{"id":299,"date":"2014-01-17T17:03:42","date_gmt":"2014-01-17T17:03:42","guid":{"rendered":"http:\/\/www.akron.duonglam.ca\/?page_id=299"},"modified":"2024-12-02T15:58:55","modified_gmt":"2024-12-02T15:58:55","slug":"odb-diabetic-strip-limits-override-codes","status":"publish","type":"page","link":"https:\/\/www.akron.duonglam.ca\/?page_id=299","title":{"rendered":"ODB Diabetic Strip Limits &#8211; Override Codes"},"content":{"rendered":"<p><strong>Limits<\/strong><\/p>\n<p>Patients managing diabetes with insulin &#8211; <strong>3,000 <\/strong><\/p>\n<p>Patients managing diabetes with anti-diabetes medication with high risk of causing hypoglycemia\u00a0 (- glyburide, gliclazide )- <strong>400<\/strong><\/p>\n<p>Paatients managing diabetes using anti-diabetes medication with low risk of causing hypoglycemia &#8211; <strong>200<\/strong><\/p>\n<p>Patients managing diabetes through diet\/lifestyle\u00a0therapy only (no insulin or anti-diabetes<br \/>\nmedications) \u00a0 &#8211;\u00a0<strong>200<br \/>\n**Including but not limited to metformin, sitagliptin phosphate monohydrate, saxagliptin, acarbose, rosiglitazone, pioglitazone, linagliptin, liraglutide, empagliflozin or dapagliflozin<br \/>\n<\/strong><\/p>\n<p><strong>Override<\/strong><br \/>\nThere may be exceptional clinical circumstances where patients may require additional<br \/>\ntest strips. When a patient has reached their limit of available test strips in a 365-day<br \/>\nperiod, two intervention codes are available for pharmacists. Documentation to support<br \/>\nthe application of each intervention code is required. Pharmacists must keep this<br \/>\ninformation on file at the pharmacy for not less than two years for audit purposes.<br \/>\n1. Override\/intervention code \u201c<strong>NF \u2013 Override \u2013 Quantity Appropriate<\/strong>\u201d<br \/>\nThis intervention code may be used for patients who require more than 200 test<br \/>\nstrips in a 365-day period, because they had claims for insulin and\/or anti-diabetes<br \/>\nmedications (at high risk for hypoglycemia) in the previous six months, that were<br \/>\nnot reimbursed under the ODB program. The identified anti-diabetes medications<br \/>\nthat were reimbursed by private drug insurance plans or paid by the patient, must<br \/>\nbe documented and readily available for audit purposes.<\/p>\n<p>2. Override\/intervention code \u201c<strong>MG \u2013 Override \u2013 Clinical Reasons<\/strong>\u201d<br \/>\nThis override code will allow for 100 additional test strips to be reimbursed for<br \/>\npatients who have been directed by a healthcare professional to monitor blood<br \/>\nglucose levels more frequently for a specific clinical reason. Documentation must<br \/>\ninclude the reason for exceeding the recommended frequency of monitoring and<br \/>\nthe name of the referring healthcare professional and Ontario College of<br \/>\nPharmacists (OCP) ID number<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Limits Patients managing diabetes with insulin &#8211; 3,000 Patients managing diabetes with anti-diabetes medication with high risk of causing hypoglycemia\u00a0 (- glyburide, gliclazide )- 400 Paatients managing diabetes using anti-diabetes medication with low risk of causing hypoglycemia &#8211; 200 Patients<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.akron.duonglam.ca\/?page_id=299\">Read more &#8250;<\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":125,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-299","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=\/wp\/v2\/pages\/299","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=299"}],"version-history":[{"count":4,"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=\/wp\/v2\/pages\/299\/revisions"}],"predecessor-version":[{"id":794,"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=\/wp\/v2\/pages\/299\/revisions\/794"}],"up":[{"embeddable":true,"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=\/wp\/v2\/pages\/125"}],"wp:attachment":[{"href":"https:\/\/www.akron.duonglam.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=299"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}