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Re: [IP] Too good hbA1C?



 John, this was pretty much what they (mm and my cde) went through for me. It
was the c-peptide test that clinched it.

 Hang in there, Joyce. It took six months for mine to get completed, and boy,
has it ever been worth every minute of hassel.
 
Billie

A Happy Pumper and new Power Wheel Chair user in Arkansas!
email @ redacted
Pumping with MiniMed Paradigm 715, 2/06 Humalog. Symlin

On a recent trip, I discovered that "Home is where my kitties are."
Today is the first day of the rest of my life!

----- Original Message ----
From: John S Wilkinson <email @ redacted>

My Insurance had these requirements:

The pump must be ordered with concurrence of an endocrinologist.
A diagnosis of diabetes mellitus ( ICD-9 codes 250.01, 250.03) requiring
insulin for proper treatment.
Documentation of a history of completing a comprehensive diabetic education
program and compliance with multiple insulin injections where 3 to 4
injections per day fail to provide normoglycemic levels.
Member has demonstrated ability to self-monitor blood glucose levels >/
4x/day

I am a type 2 diabetic. The ICD-9 codes 250.01 Diabetes, I, uncomplicated
250.03 Diabetes, I, uncontrolled. The insurance company was saying only Type
1 Diabetics would get a pump.
I was denied by my insurance the first time the doctor submitted. The second
time I had him put copies of my log in the request. The log showed that I
tested 8 - 10 times a day. That I have a Dawn Phenomium. And that my A1c of
5.8% included many lows that averaged out the highs. And that my meal plan
was being adhered to. The HMO denied me again. The third time I had the Endo
do a c-peptide test, which showed very little insulin production. That was
the winner, I got my pump. I don't know if I am Type 1 or Type 2. I know I
was type 2 for 22 years. 

John S Wilkinson, 
Rome, New York
.
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