LCD Reference Article Response To Comments Article

Response to Comments: Implantable Continuous Glucose Monitors (I-CGM)

A59832

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Source Article ID
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Article ID
A59832
Original ICD-9 Article ID
Not Applicable
Article Title
Response to Comments: Implantable Continuous Glucose Monitors (I-CGM)
Article Type
Response to Comments
Original Effective Date
06/27/2024
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The following are the comment summaries and contractor responses for Novitas Solutions Proposed Local Coverage Determination (LCD) DL38617 Implantable Continuous Glucose Monitors (I-CGM) which was posted for comment on February 15, 2024, and presented at the March 2024 Open Meeting. All comments were reviewed and incorporated into the final LCD where applicable.

Response To Comments

Number Comment Response
1

A comment was submitted by an endocrinologist and diabetes specialist offering strong support for the revised LCD.

Thank you for your comment and your support.

2

Senseonics submitted a comment agreeing with our updated proposed coverage criteria. However, they are requesting that all applicable ICD-10-CM codes be included to ensure parity across all coverage policies for CGMs. A list of 81 codes was submitted with 4 codes being highlighted as critical because they are consistently used by providers.

Thank you for your support of the expanded coverage. The requested list of ICD-10-CM codes submitted contains all unspecified diabetes diagnosis codes. Medicare requires providers to use diagnosis codes to the highest level of specificity. We have reviewed the requested codes and believe that they lack specificity. Therefore, they will not be added to the final article. Please note that ICD-10-CM code E08.3291 and E08.3521, which were included on your request, are included in the article.

3

A comment was submitted from a practicing clinical endocrinologist supporting the proposed LCD indicating that it will improve diabetes care for patients.

Thank you for your comment and your support.

4

A comment was received from an endocrinologist supporting the proposed LCD indicating that this will be good for patient care.

Thank you for your comment and your support.

5

A comment was submitted on behalf of the Juvenile Diabetes Research Foundation (JDRF) supporting the proposed LCD indicating that the proposed coverage criteria will promote improved health outcomes like decreased morbidity and mortality, and reduced harm from treatments while improving patient quality of life.

Thank you for your comment and your support.

6

A comment was received from the Diabetes Technology Access Coalition offering strong support for the proposed revisions to the LCD as the changes align with their mission of ensuring all individuals have access to diabetes technologies.

Thank you for your comment and your support.

7

A comment was received from the American Diabetes Association (ADA) offering strong support for the revised LCD. They explained that diabetes technology, like CGMs, when coupled with diabetes self-management, education, support, and follow-up improve the lives and health of people with diabetes.

Thank you for your comment and your support.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L38617 - Implantable Continuous Glucose Monitors (I-CGM)
Related National Coverage Documents
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SAD Process URL 1
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Public Versions
Updated On Effective Dates Status
06/21/2024 06/27/2024 - N/A Currently in Effect You are here

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