Find information on diabetes screening, including diabetes mellitus screening and prediabetes screening. Learn about clinical documentation and medical coding for diabetes mellitus, covering diagnosis, risk factors, and management. This resource provides guidance for healthcare professionals on screening for diabetes mellitus and implementing appropriate preventive measures. Explore details regarding diagnostic criteria, A1C testing, fasting plasma glucose, and oral glucose tolerance tests for accurate diabetes screening and effective patient care.
Also known as
Encounter for screening for diabetes mellitus
Screening for diabetes mellitus.
Other abnormal glucose
Includes impaired glucose tolerance and impaired fasting glucose, not diabetes.
Factors influencing health status and contact with health services
Encompasses general health examinations, including those for specific diseases like diabetes.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is this a routine screening?
Yes
Personal history of gestational diabetes?
No
Is diabetes suspected?
When to use each related code
| Description |
|---|
| Screening for diabetes and prediabetes. |
| Elevated blood glucose, not meeting diabetes criteria. |
| Diagnosed with type 2 diabetes. |
Coding requires specific type (1, 2, gestational) or prediabetes. Unspecified diagnoses impact quality metrics and reimbursement.
Missing lab results (A1C, FPG) or clinical findings in documentation can lead to claim denials and compliance issues.
Coding a screening test as a confirmed diagnosis without diagnostic confirmation is fraudulent and results in overpayment.
Q: What are the most current ADA recommendations for diabetes screening in asymptomatic adults, and how can I efficiently implement these guidelines in a busy primary care setting?
A: The American Diabetes Association (ADA) recommends screening all adults for prediabetes and type 2 diabetes starting at age 35, and earlier for those with risk factors such as overweight/obesity (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans), family history of diabetes, history of gestational diabetes, or belonging to high-risk racial/ethnic groups (African American, Latino, Native American, Asian American, Pacific Islander). For patients with normal risk and negative initial screening results, repeat testing should be considered at a minimum of 3-year intervals. Efficient implementation in a busy primary care setting can be achieved by incorporating screening into routine check-ups, using validated risk assessment tools, and implementing electronic health record (EHR) reminders. Explore how standardized screening protocols and patient education materials can further enhance efficiency and improve patient adherence to follow-up testing. Consider implementing point-of-care A1C testing to streamline the screening process. Learn more about the ADA's risk-based screening algorithm for individualized patient care.
Q: When should I consider screening for type 2 diabetes in children and adolescents, and what are the specific diagnostic criteria according to the latest clinical guidelines?
A: Screening for type 2 diabetes in children and adolescents is recommended for those with overweight/obesity (BMI ≥85th percentile for age and sex, weight for height ≥85th percentile, or weight ≥120% of ideal for height) and at least two additional risk factors, including family history of type 2 diabetes in a first- or second-degree relative, high-risk race/ethnicity (African American, Latino, Native American, Asian American, Pacific Islander), signs of insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, polycystic ovary syndrome), or maternal history of diabetes or gestational diabetes during the child's gestation. Diagnostic criteria include fasting plasma glucose ≥126 mg/dL, 2-hour plasma glucose ≥200 mg/dL during a 75-g oral glucose tolerance test (OGTT), A1C ≥6.5%, or random plasma glucose ≥200 mg/dL with classic symptoms of hyperglycemia. Consider implementing age-appropriate lifestyle interventions for children and adolescents identified as high-risk. Explore the International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines for detailed recommendations on screening and management. Learn more about promoting healthy lifestyle choices to prevent or delay the onset of type 2 diabetes in youth.
Patient presents for diabetes screening due to family history of type 2 diabetes mellitus and recent weight gain. Risk factors assessed include age, ethnicity, body mass index (BMI) currently calculated at 31 kg/m2, and sedentary lifestyle. Patient reports no classic symptoms of hyperglycemia such as polyuria, polydipsia, or polyphagia. Current medications include lisinopril for hypertension. Physical examination unremarkable. Plan includes hemoglobin A1c (HbA1c) testing and fasting plasma glucose (FPG) measurement to screen for prediabetes and diabetes. Patient education provided on lifestyle modifications including diet, exercise, and weight management. Follow-up appointment scheduled to review lab results and discuss management plan based on diagnostic criteria for diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance. ICD-10 code Z13.1 for encounter for screening for diabetes mellitus will be used for medical billing and coding. Differential diagnosis includes prediabetes, type 1 diabetes, and type 2 diabetes. Further evaluation may include oral glucose tolerance test (OGTT) if initial screening results are borderline. Patient advised to return for annual diabetes screening and routine primary care.