Lyumjev approved for Medicare with pumps

Type 1 and LADA
1

Just to let everyone know Lyumjev and Fiasp are now approved by medicare for use with an insulin pump.

"JK AND JL MODIFIERS

The JK and JL modifiers will be effective for claims with dates of service on or after April 1, 2023, for insulin (J1817) administered through an external insulin infusion pump (E0784), and for claims with dates of service on or after July 1, 2023, for insulin (fiasp) (J1811) and insulin (lyumjev) (J1813) administration through an external insulin infusion pump (E0784).

For a one-month or less supply of insulin, JK modifier must be added to HCPCS codes J1811, J1813 or J1817
For a three-month supply of insulin, JL modifier must be added to HCPCS codes J1811, J1813 or J1817"

This is from CMS. My Walgreens still refuses to fill it under Part B, so I have had to switch to CVS, instead of hassling with them.

2

Walgreens has a problem with their software. It will accept Fiasp but not Lumijev. I was told that the software would NOT be updated until next year when a new version is expected. This is a multi-billion dollar corporation and they can’t have software that works correctly???

Since both are pretty close to the same I went with Fiasp and will see how I respond to it. I’ve been on Humalog for a week since this happened and my time in range has dropped from 97% to 87%. I’m hoping to get back to my upper 90’s after my body gets used to the change of insulin.