Clinical Policy Bulletin: 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.
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.
CPT Codes / HCPCS Codes / ICD-9 Codes
There are no specific codes for home cholesterol monitors:
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-9 codes not covered for indications listed in the CPB (not all-inclusive):
272.0 - 272.9
Disorders of lipoid metabolism
401.0 - 405.99
Hypertensive disease
V77.91
Screening for lipoid disorders
The above policy is based on the following references:
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.
Alberta Heritage Foundation for Medical Research (AHFMR). Lifestream Technologies (TM) cholesterol monitor. Techscan. Edmonton, AB: AHFMR; 2000.
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.
Ross J. Home test measures total cholesterol. Nurse Pract. 2003;28(7 Pt 1):52-53.
Taylor JR, Lopez LM. Cholesterol: Point-of-care testing. Ann Pharmacother. 2004;38(7-8):1252-1257.
Copyright Aetna Inc. All rights reserved. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is subject to change.
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