Abbott Freestyle Libre Sensor 2 Glucose Monitoring Sensor Instructions
- June 3, 2024
- Abbott
Table of Contents
Abbott Freestyle Libre Sensor 2 Glucose Monitoring Sensor
PRESCRIPTION CRITERIA1
The Veteran has Type 1, Type 2, or other unspecify edh diabetes and requires an intensive insulin regimen (e.g. ≥3 injections/day, or insulin pump) to achieve desired glycemic control (target range) based upon shared decision- making, as recommended by VA/DoD Clinical Practice Guidelines Management of Diabetes Mellitus in Primary Care (2017).
The Veteran has the knowledge and skill set necessary to successfully utilize
CGMS, including an understanding of the need to do SMBG for calibration as
recommended by the manufacturer, and to evaluate “high” or “low” blood glucose
results or trends based upon readings and/or alarms as recommended by the FDA
and the treating healthcare team.
The Veteran has followed provider recommendations for SBGM and therapy
changes. This will assist providers with determining potential adherence with
CGMS, which is essential in achieving improved outcomes.
The Veteran agrees to ongoing medical appointments with the multidisciplinary
team at least every 6 months (more frequently as recommended) to assess the
adherence and benefit t derived from CGMS, which will be documented in the
medical record and used for justify cation for continued use.
Therapeutic CGM is provided based on the Veteran’s individual medical needs and is prescribed based upon clinician and patient shared decision making as recommended by the VA/DoD Guidelines of Management of Diabetes Mellitus in Primary Care (2017)2
- Data on File, Abbott Diabetes Care
- https://www.healthquality.va.gov/guidelines/CD/diabetes/DMCPGPocketcardfinal508.pdf. (Accessed July 8, 2022)
Abbott provides this information as a courtesy, it is subject to change and interpretation. The customer is ultimately responsible for determining the appropriate codes, coverage, and payment policies for individual patients. Abbott does not guarantee third party coverage or payment for our products or reimburse customers for claims that are denied by third party payors. See Important Safety Information on reverse.
**Ask your clinician how CGM could change the way you manage your
diabetes**
*To learn about the #1 CGM in the US, contact your Government Team at 1-844-324-5807 or visit www.Provider.FreeStyleLibre.us**
Medicare coverage is available for the Freestyle Libre 2 system if a
compatible smartphone is used in conjunction with the Freestyle Libre 2 reader
to review glucose data.
Medicare and other third party payor criteria apply.
Abbott provides this information as a courtesy, it is subject to change and
interpretation. The customer is ultimately responsible for determining the
appropriate codes, coverage, and payment policies for individual patients.
Abbott does not guarantee third party coverage or payment for our products or
reimburse customers for claims that are denied by third party payors.
*Data based on the number of patients assigned to each manufacturer based on last fi led prescription in US Retail Pharmacy and DME.
Important Safety Information
Failure to use Freestyle Libre 2 system as instructed in labeling may result
in missing a severe low or high glucose event and/or making a treatment
decision, resulting in injury. If glucose alarms and readings do not match
symptoms or expectations, use a fi gearstick value from a blood glucose meter
for treatment decisions. Seek medical attention when appropriate or contact
Abbott at 855-632-8658 or
https://www.FreeStyle.abbott/us-en/safety-information.html for safety info.
The circular shape of the sensor housing, Freestyle, Libre, and related brand
marks are marks of Abbott. Other trademarks are the property of their
respective owners. ©2022 Abbott. ADC-15397 v4.0 07/22