How To Use CPT Code 3051F

CPT 3051F describes the most recent hemoglobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% for patients with diabetes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 3051F?

CPT 3051F represents the most recent HbA1c level between 7.0% and 8.0% for patients with diabetes. The HbA1c test measures blood glucose control over a three-month period. This code is used to indicate that the patient’s blood sugar levels have been consistently high during this time frame.

2. Official Description

The official description of CPT code 3051F is: ‘Most recent hemoglobin A1c (HbA1c) level greater than or equal to 7.0% and less than 8.0% (DM).’ This code is specific to patients with diabetes and indicates their HbA1c level falls within the defined range.

3. Procedure

1. The patient undergoes a hemoglobin A1c test, which measures their blood glucose control over a three-month period.
2. If the most recent HbA1c level is between 7.0% and 8.0%, CPT code 3051F is assigned to indicate this result.
3. The provider documents the HbA1c test result and the date of the test in the patient’s medical record.

4. Qualifying circumstances

CPT code 3051F is applicable to patients with diabetes mellitus (DM), a condition characterized by insufficient production or utilization of insulin, leading to high blood glucose levels. The code is used when the patient’s most recent HbA1c level falls between 7.0% and 8.0%. It is important to note that this code is specific to patients with diabetes and should not be used for other conditions.

5. When to use CPT code 3051F

CPT code 3051F should be used when the patient’s most recent HbA1c level is between 7.0% and 8.0%. It indicates that the patient’s blood glucose control is not optimal and may require adjustments to their diabetes medication or treatment plan. This code should not be used for HbA1c levels outside of the specified range or for patients without diabetes.

6. Documentation requirements

To support a claim for CPT code 3051F, the provider must document the following information:

• Patient’s diagnosis of diabetes
• Date of the HbA1c test
• Result of the HbA1c test, indicating a level between 7.0% and 8.0%

7. Billing guidelines

When billing for CPT code 3051F, ensure that the patient has a documented diagnosis of diabetes and that the most recent HbA1c level falls between 7.0% and 8.0%. This code should not be reported with other codes, as it represents a specific range of HbA1c levels for patients with diabetes.

8. Historical information

CPT code 3051F was added to the Current Procedural Terminology system on October 1, 2019. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with diabetes has a most recent HbA1c level of 7.3%.
2. For a patient with diabetes, the most recent HbA1c level is 7.5%.
3. A patient’s HbA1c level, indicating diabetes, falls within the range of 7.0% to 7.8%.
4. A patient with diabetes has a most recent HbA1c level of 7.2%.
5. For a patient with diabetes, the most recent HbA1c level is 7.6%.
6. A patient’s HbA1c level, indicating diabetes, falls within the range of 7.1% to 7.9%.
7. A patient with diabetes has a most recent HbA1c level of 7.4%.
8. For a patient with diabetes, the most recent HbA1c level is 7.8%.
9. A patient’s HbA1c level, indicating diabetes, falls within the range of 7.2% to 7.7%.
10. A patient with diabetes has a most recent HbA1c level of 7.1%.