Question:
Do we need a modifier for submitting claims for the screening of Medicare beneficiaries diagnosed with pre-diabetes?
Answer:
You must append modifier TS to the CPT code when submitting claims for screening of Medicare beneficiaries diagnosed with pre-diabetes (previous fasting glucose level of 100–125 mg/d or a two-hour post-glucose challenge of 140–199 mg/dL). This modifier communicates to the intermediary, A/B MAC or carrier that the allowed frequency of each six months applies to the claim.
CPT® copyright 2024 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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