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US · guidance

CMS Pub. 100-04, ch. 18, § 90.2.1

Modifier Requirements for Pre-diabetes

activein force · 2026-08-25 – presentas-observed

A claim that is submitted for diabetes screening and the beneficiary meets the definition of pre-diabetes shall be

submitted in the following manner:

The line item shall contain 82497, 82950 or 82951 with an ICD-9-CM diagnosis code of V77.1 reported (if ICD-9-

CM is applicable) or, if ICD-10-CM is applicable, a diagnosis code of Z13.1in the header. In addition, modifier “TS”

(follow-up service) shall be reported on the line item.

History

(Rev. 3329, Issued: 08-14-15, Effective: 01-01-12, Implementation: 09-14-15)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
d9d0410c6be21dd672a6eb9e84572959734aa1a6a24d11826db05bbbf9c97dc1
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