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Re:[IP] Re: C-peptide

In a message dated 12/2/01 11:40:15 AM,  "sue depinto" 
<email @ redacted> writes:

<<  But, what do you meen by a positive and 
negative C-peptide result? Number-wise, I mean? >>

It depends on the test done.  Generally the lowest level that can be reported 
will be given as something like "<0.5 NG/ML"; the test is not sensitive 
enough to pick up any lower level, so it is not really saying there is no 
c-peptide, only that there is not enough for that test to measure.  I had a 
test at NIH last year for which this result was reported, with a reference 
range of 0.9-4.0 applied to fasting specimens only.  But a test I had at 
another lab gave me a result of "less than 33", with a reference range of 
170-900 pmol/L, which for that test was a negative result.  (I don't know why 
we're not multiplying by 18 x 10 to the something here to convert grams to 
moles -- Jim?  George?  Andy?)

But I saw on the website http://health.cch.com the following about Medicare "
The Coverage Issues Manual (CIM) has been revised to reflect a change in 
coverage for insulin infusion pumps. Effective Jan. 1, 2002, the C-peptide 
coverage requirement is met at less than or equal to 110 percent of the lower 
limit of normal of the laboratory's measurement method. This change expands 
the value of the laboratory test considered in determining coverage of the 
insulin infusion pump for all diabetic patients. Type II diabetes is no 
longer excluded. CIM, Trans. No. 143, Sept. 26, 2001,'' 

I would interpret this to mean that for the test above for which 0.9-4.0 was 
the reference range, a result of 0.9 would indeed qualify one for Medicare 
pump coverage starting next month.  Imogene, check the reference range for 
your test. 

Linda Z
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