Tuesday, March 8, 2016

Diabetes screening CPT CODE 82947, 82950, 82951 ICD 10 Z13.1

Diabetes Screening*

HCPCS/CPT Codes

82947 – Glucose; quantitative, blood (except reagent strip)
82950 – Glucose; post glucose dose (includes glucose)
82951 – Glucose; tolerance test (GTT), 3 specimens (includes glucose)

ICD-10-CM Codes
Z13.1

Who Is Covered

 Medicare beneficiaries with certain risk factors for diabetes or diagnosed with pre-diabetes NOTE: Beneficiaries previously diagnosed
with diabetes are not eligible for this benefit


Frequency

• Two screening tests per year for beneficiaries diagnosed with pre-diabetes; or
• One screening per year if previously tested but not diagnosed with pre-diabetes or if never tested

Beneficiary Pays
• Copayment/coinsurance waived
• Deductible waived


*Medicare will only pay claims for DME if the ordering physician and DME supplier are actively enrolled in Medicare on the date of service. Physicians and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If you are not enrolled on the date the prescription is filled or re-filled, Medicare will not pay the submitted claims. It is also important to tell the Medicare beneficiary if you are not participating in Medicare before you order DME. If you do not have an active record, please see the following fact sheet containing information on how to enroll, revalidate your enrollment, and/or make a change:  ttps://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/CMS1243432.html on the CMS website.

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