Home Blood Glucose Monitors

Home Blood Glucose Monitors

You can use the printable clinical templates and suggested clinical data elements (CDEs) for the order, face-to-face encounter, and lab test results to assist with documenting your medical records to support the need for basic and specialty home blood glucose monitors and supplies.

Health IT Vendors: To use the suggested CDEs, download or print and use as guidance in creating or enhancing existing electronic clinical templates within your electronic health record (EHR) system.

Providers: To use a printable clinical template, download and/or print the template, complete as applicable and file in the patient’s medical record.

Type of DocumentationDownload
Order 
F2F Encounter 
Lab Test Results 
Basic Home Blood Glucose Monitor & Supplies OrderCDEs (PDF) Draft R1.0a 9/5/2017
 Template (PDF) Draft R1.0a 9/5/2017
Specialty Home Blood Glucose Monitor & Supplies OrderCDEs (PDF) Draft R1.0a 9/5/2017
 Template (PDF) Draft R1.0a 9/5/2017
Basic Home Blood Glucose Monitor & Supplies F2F EncounterCDEs (PDF) Draft R1.0a 9/5/2017
 Template (PDF) Draft R1.0b 10/31/2017
Basic & Specialty Home Blood Glucose Monitor Lab Test ResultsCDEs (PDF) Draft R1.0a 9/5/2017
 Template (PDF) Draft R1.0a 9/5/2017

 

We want to hear from you! Email us your comments and suggestions about the draft templates and CDEs.

 

Page Last Modified:
12/14/2023 12:28 PM