How do I submit an order for glucose strips for a patient?

How to Submit an Order for Glucose Strips

To order glucose strips for a patient, you must first document the medical necessity by confirming the patient has diabetes requiring glucose monitoring, then submit a prescription specifying the meter type, strip quantity based on testing frequency, and diagnosis code through your institution's ordering system or to the patient's pharmacy/durable medical equipment supplier. 1

Determine Medical Necessity and Testing Frequency

Self-monitoring blood glucose (SMBG) is medically necessary for all insulin-treated patients with diabetes. 1 The frequency of testing determines the quantity of strips to order:

• Insulin-treated patients (Type 1): Order strips for testing 3 or more times daily 1
• Insulin-treated patients (Type 2): Order strips based on regimen complexity - basal-bolus requires pre-meal and bedtime testing 1
• Non-insulin treated patients on sulfonylureas or other secretagogues: Order strips for periodic monitoring to prevent hypoglycemia 1
• Patients on non-hypoglycemic agents: Testing frequency should be sufficient to facilitate reaching glucose goals when adjusting therapy 1

Specify the Correct Glucose Meter and Strips

You must specify FDA-approved meters with proven accuracy and ensure strips are compatible with the patient's meter. 1 Key considerations:

• Only 6 of the top 18 glucose meters meet FDA accuracy standards (95% of readings within 15% of actual glucose) 1
• Glucose oxidase-based meters should only be used in patients with normal oxygen saturation, as hypoxia causes falsely high readings and supplemental oxygen causes falsely low readings 1
• Glucose dehydrogenase-based meters are oxygen-independent and preferred for patients with variable oxygen status 1
• Avoid counterfeit strips by ordering only from licensed pharmacies or distributors 1

Required Prescription Elements

Your order must include:

• Patient diagnosis (ICD-10 code for diabetes type) 1
• Specific meter brand and model 1
• Strip quantity (calculate: testing frequency × 30-90 days supply) 1
• Testing frequency instructions (e.g., "Test fasting, before meals and snacks, at bedtime, prior to exercise, when hypoglycemia suspected") 1
• Justification for insulin-treated status if applicable 1

Insurance Coverage Requirements

Medical nutrition therapy (MNT), diabetes self-management education (DSME), and glucose monitoring supplies must be covered by insurance and third-party payers. 1 To ensure coverage:

• Document that strips are purchased from pharmacy or licensed distributor with unexpired dates 1
• Verify the patient's insurance formulary accepts the prescribed meter/strips 1
• Include diagnosis code clearly in the medical record 1

Special Populations

Hospitalized patients: All patients with diabetes admitted to hospital must have an order for blood glucose monitoring with results available to the entire care team 1

Patients using continuous glucose monitoring (CGM): Even patients on CGM must have access to blood glucose monitoring strips at all times as backup 1

Correctional facility patients: Systems must ensure insulin administration and meals are coordinated, with adequate strip supply for the monitoring frequency required by the patient's regimen 1

Common Pitfalls to Avoid

• Do not order generic "glucose strips" without specifying meter compatibility - strips are not interchangeable between meters 2, 3
• Do not assume all meters are equally accurate - only FDA-approved meters meeting accuracy standards should be prescribed 1
• Do not order insufficient quantities - insulin-treated patients require minimum 90-100 strips monthly for 3× daily testing 1
• Do not forget to specify high-dose vitamin C or hypoxemia as contraindications for certain meter types 1, 4