Problem:
A 38-year-old female was diagnosed with IDDM Type 1 6 months ago. She was compliant with her treatment plan, but experienced difficulty controlling episodes of hypoglycemia. An automated insulin delivery system including continuous glucose monitor (CGM), blood glucose device, insulin pump, and computer algorithm was requested and approved for purchase. The patient has experienced greater control over hypoglycemic episodes since using the equipment. Her provider has documented that the patient has completed a comprehensive diabetes education program and is compliant with her treatment plan and monitoring of her glucose levels. The pump was recently irreparably damaged and is not covered by the manufacturer warranty. The provider feels the patient would benefit from continued use of an automated insulin delivery system including CGM, blood glucose device, insulin pump, and computer algorithm and would like the patient to receive the same or similar device. Is the request medically appropriate? Review Later No, additional information regarding the requested DME is required to conduct a review. No, additional information is required regarding the patient's clinical status to conduct a review. Yes, criteria are met for the requested DME. Current evidence does not support durable medical equipment in this clinical scenario. Need Assignment Help?