Billing and Coding: HbA1c (A56686) (2024)

E08.21Diabetes mellitus due to underlying condition with diabetic nephropathyE08.311Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edemaE08.319Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edemaE08.3211Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eyeE08.3212Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eyeE08.3213Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateralE08.3291Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eyeE08.3292Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eyeE08.3293Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateralE08.3311Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eyeE08.3312Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eyeE08.3313Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateralE08.3391Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eyeE08.3392Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eyeE08.3393Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateralE08.3411Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eyeE08.3412Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eyeE08.3413Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateralE08.3491Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eyeE08.3492Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eyeE08.3493Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateralE08.3511Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eyeE08.3512Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eyeE08.3513Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateralE08.3521Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eyeE08.3522Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eyeE08.3523Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateralE08.3531Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eyeE08.3532Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eyeE08.3533Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateralE08.3541Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eyeE08.3542Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eyeE08.3543Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateralE08.3551Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eyeE08.3552Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eyeE08.3553Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateralE08.3591Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eyeE08.3592Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eyeE08.3593Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateralE08.36Diabetes mellitus due to underlying condition with diabetic cataractE08.37X1Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eyeE08.37X2Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eyeE08.37X3Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateralE08.39Diabetes mellitus due to underlying condition with other diabetic ophthalmic complicationE08.40Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecifiedE08.51Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangreneE08.69Diabetes mellitus due to underlying condition with other specified complicationE09.21Drug or chemical induced diabetes mellitus with diabetic nephropathyE09.311Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edemaE09.319Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edemaE09.3211Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eyeE09.3212Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eyeE09.3213Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateralE09.3291Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eyeE09.3292Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eyeE09.3293Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateralE09.3311Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eyeE09.3312Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eyeE09.3313Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateralE09.3391Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eyeE09.3392Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eyeE09.3393Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateralE09.3411Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eyeE09.3412Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eyeE09.3413Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateralE09.3491Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eyeE09.3492Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eyeE09.3493Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateralE09.3511Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eyeE09.3512Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eyeE09.3513Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateralE09.3521Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eyeE09.3522Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eyeE09.3523Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateralE09.3531Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eyeE09.3532Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eyeE09.3533Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateralE09.3541Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eyeE09.3542Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eyeE09.3543Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateralE09.3551Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eyeE09.3552Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left eyeE09.3553Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateralE09.3591Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eyeE09.3592Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eyeE09.3593Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateralE09.36Drug or chemical induced diabetes mellitus with diabetic cataractE09.37X1Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right eyeE09.37X2Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, left eyeE09.37X3Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, bilateralE09.39Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complicationE09.40Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecifiedE09.51Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangreneE09.69Drug or chemical induced diabetes mellitus with other specified complicationE10.21Type 1 diabetes mellitus with diabetic nephropathyE10.311Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edemaE10.319Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edemaE10.3211Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eyeE10.3212Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eyeE10.3213Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateralE10.3291Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eyeE10.3292Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eyeE10.3293Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateralE10.3311Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eyeE10.3312Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eyeE10.3313Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateralE10.3391Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eyeE10.3392Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eyeE10.3393Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateralE10.3411Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eyeE10.3412Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eyeE10.3413Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateralE10.3491Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eyeE10.3492Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eyeE10.3493Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateralE10.3511Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eyeE10.3512Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eyeE10.3513Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateralE10.3521Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eyeE10.3522Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eyeE10.3523Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateralE10.3531Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eyeE10.3532Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eyeE10.3533Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateralE10.3541Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eyeE10.3542Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eyeE10.3543Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateralE10.3551Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eyeE10.3552Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eyeE10.3553Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateralE10.3591Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eyeE10.3592Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eyeE10.3593Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateralE10.36Type 1 diabetes mellitus with diabetic cataractE10.37X1Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eyeE10.37X2Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, left eyeE10.37X3Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateralE10.39Type 1 diabetes mellitus with other diabetic ophthalmic complicationE10.40Type 1 diabetes mellitus with diabetic neuropathy, unspecifiedE10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangreneE10.69Type 1 diabetes mellitus with other specified complicationE10.8Type 1 diabetes mellitus with unspecified complicationsE11.21Type 2 diabetes mellitus with diabetic nephropathyE11.311Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edemaE11.319Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edemaE11.3211Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eyeE11.3212Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eyeE11.3213Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateralE11.3291Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eyeE11.3292Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eyeE11.3293Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateralE11.3311Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eyeE11.3312Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eyeE11.3313Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateralE11.3391Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eyeE11.3392Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eyeE11.3393Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateralE11.3411Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eyeE11.3412Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eyeE11.3413Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateralE11.3491Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eyeE11.3492Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eyeE11.3493Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateralE11.3511Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eyeE11.3512Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eyeE11.3513Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateralE11.3521Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eyeE11.3522Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eyeE11.3523Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateralE11.3531Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eyeE11.3532Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eyeE11.3533Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateralE11.3541Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eyeE11.3542Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eyeE11.3543Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateralE11.3551Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eyeE11.3552Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eyeE11.3553Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateralE11.3591Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eyeE11.3592Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eyeE11.3593Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateralE11.36Type 2 diabetes mellitus with diabetic cataractE11.37X1Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eyeE11.37X2Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eyeE11.37X3Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateralE11.39Type 2 diabetes mellitus with other diabetic ophthalmic complicationE11.40Type 2 diabetes mellitus with diabetic neuropathy, unspecifiedE11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangreneE11.638Type 2 diabetes mellitus with other oral complicationsE11.69Type 2 diabetes mellitus with other specified complicationE11.8Type 2 diabetes mellitus with unspecified complicationsE13.3211Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eyeE13.3212Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eyeE13.3213Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateralE13.3291Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eyeE13.3292Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eyeE13.3293Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateralE13.3311Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eyeE13.3312Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eyeE13.3313Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateralE13.3391Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eyeE13.3392Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eyeE13.3393Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateralE13.3411Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eyeE13.3412Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eyeE13.3413Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateralE13.3491Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eyeE13.3492Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eyeE13.3493Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateralE13.3511Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eyeE13.3512Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eyeE13.3513Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateralE13.3521Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eyeE13.3522Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eyeE13.3523Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateralE13.3531Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eyeE13.3532Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eyeE13.3533Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateralE13.3541Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eyeE13.3542Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eyeE13.3543Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateralE13.3551Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eyeE13.3552Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eyeE13.3553Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateralE13.3591Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eyeE13.3592Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eyeE13.3593Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateralE13.37X1Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eyeE13.37X2Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eyeE13.37X3Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateralE15Nondiabetic hypoglycemic comaE16.0Drug-induced hypoglycemia without comaE16.1Other hypoglycemiaE89.1Postprocedural hypoinsulinemiaR73.01Impaired fasting glucoseR73.02Impaired glucose tolerance (oral)R73.03PrediabetesR73.09Other abnormal glucoseR73.9Hyperglycemia, unspecifiedR78.71Abnormal lead level in bloodR78.79Finding of abnormal level of heavy metals in bloodR78.89Finding of other specified substances, not normally found in bloodR79.0Abnormal level of blood mineralR79.89Other specified abnormal findings of blood chemistryR79.9Abnormal finding of blood chemistry, unspecifiedZ79.84Long term (current) use of oral hypoglycemic drugsZ79.85Long-term (current) use of injectable non-insulin antidiabetic drugs
Billing and Coding: HbA1c (A56686) (2024)

FAQs

What diagnosis codes will cover hemoglobin A1c? ›

Group 1
CodeDescription
83036HEMOGLOBIN; GLYCOSYLATED (A1C)

How often will insurance pay for hemoglobin A1c? ›

HbA1C does not require fasting so it may be more convenient than either of the previously covered tests. CMS will now allow screening tests including HbA1C up to twice every 12 months for all* Medicare beneficiaries.

What is the CPT code for HbA1c? ›

3051F Most recent hemoglobin A1c (HbA1c) level ≥7.0% and <8.0%. 3052F Most recent hemoglobin A1c (HbA1c) level ≥8.0% and ≤9.0%. 3060F Positive microalbuminuria test result documented and reviewed.

What diagnosis will Medicare cover A1c? ›

Hemoglobin A1c Tests: Your doctor might order a hemoglobin A1c lab test. This test measures how well your blood glucose has been controlled over the past 3 months. Medicare may cover this test for anyone with diabetes if it is ordered by his or her doctor.

What ICD-10 code covers hemoglobin glycosylated? ›

NCD - Glycated Hemoglobin/Glycated Protein (190.21)

Why is hemoglobin A1C checked every 3 months? ›

An A1C test measures the percentage of your red blood cells that have glucose-coated hemoglobin. An A1C test can show your average glucose level for the past three months because: Glucose sticks to hemoglobin for as long as the red blood cells are alive. Red blood cells live about three months.

How many months does HbA1c cover? ›

The A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months.

How often will Medicare pay for HbA1c? ›

You may be eligible for up to 2 screenings each year. Part B covers these screenings if you have any of these risk factors: High blood pressure (hypertension) History of abnormal cholesterol and triglyceride levels (dyslipidemia)

How do I bill my A1C test? ›

CPT code 83037, Hemoglobin, glycosylated (A1C) by device cleared by FDA for home use, was established for reporting a glycosylated hemoglobin (A1C) test that is obtained in the patient's home with a Food and Drug Administration (FDA) cleared device…”

What must be included in the documentation for HbA1c control? ›

Documentation in the medical record must include a note indicating the date when the most recent HbA1c test was performed in the measurement year along with result or findings. Always list the date of service, result and test together.

What is the QW modifier for A1C? ›

Modifier QW indicates a Clinical Laboratory Improvement Amendment (CLIA) waived test performed by a lab with a CLIA certificate. Appending modifier QW to a code indicates that the test was performed at a waived complexity level.

Is A1C a medical necessity? ›

HbA1c is widely accepted as medically necessary for the management and control of patients with diabetes. It is also valuable to assess hyperglycemia, a history of hyperglycemia or dangerous hypoglycemia.

Is an A1C test considered preventive? ›

Preventive vs.

For example, if you have already been diagnosed with diabetes, an A1C blood test measuring sugar levels would be considered treatment of a medical condition and not a preventive service. Preventive services may become diagnostic services.

Is A1C a point of care test? ›

The increased reliability of point-of-care (POC) devices for A1c testing has been shown to improve individual monitoring of blood glucose levels, because they can be used directly at primary care units (PCU), just before visiting the physician.

What is the ICD-10 code for pre diabetic A1C? ›

The ICD-10 code for prediabetes is R73.

What is diagnosis code R79 89? ›

R79. 89 – Other Specified Abnormal Findings of Blood Chemistry | ICD-10-CM.

What is the ICD-10 code for R73? ›

R73: Elevated blood glucose level.

What is diagnosis code Z79-85? ›

ICD-10-CM Code for Long-term (current) use of injectable non-insulin antidiabetic drugs Z79. 85.

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