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CodeMap Compliance Briefing: 02/04/05


 

Editor's Welcome

On January 28th, CMS issued its latest instructions on the new diabetes screening benefit. Unlike the cardiovascular screening benefit that simply allows one lipid panel every five years, the diabetes screening rules are more complicated. Please feel free to email any questions on this or other screening coverage issues. We will try to answer as many inquiries as possible, either directly or as the subject of future CodeMap Compliance Briefings.

Sincerely,

Charles Root, Ph.D.

Final Diabetes Screening Rules

Coverage for Diabetes Screening Tests

Medicare patients already diagnosed with diabetes are not eligible for diabetes screening tests. Tests for such individuals are covered as medically necessary diagnostic tests when reported with covered diagnosis codes included in the glucose testing National Coverage Determination (NCD).

For coverage purposes, Medicare defines diabetes as: a condition of abnormal glucos....

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