Covered by Medicare for patients who are diabetic (ICD-9 Code 250.00-250.93) and who can better control their blood glucose levels by checking these levels and appropriately contacting their attending physician for advice and treatment.

Utilization Limits for Supplies

Normal utilization:

• For a patient who is not currently being treated with insulin injections, up to 100 test strips and 100 lancets every 3 months.

• For a patient who is currently being treated with insulin injections, up to 100 test strips and 100 lancets every month.

Patient has ICD-9 Code 250.00 - 250.93 which is being treated by a physician, the monitor and supplies have been ordered by the treating physician, the patient or caregiver has been trained in the use of the monitor and supplies, the patient (or caregiver) is capable of using the test results to assure the patient's appropriate glycemic control and the monitor is designed for home use.

High utilization:

• For a patient who is not currently being treated with insulin injections, more than 100 test strips and 100 lancets every 3 months.

• For a patient who is currently being treated with insulin injections, more than 100 test strips and 100 lancets every month.

Normal utilization requirements listed above must be met in addition to the following: the beneficiary has nearly exhausted his/her current supply; the treating physician has ordered a frequency of testing that exceeds the utilization and has documentation to support his; and the physician has seen the patient and evaluated their diabetic control within 6 months prior to ordering quantities that exceed normal utilization.

A beneficiary or their caregiver must specifically request refills of glucose monitor supplies before they are dispensed. The supplier must not automatically dispense a quantity of supplies on a predetermined regular basis, even if the beneficiary has "authorized" this in advance.

No more than a 3-month supply of test strips and/or lancets should be dispensed at a time. A new prescription is required every 12 months for the glucose monitor and supplies. Suppliers must file claims for glucose supplies and test strips on behalf of the beneficiary. Medicare will not accept claims filed by the beneficiary. Additionally, "from" and "to" dates (e.g. 04/01/02 - 06/30/02) must be documented on claims for supplies.