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New codes for continuous glucose monitors

This article was originally published in The Gray Sheet

Executive Summary

The next-generation devices are granted unique level-II HCPCS codes from CMS starting Jan. 1, 2008. Three codes will designate the CGM components: sensor, transmitter and receiver. The decision, released Nov. 5, finalizes the Medicare agency's spring proposal (1"The Gray Sheet" April 16, 2007, p. 6). Continuous glucose monitors on the U.S. market include Medtronic's Guardian Real-Time monitor and Paradigm Real-Time system with integrated insulin pump, and DexCom's Seven monitor. Abbott expects an early 2008 launch of its Freestyle Navigator continuous monitor, which remains under FDA review. The new codes represent a first step towards gaining broader coverage and reimbursement for the devices, for which patients generally pay out-of-pocket today
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