; and (2) in subsection (yy)— (A) in the heading, by adding ; Pre-Diabetes at the end; and (B) by adding at the end the following new paragraph: (4) The term pre-diabetes means a condition of impaired fasting glucose or impaired glucose tolerance identified by a blood glucose level that is higher than normal, but not so high as to indicate actual diabetes. . (b) Effective date The amendments made by this section shall apply with respect to services furnished on or after January 1, 2019.