Clinical Coding & Guidelines

CMS Proposed Rule Changes -MDPP 2017

CMS Proposed Rule Changes -MDPP 2017

July 2017 brought the Centers for Medicare & Medicaid Services (CMS) updated proposal to expand the Diabetes Prevention Program to Medicare beneficiaries. Changes in response to comments are addressed. The new start date will be April1, 2018. CMS is requesting public comment be submitted by September 1, 2017.

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Diabetes Self-Management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics

Diabetes Self-Management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics

The position statement was reviewed and approved by the Professional Practice Committee of the American Diabetes Association, the Professional Practice Committee of the American Association of Diabetes Educators, and the House Leadership Team, the Academy Positions Committee, and the Evidence-Based Practice Committee of the Academy of Nutrition and Dietetics.

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Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement 2015

Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement 2015

The United States Preventative Services Task Force (USPSTF) has updated a 2008 recommendation about blood glucose screening in adults. Previously, the USPSTF recommended screening adults between the ages of 40 and 70 years old with hypertension; this release did not mention weight. In an update of that recommendation published in October 2015, the USPSTF has changed the recommendation to screen for the disease in adults between those ages who are overweight or obese. The change comes as the prevalence of both obesity and T2DM continue to grow in the United States. Being overweight is a major risk factor for T2DM.

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Diabetes and Hypertension - ADA Position Statement

Diabetes and Hypertension - ADA Position Statement

This Position Statement is intended to update the assessment and treatment of hypertension among people with diabetes, including advances in care since the American Diabetes Association (ADA) last published a Position Statement on this topic in 2003.

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CPT Coding for Diabetes Prevention Program

CPT Coding for Diabetes Prevention Program

The American Medical Association is introducing a new Category III code, effective January 1, 2016, to be used to report the services provided in a standardized diabetes prevention program (DPP) recognized by the Centers for Disease Control and Prevention (CDC). The provider of the DPP may report one unit of CPT code 0403T for each 60-minute session provided to individuals in a group setting.

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CDC Brief and FAQs on Diabetes Prevention Program CPT Code

CDC Brief and FAQs on Diabetes Prevention Program CPT Code

Provides detailed information on use of the new DPP CPT code along with frequently asked questions and answers.

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ICD-9 to ICD-10 Crosswalk for Diabetes Self-Management Training

ICD-9 to ICD-10 Crosswalk for Diabetes Self-Management Training

In response to questions regarding the new diabetes-related ICD-10 codes, we are sharing the ICD-9 to ICD-10 crosswalk provided by the American Association of Diabetes Educators.

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2017 National Standards for Diabetes Self-Management Education and Support

2017 National Standards for Diabetes Self-Management Education and Support

The Standards define timely, evidence-based, quality DSME-S services that meet or exceed the Medicare diabetes self-management training (DSMT)regulations, however, these Standards do not guarantee reimbursement. These Standards provide evidence for all diabetes self-management education providers including those that do not plan to seek reimbursement for DSME-S. The current Standards’ evidence clearly identifies the need to provide person-centered services that embrace the ever-increasing technological engagement platforms and systems. The hope is that payers will view these Standards as a tool for reviewing DSME-S reimbursement requirements and consider change to align with the way their beneficiaries’ engagement preferences have evolved. Research confirms that less than 5% of Medicare beneficiaries utilize theirDSME-S benefit. Changes in reimbursement policies stand to increase DSME-S access and utilization, which will result in positive impact to beneficiaries’ clinical outcomes, quality of life, health care utilization, and costs.

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http://diabetesnv.org/pdf/ResourceDirectoryPart1.pdf

http://diabetesnv.org/pdf/ResourceDirectoryPart2.pdf