Wiki Pre-diabetes NOS

[cmercado0526]

Good morning - It is common knowledge that an A1c of 5.7 is considered 'pre-diabetes.' It is not indicated as abnormal in the lab report as it falls within the range of 4.0 - 6.1. Every lab report I have ever seen indicates levels that are out of range with either an 'H' or an 'L' and/or the value in bold (regardless of the test). I know the ICD-9 code for Pre-diabetes is 790.29, but that falls under "Other abnormal glucose". If a patient has an A1c of 5.7% and ALL glucose levels, fasting and non-fasting within normal limits, can they be coded with a diagnosis of 790.29? I have read in a few places that to code this, there has to actually be abnormal results. Thanks for your help!
Cathy

 

[erjones147]

I agree with you - how can it be abnormal and normal at the same time?

We use 780.29 for the first high A1C when we are evaluating for T2DM (unless Dysmetabolic Syndrome X is used, which seems to be a fashionable diagnosis amongst FNPs), and the patient gets moved to "pre-diabetic status"

Then, if and when we get that second high A1C, we move the patient into diabetic status, as long as all other ADA requirements are met

 

[mitchellde]

to code an abnormal lab code or pre diabetes the provider must be the one to state that the lab was abnormal or the patient has prediabetes. the code is not allowed to interpret lab results and code from their own interpretation.