TPN

Diabetes Coverage

One of the primary goals of diabetes treatment is to keep blood glucose levels near the normal range of 70 to 120 mg/dl before meals and under 140 mg/dl two hours after eating. This is why home blood glucose testing is an important part of controlling blood sugar.

Supplies necessary for testing blood glucose on a daily basis include:

-Electronic blood glucose meter

-Testing strips that are specific to the meter

-Some meters require a sugar control solution specific to the blood glucose meter (although most new meters are made to operate without this)

-Lancets

-Lancet device – used to position the lancet and control how deeply it penetrates the skin, and

-Clean cotton balls - used to stop the bleeding from the testing site.

Medicare covers many of the medications, supplies and services used in diabetes care.

Medicare reimbursement limits Diabetic Testing Supplies to a 3-month supply.

If the treatment regimen exceeds the quantity limitations given in their guidelines, then Medicare requires a Letter of Medical Necessity signed by the physician, printed on his or her letterhead.

Home blood glucose monitors are covered for patients who are diabetics.

To be eligible for coverage, the patient must meet all of the following basic criteria:

The patient must have diabetes (ICD-9 codes 250.00-250.93) which is being treated by a physician; and

The glucose monitor and related accessories and supplies have been ordered by that physician

and the treating physician must maintain records reflecting the care provided including, but not limited to, evidence of

medical necessity for the prescribed frequency of testing; and

The patient (or the patient's caregiver) has successfully completed training or are scheduled to begin training, and

in the use of the monitor, test strips, and lancing devices;

The patient (or the patient's caregiver) is capable of using the test results to control their glycemic index.