Diabetes Awareness and Screening

Published 03/11/2025

According to the Centers for Medicare & Medicaid Services (CMS), diabetes affects more than 25 percent of Americans aged 65 or older, and its prevalence is projected to increase approximately two-fold for all U.S. adults (ages 18–79) by 2050 if current trends continue. 

The Centers for Disease Control and Prevention, CDC’s Diabetes Report Card state total medical costs and lost work and wages for people with diagnosed diabetes is $413 billion. Medical costs for people with diabetes are more than twice as high as for people without diabetes. 

Diabetes Overview

The Centers for Disease Control (CDC) tells us diabetes is a group of diseases characterized by high blood sugar. Prediabetes is a condition in which blood sugar is higher than normal but not high enough to be classified as diabetes. When a person has diabetes, the body either does not make enough insulin (type 1) or is unable to properly use insulin (type 2). Gestational diabetes occurs only during pregnancy. This can cause health problems in both the mother and baby. If a mother had gestational diabetes, she is more likely to develop type 2 diabetes. 

When the body does not have enough insulin or cannot use it properly, blood sugar (glucose) builds up in the blood. 

People with diabetes can develop high blood pressure, high cholesterol, and high triglycerides (a type of fat in the blood). High blood sugar, particularly when combined with high blood pressure and high triglycerides or too much LDL (“bad”) cholesterol levels, can lead to heart disease, stroke, blindness, kidney failure, amputations of the legs and feet, and even early death. 

The CDC says some racial and ethnic minority groups, and people with lower socioeconomic status have historically had higher rates of illness and death from diabetes. Social determinants of health are the conditions in places where people live, learn, work, and play that affect their health risks and outcomes. Together, they account for 50 percent to 60 percent of health outcomes and are a key contributor to disparities in health and health care. Get to know your patients! See the latest statistics by race, ethnicity, income, education level, and diabetes type.

Diabetes is also associated with increased risk of certain types of cancer, such as liver, pancreatic, uterine, colon, breast, and bladder cancer. High blood sugar also increases the chance of developing dementia and Alzheimer’s disease. In addition, the average medical cost for people diagnosed with diabetes are two to three times higher than those without diabetes. These higher costs are often caused by diabetes-related health conditions and resulting hospitalizations.

People with diabetes, their caregivers, and health care providers, as well as the department of health, policy makers, and community organizations can all help reduce the risk of serious diabetes-related complications. More research and funding are still needed! There is no cure yet for diabetes. 

We do know losing weight, eating healthy, and being active can improve the way the body uses insulin.

What Does the Research Show

  • Blood pressure management can reduce the risk of heart disease and stroke by 12 percent to 27 percent and the risk of progression of kidney disease by 30 to 70 percent
     
  • Cholesterol management can reduce cardiovascular complications by 20 percent to 50 percent
     
  • Regular eye exams and timely treatment could prevent up to 90 percent of diabetes-related blindness
     
  • Regular foot exams and patient education of proper foot care could prevent up to 85 percent of diabetes-related amputations

Did You Know?

  • Approximately 38.4 million Americans have diabetes
     
  • 8.7 million Americans, or about one in five people, are unaware that they have diabetes
     
  • Approximately 97.6 million people ages 18 or older have prediabetes, a condition in which blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes
     
  • 26.4 million people aged 65 years or older have prediabetes (38 percent of the adult US population)
     
  • More than eight in 10 adults living with prediabetes are unaware they have prediabetes
     
  • About half of women with gestational diabetes go on to develop type 2 diabetes. Gestational diabetes is a type of diabetes that women develop when they are pregnant
     
  • Diabetes is the eighth leading cause of death in the United States
     
  • Diabetes is the number one cause of kidney failure, lower-limb amputations, and adult blindness
     
  • In the last 20 years, the number of adults diagnosed with diabetes has more than doubled

What Can a Provider do?

Providers should encourage all patients to manage their blood glucose, blood pressure, and cholesterol levels.

Research shows that managing diabetes as soon as possible after diagnosis may help prevent secondary health problems caused by diabetes. Start by managing the ABCs of diabetes.

  • A is for the A1C used to measure average blood glucose levels
  • B is for blood pressure
  • C is for cholesterol

Educate Your Patients

  • Encourage all patients to take the Diabetes Risk Test online
     
  • Share this information: Managing Diabetes
     
  • Help patients identify their Risk Factors 
     
  • Encourage patients to adopt healthy lifestyle habits such as planning healthy meals, being physically active, getting enough sleep, and not smoking
     
  • Refer to dieticians and personal trainers as appropriate 
     
  • Remind patients to take medications in a timely fashion, is important even when feeling well. Encourage patients to ask for education about medications from their pharmacist. 
     
  • Examine patients’ feet. Educate on the importance of safe and appropriate foot care 
     
  • Discuss the value of maintaining a healthy weight. Encourage healthy eating, physical activity, and possible other weight-loss treatments. 
     
  • Consider patients mental health. Diabetes, like all chronic illnesses, can leave patients feeing sad and overwhelmed. Refer patients to mental health counselors or support groups to learn healthy ways to cope. 
     
  • Utilize Depression Screening tools as appropriate
     
  • Diabetes can be expensive. Medications, devices, and frequent appointments can feel like an insurmountable obstacle for some patients Refer to a social worker to assist with community resources and/or financial help. 
     
  • Build a diabetic care team within your practice office, agency or facility. Identify resources available to your patients. A diabetic health care team may include the primary care physician, diabetes specialist, registered dietician and/or a certified diabetes educator. 

There are resources and information for Diabetes Professionals at CDC.gov.

Diabetes Screening

What’s Changed? No changes from the last quarter

HCPCS and CPT ® Codes

  • 82947 — Glucose; quantitative, blood (except reagent strip)
  • 82950 — Glucose; post glucose dose (includes glucose)
  • 82951 — Glucose; tolerance test (GTT), three specimens (includes glucose)

ICD-10 Codes - Z13.1

Additional ICD-10 codes may apply. Find individual change requests and specific ICD-10-CM service codes we cover on the CMS ICD-10 web page. See Palmettogba.com for more information.

Medicare Covers diabetic services for patients with Medicare Part B (who have specific risk factors or have been diagnosed with pre-diabetes). Patients previously diagnosed with diabetes are not eligible for this benefit.

Frequency

  • One screening every six months for patients diagnosed with pre-diabetes
  • One screening every 12 months for patients previously tested but not diagnosed with pre-diabetes or patients who were never tested

Note: See FAQ on Medicare Preventive Services.

Patient Pays no copayment, coinsurance, or deductible.

Other Notes

  • Add modifier TS (follow-up service) when patients meet the pre-diabetes definition.
  • Medicare will pay ordering providers’ and suppliers’ Durable Medical Equipment (DME) claims when they’re actively enrolled in Medicare on the service date or if the provider has a valid opt-out affidavit on file. If the provider does not participate in Medicare, it is imperative to explain that there may be related costs prior to ordering DME. 
  • CPT® only copyright 2024 American Medical Association. All rights reserved.

References and Resources


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