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Wiki Pre-Diabetes

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marywoodyard

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New prediabetes ICD-10 codes.
I have a provider who is trying to genetically test children who have a family history of diabetes 1.
The new codes for diabetes type 1 started on January 1, 2025, and have a level 1 and a level 2 which does not meet the requirement for the testing for a patient that does not have prediabetes but as they are doing this genetically approved testing the provider said he had heard of a change in diabetes 1 coding to meet this requirement. Has anyone seen any further changes to the diabetes 1 ICD-10 coding?
 
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marywoodyard said:
New prediabetes ICD-10 codes.
I have a provider who is trying to genetically test children who have a family history of diabetes 1.
The new codes for diabetes type 1 started on January 1, 2025, and have a level 1 and a level 2 which does not meet the requirement for the testing for a patient that does not have prediabetes but as they are doing this genetically approved testing the provider said he had heard of a change in diabetes 1 coding to meet this requirement. Has anyone seen any further changes to the diabetes 1 ICD-10 coding?
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I believe the physician is talking about codes E10.A0-E10.A2 that are used to report presymptomatic type 1 diabetes. From what I have read (and I am not a clinician), these codes provide an important differentiation between prediabetes (usually high blood glucose in type 2 diabetes) and the presence of autoantibodies that can be identified prior to symptoms appearing in type 1 diabetes. When screening results in a diagnosis of presymptomatic type 1 diabetes, a patient may be eligible for clinical trials aimed at prolonging or preventing symptomatic disease and/or close monitoring for onset of symptoms.
A code for family history of diabetes is appropriate when the patient is being screened for the autoantibodies. However, payer policies for coverage of genetic testing may vary and qualified children can be tested for free (https://www.trialnet.org/our-research/risk-screening).
I hope that helps.
Cindy
 
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