Not literally. But it made you read this discussion, didn’t it?!?
I received a call from a Dexcom representative about a week ago, telling me that my latest sensor shipment wouldn’t be processed until my Dr sent a code they needed for Aetna to help pay for the shipment (Aetna primary thru school, BCBS of SD as secondary thru Papa Willie). The rep said she’d contact my doc, get the paper work, etc then call me back when things were a go. I was slightly confused because we’d just (in March) re-faxed the prescription code to Dexcom for this same issue. Anywho, I let it slide because I was going to be traveling back to school soon and had a million and one other things on my mind.
Fast forward a week, and I receive another call from the rep saying my dr didn’t want to give the code and that Aetna probably wouldn’t pay for the sensors. She seemed a bit mystified and offended the doc didn’t follower her direction I told her, knowing my stubborn yet very attentive doc, I would look into it and let her know what we could do. So I emailed my doc and she said that Dexcom was asking for a “frequent severe hypoglycemia” code and #1 I have not ever had a severe episode (knock wood) in my three years of T1D nor did I have documentation of frequent hypoglycemia and #2 the health center doesn’t even have that code in their computer system!!! She wrote me a “uncontrolled diabetes” code (I’ve not had an A1c <7 in about a year (uncontrolled in my book)), but said she wouldn’t do much else. And on this I am with the doc. I do not know how I’ve gone a year with Dexcom and not run into this code problem before now. Perhaps it was those “make up a few <50mg/dL numbers” that I fudged (on a recommendation from Dexcom when applying for the sensor) a year ago that tided me over until now.
If I have to lie (again I guess) in order to get what I want/need, I won’t be able to do it. Has anyone else run into this problem? Isn’t it frustrating when realizing such an awesome and life-changing technology can be taken so easily from your tool kit? It’s pretty dumb that just because I do not have “frequent” hypoglycemic episodes I won’t be able to use a sensor which could literally save anyone’s life (regardless of documented history of hypoglycemia). Perhaps this goes back to the idea that, in health care’s eyes, hypoglycemia is more of a risk (malpractice?!?) than hyperglycemia. I’m not saying hypoglycemia is not an immediate threat (it is, undoubtedly), but does that mean hyperglycemia is not just as (long-term, specifically) dangerous and important to treat?
If you’ve read this far I thank you. And as I reread my post, I realize others have probably written about the same frustrations.