Glycated Hemoglobin/Glycated Protein

Glycated hemoglobin/protein testing is covered for management and long-term monitoring of diabetes and for assessing hyper- or hypoglycemia; glycated protein may substitute for HbA1c in patients with erythrocyte abnormalities. Routine HbA1c testing for a controlled diabetic is limited to every 3 months (monthly maximum for pregnant diabetics), while more frequent testing (eg, every 1–2 months or >4/year) is allowed for uncontrolled disease or regimen changes with supporting medical necessity documentation.

"Glycated hemoglobin/protein testing is medically necessary for ongoing management and long-term control of diabetes mellitus (type 1 or type 2)."

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