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Insulin Pump Requirements
MEDICARE OR MEDICAID
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C-peptide and FASTING Glucose drawn concurrently (Fasting glucose must be >225 for approval).
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C-peptide for Type 1 and Type 2 must be 10% of the lower reference range (i.e. Reference range is 1.0-3.0 then the labs must be 1.1 or lower).
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PROVIDENCE INSURANCE - *NEW* TO PUMP THERAPY
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C-peptide and FASTING Glucose drawn concurrently (Fasting glucose must be >225 for approval).
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C-peptide for Type 1 and Type 2 must be 10% of the lower reference range (i.e. Reference range is 1.0-3.0 then the labs must be 1.1 or lower).
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COMMERCIAL INSURANCE ON PUMP SWITCHING TO MEDICARE OR MEDICAID
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C-peptide and FASTING Glucose drawn concurrently (Fasting glucose must be >225 for approval).
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C-peptide for Type 1 and Type 2 must be 10% of the lower reference range (i.e. Reference range is 1.0-3.0 then the labs must be 1.1 or lower).
NOTE: Patients must contact their DME Supplier to initiate a new order/authorization request if patient updates their insurance plan.
ALSO
C-Peptide and Fasting Glucose lab results do not expire and may be reused.
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