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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
- Prescription: Obtain a prescription from a healthcare provider.
- Supply Order: Place an order for a one-month supply of CGM supplies through a medical supplier or pharmacy.
- Contents: Supply includes sensors, transmitters, and any ancillary supplies as specified.
- 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.