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Commercial Plans → Coding & Billing

 

Coding & Billing 

 
Commercial health insurance plans and self-insured employers have the option of using either an invoicing or a coding/billing process as the reimbursement method for the National Diabetes Prevention Program (National DPP) lifestyle change program. The purpose of these sections is to provide a framework to ensure the National DPP lifestyle change program is reimbursed appropriately and in a timely manner.

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This section provides information on the diagnoses (ICD) and procedure (CPT) codes that can be used by CDC-recognized organizations. This section will continue to evolve as new codes are developed and processes change over time.

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This section outlines two primary billing models commercial plans and employers can use when covering the National DPP lifestyle change program: (1) CDC-recognized organizations can invoice for payment based on the terms defined in the contract. (2) CDC-recognized organizations can submit a claim.