What Is Continuous Glucose Monitoring (CGM)?
CGM is a sensor-based technology that measures glucose from the interstitial fluid.
Takes glucose measurements at regular intervals, 24 hours a day.
Live data helps users make treatment decisions.
How Do You Use A Continuous Glucose Monitor?
Glucose sensor is worn on the outside of the body, but the sensor filament is inserted under the skin to check glucose levels in the tissue fluid.
Sensor connected to a transmitter wirelessly sends information to a display device via wireless radio frequency.
The Benefits of CGM
• CGMs provide a complete picture, not just a point in time, and can provide real-time alerts of potential harmful highs and lows.
• The technology is advancing quickly and provides actionable patient insight for dosing.
• Better on the patient
• Decrease HbA1C
• Increase Time in Range
• No more painful finger sticks
• Don’t have to wake up to test anymore
• Data can be easily shared with physicians and other caregivers.
FreeStyle Libre 2 System
Consists of a handheld reader, applicator & sensor worn on the back of the upper arm.
The sensor uses a thin, flexible filament inserted under the skin to measure glucose every minute. Sensors last up to 14 days of wear.
FreeStyle Libre 3 System
The smallest, thinnest, and most discreet sensor (smaller than 2 pennies stacked) packaged in a simpler 1 piece
preloaded applicator. Minute to minute glucose readings are continuously streamed directly to the patient’s smartphone or the FreeStyle Libre 3 reader.
Dexcom G7 System
Smaller, all in one, discreet wearable sensor. 10 day wear, plus a 12 hour grace period to swap with a new sensor when convenient for the patient.
According to the U.S. Centers for Medicare & Medicaid Services (CMS), to be eligible for coverage of a CGM and related supplies, the beneficiary must meet all of the following initial coverage criteria 1-5 as described below:
CRITERIA:
1. The beneficiary has Type 1 or Type 2 diabetes; and,
2. The beneficiary’s treating PCP/Specialist has concluded that the beneficiary (or beneficiary’s caregiver) has sufficient training using the CGM prescribed, as evidenced by providing a prescription; and,
3. The CGM is prescribed in accordance with its FDA indications for use; and,
4. The beneficiary for whom a CGM is being prescribed, to improve glycemic control, meets at least one of the criteria below:
a.The beneficiary is insulin treated; or,
b.The beneficiary has a history of problematic hypoglycemia with documentation of at least one of the following: Recurrent (more than one) level 2 hypoglycemic events (glucose <54mg/dL (3.0mmol/L)) that persist despite multiple (more than one) attempts to adjust medication(s ) and/or modify the diabetes treatment plan; or, A history of one level 3 hypoglycemic event (glucose <54mg/dL (3.0mmol/L)) characterized by altered mental and/or physical state requiring third party assistance for treatment of hypoglycemia.
5. Within six (6) months prior to ordering the CGM, the treating practitioner has an in
person or Medicare approved
telehealth visit with the beneficiary to evaluate their diabetes control and determine those criteria (1) 1)–(4) above are
