Diabetes Screening

HCPCS/CPT Codes

  • 82947 - Glucose; quantitative, blood
  • 82950 - Glucose; post glucose dose
  • 82951 - Glucose; tolerance test, three specimens
  • 83036 - Hemoglobin A1C (HbA1c)

Frequency

Two screenings within the 12-month period following the date of the patient’s most recent diabetes screening test

Diagnosis Code

Z13.1 - Encounter for screening for diabetes mellitus

Coverage

Medicare beneficiaries with certain risk factors or diagnosed with pre-diabetes

Risk factors:

  • Any one:
    • Hypertension
    • Dyslipidemia
    • Obesity
    • Previous identification of elevated impaired fasting glucose or glucose tolerance
  • Any two:
    • Overweight
    • Family history
    • Age 65 or older
    • History of gestational diabetes mellitus or delivering baby weighing over nine pounds

This screening is noncovered for beneficiaries previously diagnosed as diabetic

Payment

Copayment/coinsurance waived; Deductible waived

Noridian Medicare Portal

Yes - 82947, 82950, 82951, and 83036

Resources

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