EST. 1999
Screening for Pre-Diabetes and Type 2 Diabetes
Service:
USPSTF: United States Preventative Services Task Force
The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions.
Refer to Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors:
Behavioral Counseling Interventions
For intensive behavioral counseling interventions.
For additional diabetes screening benefits, also see the Expanded Women's Preventative Health section for Screening for Diabetes in Pregnancy and Screening for Diabetes After Pregnancy.
Procedure Code(s):
Medical Nutrition Therapy or Counseling:
97802, 97803, 97804, G0270, G0271
Preventative Medicine Individual Counseling:
99401, 99402, 99403, 99404
Behavioral Counseling or Therapy:
0403T, G0447, G0473, G9886
Diagnosis Code(s):
R73.03 (prediabetes)
Procedure Code(s):
Diabetes Screening:
82947, 82948, 82950, 82951, 82952, 83036
Blood Draw:
36415, 36416
Diagnosis Code(s):
Required Diagnosis Codes (requires at least one):
Z00.00, Z00.01, Z13.1
And one of the following additional diagnosis codes as follows:
Additional Diagnosis Codes (requires at least one):
Overweight:
E66.3, Z68.25, Z68.26, Z68.27, Z68.28, Z68.29
Obesity:
E66.01, E66.09, E66.1, E66.2, E66.811, E66.812, E66.813, E66.89 E66.9, E88.82, Z68.41, Z68.42, Z68.43, Z68.44, Z68.45
Body Mass Index 30.0 - 39.9:
Z68.30, Z68.31, Z68.32, Z68.33, Z68.34, Z68.35, Z68.36, Z68.37, Z68.38, Z68.39
Body Mass Index 40.0 and Over:
Z68.41, Z68.42, Z68.43, Z68.44, Z68.45
See the Expanded Women's Prevention Health Section for
Screening for Diabetes in Pregnancy and Screening for Diabetes After Pregnancy
Preventive Benefit Instructions:
Counseling requires diagnosis code R73.03
Diabetes Screening:
Limited to age 35-70 years (ends on 71st birthday).
Requires on of the Required Diagnosis Codes listed above and one of the listed Additional Diagnosis Codes above.
Blood Draw:
Requires all of the following:
One of the listed Diabetes Screening Procedure codes listed above and
One of the listed Required Diagnosis Codes and
One of the listed Additional Diagnosis Codes.
Preventive Benefits Does Not Apply:
If a Diabetes Diagnosis Code is present in any position, the preventative benefit does not apply; see the Diabetes Diagnosis Code List in the below link