs), which included all supplies and accessories with one month equal to one unit of service, was deleted effective January 1, 2023.