Search all medical codes

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

HCPCS code

Name of the Procedure:

Supply Allowance for Therapeutic Continuous Glucose Monitor (CGM)

  • Common Names: CGM Supply Refill
  • Technical/Medical Term: K0553

Summary

A procedure to provide a one-month supply of essential supplies and accessories required for the continuous functioning of a therapeutic continuous glucose monitor, which assists patients in managing their blood sugar levels.

Purpose

  • Addresses: Diabetes management, both Type 1 and Type 2.
  • Goals: Ensures consistent and accurate glucose monitoring, preventing complications of diabetes such as hyperglycemia and hypoglycemia.
  • Expected Outcomes: Stabilized blood sugar levels, improved diabetes management, and reduced risk of diabetes-related complications.

Indications

  • Symptoms/Conditions: Persistent hyperglycemia, hypoglycemia, brittle diabetes, or frequent fluctuations in blood glucose levels.
  • Patient Criteria: Diagnosed with diabetes and prescribed a CGM by a healthcare provider.

Preparation

  • No specific preparation is required.
  • Ensure previous supplies and accessories have been used as directed for optimal CGM function.
  • Diagnostic tests like HbA1c levels may be monitored regularly.

Procedure Description

  1. Prescription: Obtain a prescription from a healthcare provider.
  2. Supply Order: Place an order for a one-month supply of CGM supplies through a medical supplier or pharmacy.
  3. Contents: Supply includes sensors, transmitters, and any ancillary supplies as specified.
  4. Usage: Follow manufacturer’s instructions for replacing sensors and any other necessary components.

Duration

  • The ordering and receiving process typically takes a few days.
  • Supplies are intended to last one month.

Setting

  • The supply can be ordered and delivered to the patient's home.
  • May be initiated in an outpatient clinic or prescribed during a regular doctor’s visit.

Personnel

  • Healthcare providers involved include endocrinologists, diabetes educators, and pharmacists.

Risks and Complications

  • Common Risks: Potential for delayed shipment, incorrect supply amounts.
  • Rare Risks: Allergic reaction to sensor adhesive, sensor malfunction.
  • Management: Contact your supplier or healthcare provider for any issues with possession or function of supplies.

Benefits

  • Expected Benefits: Consistent, real-time glucose monitoring assists in better diabetes management.
  • Timeline: Benefits are ongoing with continuous use.

Recovery

  • Post-Procedure Care: Ensure proper disposal of used sensors as per local regulations.
  • Follow-Up: Regular follow-up appointments with a healthcare provider to assess diabetes management and adjust CGM settings as necessary.

Alternatives

  • Other Options: Traditional blood glucose monitoring using fingerstick testing.
  • Pros and Cons: Fingerstick testing is less costly but provides less continuous data compared to CGMs.

Patient Experience

  • During Procedure: No discomfort should be experienced during the ordering of supplies. Minimal discomfort while applying sensors.
  • After Procedure: Patients typically experience improved glucose control and convenience. Discomfort is minimal and manageable with correct sensor application and change procedures. Any pain or adhesive sensitivity should be communicated to a healthcare provider.

Medical Policies and Guidelines for Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

Related policies from health plans

Similar Codes