Medicare Announces Criteria Covering Dexcom G5 Mobile CGM for All People with Diabetes on Intensive Insulin Therapy
March 24 2017 - 8:30AM
Business Wire
DexCom, Inc. (NASDAQ:DXCM), the leader in continuous glucose
monitoring (CGM) for people with diabetes, is pleased to announce
that the U.S. Centers for Medicare & Medicaid Services (CMS)
has published an article clarifying criteria for coverage and
coding of the Dexcom G5 Mobile system, the only therapeutic CGM
under this CMS classification. People covered by Medicare who have
either Type 1 or Type 2 diabetes and intensively manage their
insulin will now be able to obtain reimbursement.
“This is a new era and a huge win for people with diabetes on
Medicare who can benefit from therapeutic CGM,” said Kevin Sayer,
President and Chief Executive Officer, Dexcom. “This decision
supports the emerging consensus that CGM is the standard of care
for any patient on intensive insulin therapy, regardless of
age.”
According to CMS, therapeutic CGM may be covered by Medicare
when all of the following criteria are met:
- 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
multiple daily injections (MDI) of insulin or a continuous
subcutaneous insulin infusion (CSII) pump; and,
- The patient’s insulin treatment regimen
requires frequent adjustment by the beneficiary on the basis of
therapeutic CGM testing results.
In order to be included in this category, the system must be
defined as therapeutic CGM, meaning you can make treatment
decisions using the device. Dexcom G5 Mobile is the only system
approved by the FDA to meet that criteria.
See the Medicare Administrative Contractor (MAC) website for
instructions for individual claim adjudication. Coverage is
effective for claims with dates of service on or after January 12,
2017. A link to the article on coding and coverage can be found at:
https://med.noridianmedicare.com/web/jddme/policies/dmd-articles/coding-and-coverage-therapeutic-continuous-glucose-monitors.
To learn more about CGM, visit www.dexcom.com.
About Diabetes and Continuous Glucose Monitoring
With diabetes, the body cannot produce or use the hormone
insulin effectively, causing a buildup of glucose, or sugar, in the
blood. People with diabetes who take insulin must monitor their
blood glucose levels frequently. Uncontrolled glucose can cause
health complications and even death.i,ii
Continuous glucose monitoring (CGM) is considered the most
significant breakthrough in diabetes management in the past 40
years.iii CGM is important because, in addition to providing the
glucose level, it provides the direction and rate of glucose change
with the push of a button and alerts users when glucose is too low
or too high with built-in and customizable alarms. A recent study
showed that after one year, patients with Type 1 diabetes who used
CGM alone had significant A1C reductions regardless of the type of
insulin delivery method used, including insulin pumps.iv
About DexCom, Inc.
DexCom, Inc., headquartered in San Diego, CA, is dedicated
to helping people better manage their diabetes by developing and
marketing continuous glucose monitoring (CGM) products and tools
for adult and pediatric patients. With exceptional performance,
patient comfort and lifestyle flexibility at the heart of its
technology, users have consistently ranked DexCom highest
in customer satisfaction and loyalty. For more information on the
DexCom CGM, visit www.dexcom.com.
References
i Hyperglycemia (High blood glucose). American Diabetes
Association Web site.
http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html.
Updated August 5, 2013. Accessed December 3, 2013.
ii Hypoglycemia (Low blood glucose). American Diabetes
Association Web site.
http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html.
Updated July 16, 2013. Accessed December 3, 2013.
iii Clarke SF and Foster JR. A history of blood glucose meters
and their role in self-monitoring of diabetes mellitus. Br J Biomed
Sci. 2012;(3)2:83-93.
iv J. Soupal, J. Skrha Prazny, M. Flekac, L. Petruzelkova, J.
Skrha, et al. Comparison of different treatment modalities for Type
1 diabetes including Sensor-Augmented Insulin Regimens (SAIR), in
52 weeks of follow ups: A COMISAIR Study. Diabetes Technology and
Therapeutics. Vol 18, No. 9, Sept. 2016.
View source
version on businesswire.com: http://www.businesswire.com/news/home/20170324005110/en/
DexCom, Inc.INVESTOR CONTACT:Steve Pacelli, 858-200-0200orPRESS
CONTACT:Melissa Katz, 215-514-0957
DexCom (NASDAQ:DXCM)
Historical Stock Chart
From Mar 2024 to Apr 2024
DexCom (NASDAQ:DXCM)
Historical Stock Chart
From Apr 2023 to Apr 2024