Coverage and Coding of Continuous Glucose Monitors

Coverage and Coding of Continuous Glucose MonitorsHello and welcome to another edition of Medicare Minute MD. I m Dr. Robert Hoover, medical director at CGS Administrators, the Jurisdiction C DME MAC. Today I m go-ing to talk about a recent decision by the Centers for Medicare and Medicaid Services or CMS, that changed the Medicare Program s Coverage of Continuous Glucose monitor sys-tems. This change was effective January 12, 2017. What is a Continuous Glucose monitor system? A typical CGM system has three compo-nents a sensor that is inserted under the skin and measures Glucose levels; some way to transmit that measurement; and, some way to display those measurements. With most CGM systems on the market today, the sensor and transmitter are replaced on a regular basis. I mentioned January 12 and that s a key date here. To understand what CMS did you have to go back about a month before the January 12 Ruling to an action taken by the Food and Drug Administration in December 2016.

Therapeutic CGM and Non-Therapeutic CGM. The CMS Ruling declared that therapeu-tic CGM systems are covered under the DME benefit because they’re used to make thera-peutic decisions about blood glucose treatment. And as of the date of this video, there is only one CGM system that meets this CMS benefit category definition – the Dexcom G5

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  Earth, Coding, Coverage, Therapeutic, Continuous, Monitor, Glucose, Therapeu tic, Therapeu, Pictue, Coverage and coding of continuous glucose monitors

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