CPT® Code 0488T

Official Description

Preventive behavior change, online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum, provided to an individual, per 30 days

Common Language Description

The CPT® Code 0488T refers to a preventive behavior change program that is delivered online or electronically. This structured intensive program is specifically designed for the prevention of diabetes and utilizes a standardized diabetes prevention program curriculum. It is aimed at individuals who have been identified as having risk factors for developing type 2 diabetes, such as impaired fasting glucose and/or impaired glucose tolerance. The primary objective of this program is to delay or prevent the onset of type 2 diabetes by promoting significant lifestyle changes, particularly in the areas of weight management and physical activity.

The program emphasizes achieving a target weight loss of 7% of the individual's body weight, alongside an increase in moderate-intensity physical activity to a minimum of 150 minutes per week. These lifestyle modifications are crucial as they enhance the body's ability to utilize insulin effectively and improve glucose metabolism. The structured nature of the program includes regular monitoring by qualified healthcare providers, who are responsible for documenting the participant's physical activity, dietary habits, and weight loss progress. Additionally, these providers offer ongoing recommendations and encouragement to help participants meet their health goals. The code 0488T specifically captures the provision of this individualized support through the online/electronic format, with billing occurring on a per 30-day basis.

1. Indications

The preventive behavior change program represented by CPT® Code 0488T is indicated for individuals who are at risk of developing type 2 diabetes. This includes patients with the following conditions:

Impaired Fasting Glucose Individuals who have elevated blood glucose levels after fasting, indicating a higher risk for diabetes.
Impaired Glucose Tolerance Patients who exhibit abnormal glucose levels after consuming glucose, suggesting a potential progression to diabetes.

2. Procedure

The procedure associated with CPT® Code 0488T involves several key steps that are integral to the delivery of the structured intensive program for diabetes prevention:

Enrollment in the Program Individuals identified as at risk for type 2 diabetes are enrolled in the online/electronic structured intensive program. This enrollment process includes an initial assessment to determine eligibility based on risk factors such as impaired fasting glucose or impaired glucose tolerance.
Implementation of the Standardized Curriculum Participants engage with a standardized diabetes prevention program curriculum that outlines specific behavioral changes aimed at reducing the risk of diabetes. This curriculum includes educational materials and resources focused on nutrition, physical activity, and lifestyle modifications.
Regular Monitoring and Support Throughout the program, participants receive regular monitoring from qualified healthcare providers. This includes tracking physical activity levels, dietary intake, and weight loss progress. Providers offer personalized recommendations and encouragement to help participants achieve their goals.
Goal Setting and Adjustment The program emphasizes setting achievable goals, such as a 7% reduction in body weight and increasing physical activity to at least 150 minutes per week. Providers work with participants to adjust these goals as necessary based on individual progress and challenges encountered during the program.

3. Post-Procedure

After completing the 30-day cycle of the program, participants are expected to continue implementing the behavior changes learned during the program. Follow-up sessions may be scheduled to assess ongoing progress and provide additional support. The goal is to maintain the lifestyle changes that contribute to weight loss and improved physical activity levels, thereby reducing the risk of developing type 2 diabetes. Continuous engagement with healthcare providers is encouraged to ensure long-term success and adherence to the program's recommendations.

Short Descr	DIABETES PREV ONLINE/ELEC
Medium Descr	DIABETES PREV ONLINE/ELECTRONIC PRGRM PR 30 DAYS
Long Descr	Preventive behavior change, online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum, provided to an individual, per 30 days
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Non-Covered Service, not paid under OPPS
Berenson-Eggers TOS (BETOS)	none
MUE	1