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Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook-up, calibration of monitor

CPT4 code

Name of the Procedure:

Ambulatory Continuous Glucose Monitoring (CGM) of Interstitial Tissue Fluid via Subcutaneous Sensor

Summary

Ambulatory Continuous Glucose Monitoring (CGM) involves placing a small sensor under the skin to track glucose levels continuously for at least 72 hours. This data helps in managing blood sugar levels more effectively.

Purpose

The CGM procedure addresses issues related to diabetes management by providing real-time glucose level data. It helps in identifying trends and patterns in blood sugar fluctuations, ultimately aiding in better diabetes control and reducing the risk of complications.

Indications

  • Frequent and unpredictable fluctuations in blood sugar levels.
  • History of hypoglycemia or hyperglycemia episodes.
  • Difficulty achieving target blood glucose levels with current management.

Preparation

  • No specific fasting required unless otherwise instructed by the healthcare provider.
  • Bring your glucose meter and logbook for comparison and calibration purposes.
  • Review of any medications, with adjustments if needed, as directed by the healthcare provider.

Procedure Description

  1. The healthcare provider will clean the site (usually the abdomen or upper arm) where the sensor will be placed.
  2. A small sensor is inserted just under the skin using a special insertion device.
  3. The sensor is hooked up to a small, lightweight transmitter that sends the glucose data to a monitoring device or smartphone.
  4. The device needs to be calibrated, usually with a standard finger-stick glucose test, to ensure accurate readings.
  5. The patient is instructed on how to use the monitoring equipment to track glucose levels and respond appropriately.

Duration

The sensor remains in place and monitors glucose levels continuously for at least 72 hours.

Setting

The procedure is typically performed in an outpatient clinic or doctor's office.

Personnel

The procedure involves a physician or other qualified healthcare professional, such as a nurse or certified diabetes educator.

Risks and Complications

  • Minor skin irritation or discomfort at the insertion site.
  • Rarely, infection at the insertion site.
  • Potential for inaccurate readings if the sensor is not calibrated correctly.

Benefits

  • Provides detailed information about glucose levels throughout the day and night.
  • Helps in making more informed decisions about diet, activity, and insulin dosage.
  • Can lead to better long-term glucose control and reduced risk of complications.

Recovery

  • Minimal recovery time; patients can resume normal activities immediately after sensor placement.
  • Patients should follow up with their healthcare provider to review the collected data and adjust their diabetes management plan accordingly.

Alternatives

  • Traditional blood glucose monitoring using finger-stick tests several times a day.
  • Other types of continuous glucose monitoring systems that may differ in sensor lifespan or data transmission methods.

Patient Experience

During the procedure, patients might feel a minor pinch or discomfort when the sensor is inserted. The device is generally discreet and minimally invasive. Post-procedure, patients should monitor the insertion site for any signs of irritation or infection. Regular calibration may involve finger-stick glucose tests. Comfort measures include the flexibility of wearing the device and the ability to carry on with normal daily activities.

Medical Policies and Guidelines for Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook-up, calibration of monitor

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