[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

[IP] Re: C-Peptide

Michael, I have always read the statement as saying that no matter whether 
you are covered per criteria A or criteria B the final, deciding 
documentation rests with the c-peptide test. The sentence seems to me to be 
a straightforward statement addressing type I diabetes and not which 
criteria it falls under. For Medicare it is their escape clause. The 
criteria indicates a diabetic condition for the patient and the C-Peptide 
level indicates how much assistance Medicare will recognize. For the record 
my C-Peptide came back at < 0.1 after being diagnosed in October 1961. I 
guess they knew diabetes by sight back then, didn't need all the tests. 
Although one test did show I was in less than good shape. The gtt started 
out with an orange(?) flavored syrupy sickeningly sweet liquid that I 
immediately refused after tasting. Being apprised of what happened to young 
seven year old boys who didn't follow orders in the hospital (yes they 
could infer things then and it did get my attention) I drank it down. Lying 
back in bed I realized why I kept telling them I didn't want to drink that 
liquid. I also imagine the uniform of that nurse is still orange to this 
day. The gtt was called off and I though good no blood lost and only 5 
minutes maybe they will let me go home.

To be continued...........? or not.


At 08:51 AM 11/5/01 -0800, you wrote:
>insulin-pumpers-digest    Monday, November 5 2001    Volume 05 : Number 551
>Date: Mon, 5 Nov 2001 08:51:08 -0800
>From: "Michael" <email @ redacted>
>Subject: Re: [IP] C- Peptide Test Why & What
>The regs read:
>5. Continuous subcutaneous insulin infusion pumps (CSII) (Effective
>for Services Performed On or After 4/1/2000).--
>An external infusion pump and related drugs/ supplies will be covered
>as medically necessary in the home setting in the following situation:
>Treatment of Type I diabetes
>In order to be covered, patients must meet criterion A or B:
>  (A)..................................
>  (B)..................................
>Type I diabetes needs to be documented by a C-peptide level < 0.5
>Continued coverage of the insulin pump would require that the patient
>has been seen and evaluated by the treating physician at least every 3
>- --------------------------------------
>It is not clear for persons qualifying under part (B) if the
>C-peptide level test is required. There are credible reports that if
>you are currently on a pump, your benefits will be covered. In any
>event, C-peptide tests are fairly unreliable in terms of exact
>numeric results. The results are highly dependent on the individual
>lab and may differer greatly from test to test. -- best advice is
>that if the results are not suitable, try a different lab or even the
>same lab at some other time.
>email @ redacted
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml