Pathology/Lab Coding Alert

But pre-diabetes means more frequent testing  Medicare's annual screening coverage applies to those at risk for developing diabetes, says Maggie Mac, a healthcare consultant with Pershing, Yoakley & Associates in Clearwater, Fla. Medicare says it will consider patients to be "at risk" if they present with at least one of the following conditions:

 hypertension

 dyslipidemia

 obesity (a body mass index equal to or greater than 30 kg/m2)

 previously identified elevated fasting glucose or glucose intolerance. Or, individuals who have at least two of the following characteristics are eligible for Medicare's diabetes screening benefit:
 overweight (a body mass index greater than 25, but less than 30 kg/m2)

 a family history of diabetes

 age 65 years or older

 a history of gestational diabetes mellitus, or delivering a baby weighing more than nine pounds. Pre-Diabetes Means Rescreening at 6 Months Your lab can get paid for two screening tests per year for individuals diagnosed with pre-diabetes. Otherwise, Medicare only covers one screening per year. Pre-diabetes means that the patient exhibits impaired fasting glucose or impaired glucose tolerance. Medicare specifically defines pre-diabetes as a fasting glucose level of 100 to 125 mg/dL, or a 2-hour post-glucose challenge of 140 to 199 mg/dL.