Billing Code

Product Name

Description

Size

Min Benefit

Max Benefit

Note

DF001

DANAIIS Insulin Pump

Continuous insulin infusion pump

75mm x 45mm x 19mm

4000

AN011

Animas Vibe/One Touch Vibe Plus Insulin Pump

Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability

8.26 x 5.08 x 2.18cm

8950

DF002

DANAR Insulin Pump

The DANAR Insulin Pump is a small device about the size of a pager. It holds up to 300 units of insulin, which is delivered continuously through a small tube to the patient. The DANAR Insulin Pump also has an integrated blood glucose meter and remote control via bluetooth communication.

75 x 45 x 19mm, 60grams

8950

MS066

Cellnovo Insulin Infusion System

Continuous Subcutaneous Insulin Infusion Pump

The Cellnovo Insulin Infusion System is only available in one size.

8950

RB001

Accu-Chek Combo System

Insulin delivery device capable of remotely receiving and acting on information about blood glucose levels, performing bolus calculation and bolus advice on additional parameters than what is normally provided.

The Accu-Chek Combo System is only available in one size.

8950

RB002

ACCU-CHEK Insight System

Insulin delivery device capable of remotely receiving and acting on information about blood glucose levels, performing bolus calculation and bolus advice on additional parameters than what is normally provided.

No variable sizes offered. Only one system provided.

8950

MC839

Medtronic MiniMed Insulin Infusion Pump

Paradigm Veo Model MMT-554. 'Smart' Insulin Pump with REAL-Time continuous glucose monitoring capability, incorporating a low glucose suspend and with remote control.

5.1 x 7.6 x 2.0cm

9500

MC840

Medtronic MiniMed Insulin Infusion Pump

Paradigm Veo Model MMT-754. 'Smart' Insulin Pump with REAL-Time continuous glucose monitoring capability, incorporating a low glucose suspend and with remote control.

5.1 x 9.4 x 2.0cm

9500

MI150

MiniMed 640G Insulin Pump

MiniMed 640G Insulin Pump with SmartGuard Technology and continuous glucose monitoring capability, designed to automatically suspend insulin delivery before dangerous lows occur, and automatically resume after levels recover.

1.8ml and 3.0ml

9500

Billing Code

Product Name

Description

Size

Min Benefit

Max Benefit

Note

MC763

Reveal XT

Reveal XT Insertable Cardiac Monitor

61 x 19 x 8 mm with a volume of 9cc

3900

SJ152

SJM Confirm Model DM2102

Implantable cardiac monitor with atrial fibrillation monitoring.

6.5cc, 12g

3900

BT186

BioMonitor 2-AF  Implantable Cardiac Monitor

Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope

88.4 mm x 15.2 mm x 6.2 mm , 10.1g , 5cm3

3900

MI141

Reveal LINQ

Insertable Cardiac Monitor

45 x 7 x 3.5mm, 1.18cc

3900

BT187

CardioMessenger Smart 3G

Bedside/Remote transmitter w/ pacemaker/ICD device life network access to Biotronik standard home monitoring data management service.

Length - 130mm, Width - 65mm,  Height - 13mm        Weight - 75g

1960

MI196

MyCareLink Smart Patient Reader

Electronic cellular patient reader which gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.

One size only

1960

SA173

Smartview Remote Monitoring Solution

The Smartview PSTN monitor and Smartview Monitor GPRS - Pacemaker programmer is designed to allow physicians and nurses following patients with a Sorin PARADYMTM RF or INTENSIA family of ICD and CRT-D devices to access valuable cardiac data and alert messages from the device while the patient is at home.

Single Device Product

1960

SJ369

Merlin@Home wireless

Home cardiac monitor (RF) with landline, cellular and broadband connectivity

one size

1960

SJ370

Merlin@Home Inductive

Home cardiac monitor (inductive) with landline, cellular and broadband connectivity

one size

1960

BT179

Cardio Messenger II-S 3G

Bedside/Remote transmitter w/ ICD device life network access to Biotronik standard home monitoring data management service.

Bedside Device - 203 x 136mm x 80mm, 450 grams

1960

BS294

Latitude Communicator

Remote patient management system for implanted cardiac devices

One size only

1960

MI180

MyCareLink Patient Monitor

Electronic cellular patient monitor which gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.

One size

1960