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by Service Type of Visit Initial Visit Type 2 Diabetes Length of Visit 2 hours This document Preconception with: knowledge and pregnancy.

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The purp when bi services for cons Procedu  

Type o

Preconc Type 1 D or Type 2 D Preconc Type 1 D or Type 2 D

pose of this doc illing for these s s codes may nee sistent billing w ural Terminolo

of Diabetes

ception with: Diabetes Diabetes ception with: Diabetes Diabetes

 

cument is to prov services. The sum

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(2)

Type of Diabetes

Length of Visit

Type of Visit

CPT Codes:

99214-99215 Office visit, established patient OR

99242-99244 Office consultation, new or established patient - select CPT code based on time with the patient and key components of care provided.

Pregnancy with: Type 1 Diabetes or

Type 2 Diabetes

2 hours Initial Visit

Obtain family, medical, and obstetrical history; institute individual self-care plan including medical nutrition therapy, exercise recommendations, blood glucose monitoring, medication adjustments, record keeping and psychosocial efficacy with the care plan. Make referrals as needed.

CPT Code:

99245 Office consultation, new or established patient Pregnancy with:

Type 1 Diabetes or

Type 2 Diabetes

1 hour Follow-up in one week to determine effectiveness of the care plan, diet and weight gain appropriateness, make adjustments in diet, exercise, medications as needed.

CPT Code:

99244 Office consultation, new or established patient Pregnancy with:

Type 1 Diabetes or Type 2 Diabetes

1/2 – 1 hour Subsequent follow-ups at one to two week intervals to clarify diet, blood glucose monitoring, review sick-day rules, provide additional information for breastfeeding/ infant feeding, future pregnancy planning and continued good health postpartum (i.e., nutrition, exercise, family planning).

Further follow-up sessions will be determined by blood glucose control, adequacy of nutritional intake and weight gain, and presence of ketones in the urine, use of sick-day rules, and any red-flag psychosocial conditions.

CPT Codes:

99242-99244 Office consultation, new or established patient - select CPT code based on time with the patient and key components of care provided.

Impaired Glucose Tolerance (IGT) in

1 hour Initial Visit

(3)

Type of Diabetes

Length of Visit

Type of Visit

pregnancy:

one abnormal value on the 2 or 3 hr. Oral Glucose

Tolerance Test (OGTT)

medical nutrition therapy, exercise recommendations, blood glucose monitoring, record keeping and psychosocial efficacy with the care plan.

CPT Code:

99244 Office consultation, new or established patient GDM:

diet controlled in pregnancy

1 1/2 hours Initial Visit

Obtain family, medical, and obstetrical history; institute individual self-care plan including medical nutrition therapy, exercise recommendations, blood glucose monitoring, record keeping and psychosocial efficacy with the care plan. Make referrals as needed.

CPT Code:

99245 Office consultation, new or established patient GDM:

diet controlled in pregnancy

1 hour Follow-up in one week to determine effectiveness of the care plan, diet and weight gain appropriateness, make adjustments in diet, exercise, and determine if medications are needed.

CPT Code:

99244 Office consultation, new or established patient GDM:

diet controlled in pregnancy

1/2 – 1 hour Subsequent follow-ups at one to two week intervals to clarify diet, blood glucose monitoring, review sick-day rules, provide additional information for breastfeeding/ infant feeding, future pregnancy planning and continued good health postpartum (i.e., nutrition, exercise, family planning).

Further follow-up sessions will be determined by blood glucose control, adequacy of nutritional intake and weight gain, and presence of ketones in the urine, use of sick-day rules, and any red-flag psychosocial conditions.

CPT Codes:

99242-99244 Office consultation, new or established patient - select CPT code based on time with the patient and key components of care provided.

GDM:

on oral hypoglycemic

2 hour Initial Visit

(4)

Type of Diabetes

Length of Visit

Type of Visit

agent/s in pregnancy use of oral hypoglycemic agents, medical nutrition therapy, exercise recommendations, blood glucose monitoring, record keeping and psychosocial efficacy with the care plan. Make referrals as needed.

CPT Code:

99245 Office consultation, new or established patient GDM:

on oral hypoglycemic agent/s in pregnancy

1/2 – 1 hour Follow-up in one week to determine effectiveness of the care plan, diet and weight gain appropriateness, make adjustments in diet, exercise, and determine if medications working or need to switch to insulin.

CPT Codes:

99242-99244 Office consultation, new or established patient - select CPT code based on time with the patient and key components of care provided.

GDM:

on oral hypoglycemic agent/s in pregnancy

1/2 – 1 hour Subsequent follow-ups at one to two week intervals to clarify diet, blood glucose monitoring, provide additional information for breastfeeding/infant feeding, future

pregnancy planning and continued good health postpartum (i.e., nutrition, exercise, family planning). Further follow-up sessions will be determined by blood glucose control, adequacy of nutritional intake and weight gain, and presence of ketones in the urine, use of sick-day rules, and any red-flag psychosocial conditions.

CPT Codes:

99242-99244 Office consultation, new or established patient - select CPT code based on time with the patient and key components of care provided.

GDM:

on insulin in pregnancy

2 hours Initial Visit

Obtain family, medical, and obstetrical history; institute individual self-care plan including medical nutrition therapy, exercise recommendations, blood glucose monitoring, initial insulin instruction, record keeping and psychosocial efficacy with the care plan. Make referrals as needed.

CPT Code:

(5)

Type of Diabetes

Length of Visit

Type of Visit

GDM:

on insulin in pregnancy

1 hour Follow-up in one week to determine effectiveness of the care plan, diet and weight gain appropriateness, make adjustments in diet, exercise, and determine if insulin adjustments are needed.

CPT Code:

99244 Office consultation, new or established patient GDM:

on insulin in pregnancy

1/2 - 1 hour Subsequent follow-ups at one to two week intervals to clarify diet, blood glucose

monitoring, insulin administration, provide additional information for breastfeeding/ infant feeding, reduction of risk for Type 2 diabetes, future pregnancy planning and continued good health postpartum (i.e., nutrition,

exercise, family planning).

Further follow-up sessions will be determined by blood glucose control, adequacy of nutritional intake and weight gain, presence of ketones in the urine, use of sick-day rules, and any red-flag psychosocial conditions.

CPT Codes:

99242-99244 Office consultation, new or established patient - select CPT code based on time with the patient and key components of care provided.

Postpartum follow-up 1/2 - 1 hour Assessment at 6 to 8 weeks postpartum to determine Medical Nutrition Therapy based on non-pregnant state, lactation needs, and other medical conditions requiring adjustment of the diet. Insulin adjustments for non-pregnant state, blood glucose monitoring, risk reduction counseling regarding weight control, exercise and follow-up testing for diabetes (if GDM). Emphasis on appropriate contraception and family planning for future pregnancies and to promote preconception planning.

Referral to other providers as needed. CPT Codes:

99242-99244 Office consultation, new or established patient - select CPT code based on time with the patient and key components of care provided.

References

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