Home Cholesterol Monitors

Number: 0367

Policy

Aetna considers cholesterol monitors for home use (e.g., Cholestron cholesterol monitor) experimental and investigational because effective treatment of elevated cholesterol levels does not require daily blood testing.  Thus, the value of home monitoring over periodic laboratory testing has not been established.

See also CPB 0525 - Screening for Lipid Disorders.

Background

Cholestron (Lifestream Technologies, Post Falls, ID) is a hand-held device that measures cholesterol.  It is about the size of a palmtop computer and can screen a patient's overall cholesterol level with 1 drop of blood within 3 minutes.  It was cleared by the U.S. Food and Drug Administration on October 5, 1998, and is manufactured by Lifestream Technologies Inc.  Recommended conservative treatments for hypertension and hyperlipidemia include changes in dietary habits, increase in physical activity, and if necessary, drug therapy.  There are no prospective studies demonstrating that home monitoring of cholesterol improves clinical outcomes compared to periodic testing performed in the clinic.

Table: CPT Codes / HCPCS Codes / ICD-10 Codes
Code Code Description

Information in the [brackets] below has been added for clarification purposes.   Codes requiring a 7th character are represented by "+":

Home cholesterol monitors:
No specific code

HCPCS codes not covered for indications listed in the CPB:
A9279 Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified [not covered for home cholesterol monitors]

ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):
E71.30, E75.21 - E75.22, E75.240 - E75.249, E75.3, E75.6, E77.0 - E77.9, E78.00 - E78.9, E88.1 - E88.2, E88.89 Disorders of lipoid metabolism
Z13.220 Encounter for screening for lipoid disorders

The above policy is based on the following references:

  1. Alberta Heritage Foundation for Medical Research (AHFMR). Lifestream Technologies (TM) cholesterol monitor. Techscan. Edmonton, AB: AHFMR; 2000.
  2. Lifestream Technologies, Inc. Lifestream Plus Cholesterol Monitor with Health Risk Assessment [website]. Post Falls, ID: Lifestream Technologies; 2005. Available at: https://www.knowitforlife.com/monitors.asp. Accessed June 8, 2005.
  3. National Institutes of Health (NIH), National Heart, Lung and Blood Institute (NHLBI), Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Executive Summary. Bethesda, MD: NIH; May 2001.
  4. Ross J. Home test measures total cholesterol. Nurse Pract. 2003;28(7 Pt 1):52-53.
  5. Taylor JR, Lopez LM. Cholesterol: Point-of-care testing. Ann Pharmacother. 2004;38(7-8):1252-1257.