2025 HCPCS code S1034
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Medical Supplies - Temporary National Codes (Non-Medicare) Miscellaneous Provider Services and Supplies Feed
This HCPCS code represents a low glucose suspend artificial pancreas device system (APDS), including a continuous glucose monitor, blood glucose device, insulin pump, and coordinating computer algorithm.
Modifiers may be applicable depending on the circumstances of service.Consult payer-specific guidelines for proper modifier usage.
Medical necessity for S1034 is established by the presence of diabetes mellitus (types 1 or 2) that is inadequately controlled despite other treatment strategies.Frequent episodes of hypo- or hyperglycemia would necessitate use of this technology to prevent adverse health events.
The clinical responsibility involves the physician or healthcare professional ordering, overseeing, and monitoring the patient's use of the APDS. This includes proper setup, training, and ongoing management to ensure safe and effective operation. Regular follow-up and adjustments might be necessary.
In simple words: This code covers a special device that helps people with diabetes manage their blood sugar.It uses sensors, a pump to give insulin, and a computer to automatically adjust insulin based on blood sugar readings, keeping it within a safe range.
HCPCS code S1034 encompasses the supply of a low glucose suspend artificial pancreas device system (APDS).This system includes a continuous glucose monitor, a blood glucose device, an insulin pump, and a computer algorithm that coordinates the functions of all components. The APDS helps regulate blood glucose levels by temporarily providing or withholding insulin delivery based on the patient's glucose levels, preventing both hyper- and hypoglycemia.
Example 1: A type 1 diabetic patient with frequent hypoglycemic episodes is prescribed the APDS to prevent dangerously low blood sugar. The system continuously monitors glucose levels and automatically adjusts insulin delivery to maintain optimal glucose control., A type 2 diabetic patient on multiple daily insulin injections experiences unpredictable blood sugar fluctuations. The APDS is implemented to improve glucose control and reduce the burden of frequent manual insulin adjustments., A pregnant woman with gestational diabetes is fitted with the APDS to closely manage her blood glucose throughout her pregnancy, mitigating risks associated with fluctuating blood sugar.
** S1034 is a temporary HCPCS code and may be subject to change. Always refer to the most current HCPCS coding guidelines and payer-specific instructions for accurate billing.
- Payment Status: Not payable by Medicare
- Specialties:Endocrinology, Diabetes Management, Internal Medicine
- Place of Service:Office, Hospital Outpatient