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RE: [IP] CGMS Denial Info



What insurance is saying is if you meet all goals without the CGMS then you
don't need CGMS. 

-----Original Message-----
From: email @ redacted
[mailto:email @ redacted] On Behalf Of Sue Ann Bowling
Sent: Friday, July 04, 2008 12:55 PM
To: email @ redacted
Subject: Re: [IP] CGMS Denial Info

>  Our criteria for "qualifying" for CGMS is
>
>1. Type 1 DM
>2. Test BS at least 4 times a day
>3. Recurrent "severe" hypoglycemia of less than 50 mg/dl
>4. Frequent BS above 150 mg/dl
>5."Poor control despite compliance with frequent changes in the 
>medical regimen."
>6. Three or more injections a day or use of an insulin pump.

This is probably moot, since Medicare is my primary, but what if 
someone meets all the criteria except 3 and possibly 5 and does not 
meet those because they're testing 15 or so times a day and/or are 
using a CGMS out of pocket?
-- 
Sue Ann Bowling, North Pole, Alaska
http://climate.gi.alaska.edu/Bowling/Bowling.html (professional--retired)
.
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