PURPOSE
To establish a basis for determining medical necessity in order to diagnose, educate, and treat those individuals with diabetes.
DESCRIPTION
Diabetes is a chronic illness in which carbohydrate metabolism is severely impaired, characterized by hyperglycemia and glycosuria and resulting from inadequate production or utilization of insulin. The individual diagnosed with diabetes requires continuing medical care and education in order to prevent acute complications and to reduce the risk of developing other conditions related to uncontrolled blood glucose levels such as: retinopathy, nephropathy, neuropathy and/or cardiovascular disease.
POLICY
BlueCross BlueShield of Tennessee recognizes the need for consistency in the determination of medical appropriateness for testing and treatment of diabetes.
Services will be considered medically appropriate only if they have met BlueCross BlueShield of Tennessee's technology evaluation criteria.
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THE FOLLOWING POLICIES HAVE BEEN |
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REVIEWED. PLEASE REFER TO THE POLICY |
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TO DETERMINE MEDICAL APPROPRIATENESS. |
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DIAGNOSTICS:
Short-Term and Long-Term Continuous Glucose Monitoring of the Interstitial Fluid
THERAPEUTICS:
ORIGINAL EFFECTIVE DATE: 7/1/1997
MOST RECENT REVIEW DATE: 2/2/2012
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
This document has been classified as public information.