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Wiki Nutrition counseling

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MLH

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Sacramento, CA
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I am billing for a practice who sees children who are at risk for diabetes or heart disease. The patients are referred by their pediatrician. In addition to seeing the doctor, the patient will usually also see the nutritionist, exercise therapist or psychologist. I am trying to figure out how to bill for the time and counseling provided by the non-physicians. I was thinking their services can be billed as 'incident to', but what CPT makes the most sense? G0447 is for patients who are obese. But there is also S9470 which seems like it would have to be billed by the nutritionist/dietician not as part of 'incident to'. There was some opinion that using a prolonged visit code would be a way to bill for the extra time for the auxillary personnel, but this code specifically needs to be FTF with the MD. I am also thinking 99401-99404 might be appropriate. These are preventative, so would I use a V code for the diagnosis even though many patients have abnormal labs and/or weight problems?

Any ideas?
 
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