dietitian billing: Hi i need help with some dietitian billing. any experts? what are the proper cpt codes for billing a dietitian visit?

dravekar

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dietitian billing:
Hi i need help with some dietitian billing. any experts? what are the proper cpt codes for billing a dietitian visit?
dietitian is in process of getting credentials and is billing under the main provider as of now.
which codes will be appropriate to bill? 99402..series, 97802 series and can they also bill a e/m 99212 series for same day?

Any help will be much appreciated.

Thanks.
 
Dietitians are not a recognized provider type that can bill the 99211-99205 series of codes. Providing E/M services are not in the scope of practice for a dietitian. Those codes are reserved for physicians, nurse practitioners, physician assistants, certified nurse midwives, and certified registered nurse anesthetists. Dietitian services are coded using CPT codes 97802-97804. Other questions I would consider are if the dietitian is contracted with your payers and able to submit claims under themselves? Is the dietitian employed by a physician and providing these services under their supervision? What setting are these services occurring in?
 
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Hi Dravekar :)
Amanda is right your diet gurus cannot bill CPT 99202-99215 unless a clinician such as MD DO NP or PA. Dieticians not allowed to use those codes. CPT 99402, 97802 can be used and 98960 series for phone calls to check up on the person/patient at home. Ensure the dietician use descriptive documentation and add minutes helped patient . Some dx codes accessible are dx blocks E66 E63 Z71.3, Z68 series in conjunction with BMI % and dx block of R63 and Anemias D50-D60 if applicable. Add those chronic conditions DM, N18, I50, F32, M54, if meds interfere with losing poundage. Also tell them to add if patient is current smoking or drinking F17 or F10 if applicable or if pt. stressed due to life situations. F41, Z63. Our billing folks been told add referring doctor on these claim if this is true.
Take care and hope helped you
Lady T:cool:
 
Hi Amanda, Many thanks for your reply, I appreciate it very much. Answers to your above queries.

if the dietitian is contracted with your payers and able to submit claims under themselves? I dont think so , she is under the process of credentialling and currently bills under the physician.

Is the dietitian employed by a physician? YES.

and providing these services under their supervision? YES

What setting are these services occurring in? pediatricians office setting: POS 11, sometimes tele visit POS:10

Pl let me know if you have an email adress where i can reach you in future if needed? Thanks for your help. Happy Independence day !!!
 

Hi TThivierge,​

Thanks for your response as well, tips are very helpful. the dietitian is documenting the time in her notes for sure. and i do see the dx codes that you have mentioned , the dietitian is using them along with BMI%
 
Hi Amanda,
I got some more information: so the dietitian is not credentialed YET, she is still in the works to become credentialed and currently is billing under a different doc who is a MD pediatricians.
what would be appropriate and correct codes to bill for the dietitian visits under this circumstances? please help.
 
So your dietitian would bill under the supervising provider who is present in the office when she is seeing patients. I would still recommend the 97802-97804 codes. Some insurance carrier may accept 99402, but this code is typically reserved for physicians, APPs, etc. The dietitian can absolutely use 97804 any time 2 or more individuals are assessed at the same time. Once the dietitian is credentialed with payers, the terms of the contract will help direct what can and can't be billed.
 
Thanks Amanda. The dietitian is under the process of getting her credentials and is billing under the main doctor in the practice. The main doc is not a registered dietitian. I am not sure if the main doc is present with her while she is seeing the patients but i can verify this with her . so lets say the doc is present while the dietitian is treating the patient. then its ok to bill 99212 or 99202 series? Thanks for clarifying code 97804, yes she sometimes does group counseling.
 
does the main doc (under whom the dietitian bills) has to be present with the dietitian in the room while she performs her visits? in that case would a 99212 or 99202 series be valid to bill?

if he is not present then just stick to the dietitian codes 97802 99402 series that is what i am taking from your reply. pl confirm.
 
Also, 97802 is for initial assessment and after that every time patient comes in for f/u we will have to use 97803 right?
 
So your dietitian would bill under the supervising provider who is present in the office when she is seeing patients. I would still recommend the 97802-97804 codes. Some insurance carrier may accept 99402, but this code is typically reserved for physicians, APPs, etc. The dietitian can absolutely use 97804 any time 2 or more individuals are assessed at the same time. Once the dietitian is credentialed with payers, the terms of the contract will help direct what can and can't be billed.
Amanda, Could an NP (who is also a CDCES/CDE) who provides education on insulin pump usage bill 98960 on the same day the patient is in to see the MD for a regular office visit? Is there another way to bill for this education?
 
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