September 1st, 2017
The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Diabetes Screening:
|82947 -||Glucose; quantitative, blood (except reagent strip)|
|82950 -||Glucose; post glucose dose (includes glucose)|
|82951 -||Glucose; tolerance test (GTT), 3 specimens (includes glucose)|
Who Is Covered
Medicare beneficiaries with certain risk factors for diabetes or diagnosed with pre-diabetes
NOTE: Medicare beneficiaries previously diagnosed with diabetes are not eligible for this benefit
- One screening every 6 months for Medicare beneficiaries diagnosed with pre-diabetes
- One screening every 12 months if previously tested but not diagnosed with pre-diabetes or if never tested
Medicare Beneficiary Pays
- Copayment/coinsurance waived
- Deductible waived
- Append modifier -TS when submitting claims for Medicare beneficiaries with pre-diabetes.
- Medicare only pays claims for Durable Medicare Equipment (DME) if the ordering provider and DME supplier are actively enrolled in Medicare on the date of service. Tell your Medicare patients if you are not participating in Medicare before you order DME. Refer to Medicare Enrollment Guidelines for Ordering/Referring Providers for information on how to enroll as an ordering/referring provider.
Please note: The information in this educational product applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). For additional guidance on using diagnosis codes, go to the Medicare Claims Processing Manual, Chapter 18 on the Centers for Medicare & Medicaid Services (CMS) website.
Watch the CMS Provider Minute: Preventive Services video for pointers to help you submit sufficient documentation when billing for certain preventive services.