[Diabetes-Talk] FW: Thank you for your interest in Dexcom; getting the Dexcom approved thru Medicare

Sat Sep 22 15:58:17 UTC 2018

Hello again,

I answered the message about getting the Dexcom approved thru Medicare prior to reading the message below. It has good information.

Walter

From: Dexcom [mailto:no-reply at dexcom-email.com] 
Sent: Friday, September 21, 2018 11:37 AM
To: walterl.mitch2 at gmail.com
Subject: Thank you for your interest in Dexcom

Dexcom Medicare CGM Coverage & Next Steps

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Thank you for your form submission and your interest in the Dexcom G5® Continuous Glucose Monitoring (CGM) System. 

Dexcom is now shipping the Dexcom G5 CGM to eligible Medicare patients. A Dexcom representative will review the information you provided and can expect to hear from Dexcom or an authorized Dexcom distributor about getting started. We are not yet licensed to service all 50 states and will be using Medicare distributors to support us. 

Priority will be given to existing Dexcom CGM patients followed by new patients in the order in which they were originally received. 

  _____  

Medicare Reimbursement Coverage Criteria

As a reminder, we wish to reiterate the coverage criteria so you are aware of what needs to be documented by your physician in your medical records/chart notes to support your eligibility for reimbursement as therapeutic CGM of the Dexcom G5 CGM System prescribed by your physician.

Medicare patients with type 1 and type 2 diabetes on intensive insulin therapy who meet the following criteria may now be able to obtain reimbursement: 

*	The beneficiary requires a therapeutic CGM. The beneficiary has diabetes mellitus; and,
*	The beneficiary has been using a home blood glucose monitor (BGM) and performing frequent (four or more times a day) BGM testing; and,
*	The beneficiary is insulin-treated with 3 or more daily injections (MDI) of insulin or a continuous subcutaneous insulin infusion (CSII) pump; and,
*	The beneficiary's insulin treatment regimen requires frequent adjustments by the beneficiary on the basis of therapeutic CGM testing results.
*	Within six (6) months prior to ordering the CGM, the beneficiary had an in-person visit with the treating practitioner to evaluate their diabetes control and determine that the above criteria are met; and,
*	Every six (6) months following the initial prescription of the CGM, the beneficiary has an in-person visit with the treating practitioner to assess adherence to their CGM regimen and diabetes treatment plan.

Please review our  <http://click.dexcom-email.com/?qs=71efab5d7b3dcae97cf622d53003b25a172b8eff2dd6e3b602e710c2acece919fd39a465a13442eeefb3b86cfefdb4f778a0e357449b40d4> Medicare FAQ for reimbursement criteria and coverage requirements.

Sincerely,
Dexcom

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BRIEF SAFETY STATEMENT  The Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System ("G5") is a glucose monitoring system indicated for the management of diabetes in persons age 2 years and older. The G5 is designed to replace fingerstick blood glucose testing for diabetes treatment decisions. The G5 also aids in the detection of episodes of hyperglycemia and hypoglycemia. The G5 is intended for single patient use and requires a prescription. CONTRAINDICATIONS Do not rely on the G5 CGM data if you have recently taken acetaminophen. Remove the G5 (sensor, transmitter, and receiver) before Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, or high-frequency electrical heat (diathermy) treatment. The G5 is MR Unsafe. Do not bring any portion of the G5 into the MRI environment. WARNING CGM-based diabetes treatment decisions are only approved with the G5, not previous generations of Dexcom CGM systems. Calibrate at least once every 12 hours using a fingerstick. If your G5 does not display a sensor glucose reading and an arrow, or if you are getting inaccurate or inconsistent readings, take a fingerstick. If your glucose readings and alerts do not match your symptoms or expectations, take a fingerstick to confirm. Failure to do so may lead to hyperglycemia or hypoglycemia. The G5 is not approved for use in pregnant women, persons on dialysis or critically ill persons. If a sensor breaks and no portion of it is visible above the skin, do not attempt to remove it. Seek professional medical help if you have infection or inflammation on or near the sensor insertion point. Report broken sensors to Dexcom Technical Support. Sensor placement is not approved for sites other than under the skin of the belly (ages 2 years and older) or upper buttocks (ages 2-17 years). To “share” data, you need an internet connection and a separate compatible smart device running the Dexcom Follow App. Contact Dexcom Toll Free at 877-339-2664 or www.dexcom.com for detailed indications for use and safety information.

LBL015148 Rev002

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