Eli's Rehab Report
Report New MNT Codes for Changes
PDF
Question: A dietitian comes to our rehab facility once a week to meet with some of our patients. She told us that Medicare recently created a new medical nutrition therapy (MNT) code, but we can't find any new CPT codes in this category. Are we looking in the right place? Puerto Rico Subscriber Answer: Although they are not included in CPT 2003, CMS Transmittal A-02-115 introduced two new HCPCS codes for medical nutrition therapy (MNT) services rendered to patients whose conditions have changed. These codes are printed in the 2003 HCPCS manual: Registered dietitians (RDs) should use the new G codes when patients with diabetes or non-dialysis kidney disease require additional hours of MNT beyond what CMS normally covers three hours in the initial year and two follow-up hours of MNT in subsequent years with a physician referral. For instance, your RD renders three hours of MNT to a diabetic Medicare beneficiary, and then the patient develops kidney disease. The diagnosis change would warrant additional MNT to adjust the patient's nutrition prescription and goals. Remember that the MNT codes do not apply to physicians or therapists (unless they also happen to be RDs). Include the physiatrist's nutrition advice to patients when assigning codes for his or her E/M services.
Eli's Rehab Report
- Multiple Diagnoses, High Risk May Increase Inpatient Code Level
According to CMS data, physiatrists report 99231 more than any other CPT code, which indicates [...] - You Be the Coder:
Use V67.09 for Annual Visit
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Know CMS Guidelines for Subsequent Hospital Care
The following are CMS'documentation guidelines for the three subsequent hospital care codes:
99231 Subsequent hospital [...] - High-Risk Patients May Warrant 99233
The following scenarios illustrate typical examples of when physiatrists use subsequent hospital care codes: Scenario [...] - Bier Block Coding Can Be Painless
Although you should choose 01995 when administering Bier blocks for surgical anesthesia, some payers do [...] - Clarification:
Coding Late Effects of CVA
The February 2003 article "Use Just One Diagnosis Code for Late Effects of Stroke" advised [...] - Reader Question:
Append -51 to Block With SI Injection
Question: Our physiatrist administered a caudal epidural block and a left sacroiliac (SI) joint injection [...] - Reader Question:
Use 64622 for Nerve Destruction
Question: Our physiatrist performed a radiofrequency thermal coagulation (RFTC) to disable the nerves in a [...] - Reader Question:
Mental Assessment Differs From MME
Question: One of our physiatrists performed a mental assessment on a patient who exhibited symptoms [...] - Reader Question:
Dont Code Both Injection and Nurse Visit
Question: When our nurses administer injections, we usually report the codes for injection administration, the [...] - Reader Question:
Report New MNT Codes for Changes
Question: A dietitian comes to our rehab facility once a week to meet with some [...] - Reader Question:
Medicare Will Deny Prolotherapy
Question: We have been performing an increasing number of prolotherapy injections in our practice, but [...] - Reader Question:
Report 99271 Series for Second Opinions
Question: One of my former patients, whom I havent seen in more than a year, [...]