Risk Assessment Criteria & Frequency

In October 2015, the U.S. Preventive Services Task Force (USPSTF) recommended screening for abnormal blood glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. Clinicians should offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to promote a healthful diet and physical activity.

Age & BMI

Grade B recommentation

• 40-70 age AND
• BMI ≥ 25

The USPSTF standards suggest testing adults of a lower age or BMI if risk factors are present.

• Family history
• Medical history of gestational diabetes or polycystic ovary syndrome
• Racial & ethnic minorities

Visit the AMA's Prevent Diabetes STAT website for more information.

Reference: Siu AL. U S Preventive Services Task Force. Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2015;163(11):861-8.

Identifying Patients

For more information visit the CDC's website at www.cdc.gov/diabetes/prevention/lifestyle-program/deliverers/index.html.

Resources for screening, testing and referring on the CDC's website.

• Sample flow chart for physician's office (PDF)
• Visit the CDC's Keys to Success: Resources for Organizations page to download Keys to Success Tip Sheets.

Referring a Patient

A formal referral from the physician is a recommended best practice. The program administrator or coach typically reaches out to the patient and shares program details, which in turn increases the likelihood of enrollment. The Utah Deparment of Health will soon offer at no cost to physicians the use of an online bi-directional referral system to refer patients into the National DPP and other self-management classes.

Patients can be referred to the National DPP by downloading and printing our Fax Referral Form (PDF) and soon online!

Best Practices for Referrals

Listed here are a few best practices for enabling physicians and care teams to refer into National DPP classes:

• Identify champions through local medical societies and health systems
• Raising awareness amongst physicians, care teams and patients through Ad Council campaign, grand rounds, webinars and CME such as the online module, Preventing Type 2 Diabetes in At-Risk Patients (CME credits = 1.0) on the www.stepsforward.org website.
  
• Frame as a process or quality improvement initiative
  
• With physician support, “automate” screening and referrals from the www.preventdiabetesstat.org toolkit:
  
  • Retrospective Prediabetes Identification Algorithm (PDF) to identify those at risk
    
  • Point-of-Care Identification Algorithm (PDF) to identify those most at risk/likely to act/likely to be successful
    
  • Referral through Electronic Medical Records
    
  • Build feedback loops so that physicians can discuss progress with their patients
    
  • Provide on the ground support in the practices

Reimbursement for Prediabetes Screening

The following ICD billing code sheet will enable physician practices to obtain reimbursement for prediabetes screening.

ICD Billing Codes

Commonly Used Current Procedural terminology and ICD Codes (PDF)

Prevent Diabetes STAT Toolkit

The American Medical Association's (AMA) Prevent Diabetes STAT (Screen/Test/Act/Today) Toolkit is available for you to use to learn more on creating partnerships with healthcare organizations and clinics.

Business Associate Agreement

The AMA provides additional resources that may be helpful in connecting with diabetes prevention programs, including a sample Business Associate Agreement (PDF).

Sample Referral Form

Download and print the Sample Referral Form with a BMI table (PDF).

Be sure to watch the AMA’s Preventing Diabetes in At-Risk Patients (CME Credits: 1.0) at www.stepsforward.org/modules/prevent-type-2-diabetes

For more information visit the CDC's website at www.cdc.gov/diabetes/prevention/lifestyle-program/deliverers/index.html.