§410.130. Definitions.
42 C.F.R. § 410.130
Chronic renal insufficiency means the stage of renal disease associated with a reduction in renal function not severe enough to require dialysis or transplantation (glomerular filtration rate [GFR] 15-59 ml/min/1.73m 2).
Diabetes means diabetes mellitus, a condition of abnormal glucose metabolism .
Episode of care means services covered in a 12-month time period when coordinated with initial diabetes self-management training (DSMT) and one calendar year for each year thereafter, starting with the assessment and including all covered interventions based on referral(s) from a physician as specified in § 410.132(c). The time period covered for gestational diabetes extends only until the pregnancy ends.
Medical nutrition therapy services means nutritional diagnostic, therapeutic, and counseling services provided by a registered dietitian or nutrition professional for the purpose of managing diabetes or a renal disease.
Physician means a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he or she performs such function or action (including a physician within the meaning of section of 1101(a)(7) of the Act).
Renal disease means chronic renal insufficiency, end-stage renal disease when dialysis is not received, or the medical condition of a beneficiary for 36 months after kidney transplant.
Notes, amendments, and revision history
Amendments
[66 FR 55331, Nov. 1, 2001, as amended at 68 FR 63261, Nov. 7, 2003; 86 FR 65667, Nov. 19, 2021; 88 FR 79529, Nov. 16, 2023]
Source
Source: 66 FR 55331, Nov. 1, 2001, unless otherwise noted.
Authority
Authority: 42 U.S.C. 1302, 1395m, 1395hh, 1395rr, and 1395ddd.
Source
Source: 51 FR 41339, Nov. 14, 1986, unless otherwise noted.
Amendments
[66 FR 55331, Nov. 1, 2001, as amended at 68 FR 63261, Nov. 7, 2003; 86 FR 65667, Nov. 19, 2021; 88 FR 79529, Nov. 16, 2023]