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Re: [IP] Re: C-Peptide and Medicare

John I couldn't locate the coverage criteria on the ADA page. The Coverage 
Issues Manual Durable Medical Equipment of HCFA states what your report of 
the ADA site has but does have the tag line below the B criteria of:

"Type I diabetes needs to be documented by a C-peptide level < 0.5"

This can be found at http://www.hcfa.gov/pubforms/06%5Fcim/ci60.htm#_1_10
Does the ADA site indicate the date of issue and or the revision date of 
their information?


At 12:20 AM 6/27/00 -0400, you wrote:
>"Severe glycemic excursions", as indicated by your frequent
>DKA episodes, would also qualify you.
>The amended HCFA coverage manual 60-14 states that "In order to be covered,
>patients must meet criterion A or B:
>A. The patient has completed a comprehensive diabetes education program, and
>has been on a program of multiple daily injections of insulin (i.e., at
>least three injections per day), with frequent self-adjustments of insulin
>dose for at least 6 months prior to initiation of the insulin pump, and has
>documented frequency of glucose self-testing an average of at least four
>times per day during the two months prior to initiation of the insulin pump,
>and meets one or more of the following criteria while on the multiple daily
>injection regimen:
>(1) Glycosylated hemoglobin level (HbA1c) > 7.0 percent
>(2) History of recurring hypoglycemia
>(3) Wide fluctuations in blood glucose before mealtime
>(4) Dawn phenomenon with fasting blood sugars frequently exceeding 200 mg/dl
>(5) History of severe glycemic excursions
>B. The patient with type 1 diabetes has been on a pump prior to enrollment
>in Medicare and has documented frequency of glucose self-testing an average
>of at least four times per day during the month prior to Medicare
>John Kinsley
>email @ redacted
>Type 1 since 1956
>MM 507 since 6/9/98

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