Dx Test experimental and investigational because there is inadequate evidence in the published peer- reviewed clinical literature regarding its effectiveness. Anti- GAD antibody measurement is considered experimental and investigational for predicting the onset of diabetes and for all other indications. Measurement of anti- GAD antibodies is also considered medically necessary in diagnosing stiff- person syndrome. Aetna considers measurement of autoantibodies to GAD medically necessary for distinguishing type 1 from type 2 diabetes when the clinical history is ambiguous and the results of testing will influence patient management. Glycated Serum Proteins (GSP)Aetna considers devices to measure glycated serum proteins (fructosamine) (e.ĭuet™ Glucose Control System by LXN Corporation) experimental and investigational because the clinical utility of monitoring glycated serum proteins has not been established. Glutamic Acid Decarboxylase (GAD) Autoantibodies. There is insufficient evidence in the peer- reviewed medical literature that laser skin perforation offers clinically significant advantages over standard lancets. Aetna considers the Lasette laser blood glucose monitoring device (Cell Robotics International Inc., Albuquerque, NM), which uses a laser instead of a lancet to perforate the skin to obtain a blood sample for glucose measurement, experimental and investigational. Lasette™ Laser Blood Glucose Monitoring Device. Note: Coverage of diabetic supplies varies by medical and pharmacy plan.
The following diabetic supplies are considered medically necessary for persons with diabetes: Alcohol swabs Blood glucose monitors Blood glucose test strips Control solutions Insulin pens Lancets Needles and syringes for insulin administration and. The program is ordered by the physician treating the member's diabetes and includes a statement signed by the physician that the service is needed.
The program is designed to educate the member about medically necessary diabetes self- care and.
Aetna considers outpatient medical self- care programs medically necessary for persons with diabetes when such programs meet the following criteria: The program consists of services of recognized healthcare professionals (e. Please check plan benefits.ĭiabetes Self- Care Programs. Certain diabetic supplies may also be covered under the medical plan if no pharmacy or diabetic supplies rider is available. Note: Except for Medicare plans and where coverage is mandated by state law, generally coverage for diabetic supplies would be provided under a pharmacy rider and not as part of medical coverage.
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