[Previous Months][Date Index][Thread Index][Join - Register][Login]   Help@Insulin-Pumpers.org
  [Message Prev][Message Next][Thread Prev][Thread Next]   for subscribe/unsubscribe assistance
 
 

RE: [IP] c-peptide test criteria



http://tinyurl.com/pqx3kld



Decision Memo for Insulin Pump: C-Peptide Levels as a Criterion for Use
(CAG-00092R)

    Expand All All sections on the page are Expanded
    Collapse All

 
Decision Summary

CMS has determined that the evidence is adequate to conclude that continuous
subcutaneous insulin infusion (CSII) is reasonable and necessary for
treatment of diabetic patients: 1) who either meet the updated fasting
C-peptide testing requirement or are beta cell autoantibody positive; and 2)
who satisfy the remaining criteria for insulin pump therapy detailed in the
Medicare National Coverage Determinations Manual (Medicare NCD Manual
280.14, Section A.5).

CMS has determined that fasting C-peptide levels will only be considered
valid when a concurrently obtained fasting glucose is ? 225 mg/dL.
Insulinopenia is defined as a fasting C-peptide level that is less than or
equal to 110 percent of the lower limit of normal of the laboratory's
measurement method. Alternatively, for patients with renal insufficiency and
a creatinine clearance (actual or calculated from age, gender, weight and
serum creatinine) ? 50 ml/minute, insulinopenia is defined as a fasting
C-peptide level that is less than or equal to 200 percent of the lower limit
of normal of the laboratory's measurement method. Levels only need to be
documented once in the medical records.

CMS will also continue to allow coverage of all other uses of CSII in
accordance with the Category B IDE clinical trials regulation (42 CFR
405.201) or as a routine cost under the clinical trials policy (Medicare NCD
Manual 310.1).

-----Original Message-----
From: email @ redacted
[mailto:email @ redacted] On Behalf Of Steve's
Sent: Wednesday, February 5, 2014 1:32 PM
To: email @ redacted
Subject: RE: [IP] c-peptide test criteria

Mike,
    Allow me to chime in.  Yes it does matter what you are as it is my
understanding that Medicare does not provide nor support insulin pumps for
Type II diabetics.  Or is this something else that is not factual? Or on an
individual basis they will cover it?

Steve
Follow us at https://www.twitter.com/insulinpumpers
Make a long URL short at http://type1.org
.
----------------------------------------------------------
for HELP or to subscribe/unsubscribe/change list versions,
contact: HELP@insulin-pumpers.org
Follow us at https://www.twitter.com/insulinpumpers
Make a long URL short at http://type1.org