Continuous Coverage and Clinical Application of Real-Time CGM:
Pathway to Improved Outcomes and Reduced Cost
with Kathleen Wyne, MD, PhD, and Eric A. Orzeck, MD

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Welcome and Introduction
Clinical Consult: Practical Use of CGM to Improve Clinical Outcomes
Real-Time CGM in Daily Practice: Patient Assessment and Interpretation
Continuous National Coverage of CGM: Pathway to Improved Outcomes, Reimbursement and Reduced Healthcare Cost
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Dr. Orzeck, if you look at the patients data and talk to them on the phone, can you bill the 95251 code for CGM interpretation for in-between office visits?
David Smith on 07/31/15
Yes, it's your interpretation of the data. It's a billable non face-to-face code.
Eric Orzeck, MD, FACP, FACE on 07/31/15
Dr. Wyne, have you seen CGM used in the inpatient unit at the hospital?
D. Jones, MD on 07/31/15
I've seen it used in a number of places in the hospital. I've had patients who have insisted on keeping the CGM on. One time there was a type 1 diabetes patient going in for a bone marrow transplant. He loved having his CGM; he felt so much safer having it with him throughout the 6 weeks when he was in the hospital. He ended up teaching the nurses at the hospital about it. The surgical ICU nurses like being able to walk into a patient's room and see what their glucose level is. CGM can be a great teaching tool, helping the staff, nurses, pharmacists, family members etc, learn about the patient's sugars, trends, and response to medication etc. However, we need studies to formally assess CGM use in the hospital and specifically demonstrate use in both ICU and non ICU settings.
Kathleen Wyne, MD, PhD, FACE, FNLA on 07/31/15
Dr. Wyne, How do you get CGM sensor to stick?
Alice Peart, MD on 07/31/15
Great question! Here are some tools we use in our practice. 1) Tegaderms, a transparent medical dressing 2) Bard wipes 3) a liquid adhesive called Mastisol that should be ordered in conjunction with its companion product Detachol, an adhesive remover
Kathleen Wyne, MD, PhD, FACE, FNLA on 07/31/15
Dr. Orzeck, Do you use the -25 modifier, when you are starting or stopping CGM?
Patricia Cunningham on 07/31/15
You can use the -25 modifier anytime you bill a second E&M code during the same visit. You should append the modifier to the E&M code representing the patient's visit.
Eric Orzeck, MD, FACP, FACE on 07/31/15
Dr. Orzeck, whether CGM can be used in the glycemic management of chronic kidney disease ? how to focus on behaviors??
radhika prakash on 04/19/16
SueEllen Weigel, RN, BSN, CDE, CCRC on 02/02/17
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