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Dietitian codes

  1. Smile Dietitian codes
    Medical Coding Books
    What CPT codes should an out-ptient clinical practice owned by physicians use for billing dietary counseling services? In this situation a registered dietitian meets face-to-face with patients providing nutritional counseling.

    what specific requirements do we need in order for our clinic to bill these codes. If the registerd dietitian is providing diabetic counseling and nutritional therapy, does the dietitian have to be a certified diabetic counselor?

    Is it required by the third pary payor that the physician also meet with the patient during that same day visit.

    When billing for this service under the physician doctor #/provider#, or should we be billing the service under a separate provider # associated with the registered dietitian (and if this is the case, does the payor require credentialing of the registered dietitian)?

    Any response at all would be appreciated. Toni R

  2. #2
    Default dietician billing codes to use - a question to Shannia and other Coders
    Hello Shannia and other coders,

    Did you receive an answer to your questions. I have the same questions, but it is now 2013. Specifically, I need to know what CPT codes should be used for a dietician. I am coming up with some possibilities, 97802-97804( medical nutrition therapy); 99078 (educational services to a group eg. prenatal, obesity, diabetic); and 99401 -99404 (preventive medicine, individual) with 99411-99412 (preventive medicine, group).

    Thanks,
    Holly Eustice, CPC, CPC-H
    Indianapolis, Indiana

    Quote Originally Posted by shannia View Post
    What CPT codes should an out-ptient clinical practice owned by physicians use for billing dietary counseling services? In this situation a registered dietitian meets face-to-face with patients providing nutritional counseling.

    what specific requirements do we need in order for our clinic to bill these codes. If the registerd dietitian is providing diabetic counseling and nutritional therapy, does the dietitian have to be a certified diabetic counselor?

    Is it required by the third pary payor that the physician also meet with the patient during that same day visit.

    When billing for this service under the physician doctor #/provider#, or should we be billing the service under a separate provider # associated with the registered dietitian (and if this is the case, does the payor require credentialing of the registered dietitian)?

    Any response at all would be appreciated. Toni R

  3. #3
    Location
    Palo Alto, CA
    Posts
    18
    Default Any new info???
    Did you receive any additional information regarding coding for these visits? Any help would be appreciated!


    thanks!

  4. #4
    Default Dietician billing/Coding
    hello!

    My Infectious Specialist want to hire a dietician to who he will refer patients for Obesity and BMI over 30. Based on PQRS guidelines, Physicians has to go over obesity and BMI. I am wondering

    1. Are these conditions are covered now under Medicare?
    2. Can Dietician provide service to patients from Physician's office?
    3. Will I use 97802/97803 or 99401 - 99404?

    Any response will be appreciated by experts.

    Thanks
    Chhaya

  5. Default
    These are my experiences billing for a dietitian in a tribal clinic. As always, your mileage may vary.....


    1) yes, as long as the dietitian is licensed and enrolled with Medicare under their own NPI and PTAN. For Medicare, make sure the REFERRING provider is the doc who referred the patient, not the dietitian

    2) Yes

    3) We use the 9780x codes and G0270 for Medicare patients, and we have a pretty high success rate for getting paid. Don't forget to adjust your "quantity" based on how long the visit took

  6. #6
    Smile
    Quote Originally Posted by erjones147 View Post
    These are my experiences billing for a dietitian in a tribal clinic. As always, your mileage may vary.....


    1) yes, as long as the dietitian is licensed and enrolled with Medicare under their own NPI and PTAN. For Medicare, make sure the REFERRING provider is the doc who referred the patient, not the dietitian

    2) Yes

    3) We use the 9780x codes and G0270 for Medicare patients, and we have a pretty high success rate for getting paid. Don't forget to adjust your "quantity" based on how long the visit took
    Thanks for reply erjones147,

    I have sent you message in inbox.

  7. #7
    Default Dietitian Referral
    If Dietitian is working for a specialty group like Urologist, infectious Disease or Gastroenterologist, then can a Physician from same group refer a patient to Dietitian who is under same group NPI and Ptan?

    Any response from experts is appreciated.

  8. #8
    Default
    Quote Originally Posted by erjones147 View Post
    These are my experiences billing for a dietitian in a tribal clinic. As always, your mileage may vary.....


    1) yes, as long as the dietitian is licensed and enrolled with Medicare under their own NPI and PTAN. For Medicare, make sure the REFERRING provider is the doc who referred the patient, not the dietitian

    2) Yes

    3) We use the 9780x codes and G0270 for Medicare patients, and we have a pretty high success rate for getting paid. Don't forget to adjust your "quantity" based on how long the visit took
    Erjones147,

    Medicare rep advised me that they will cover 9780x or G0270 with only diabetes or ESRD conditions, but obesity and BMI is not covered. Are you getting paid with Obesity and BMI dx?

  9. Default
    Erjones147,

    Medicare rep advised me that they will cover 9780x or G0270 with only diabetes or ESRD conditions, but obesity and BMI is not covered. Are you getting paid with Obesity and BMI dx?


    yeah, I have found that to be true. The obesity/BMI thing was what I was referring to when I mentioned "pretty high success rates." At our clinic, more that 90% of the patients referred to the dietitian are diabetic anyway, so I'm OK with just eating the bill for obesity-only referrals

    At our clinic, we can't refuse service as long as the patient is eligible to receive care (tribal health clinic), so we have a lot of non-pay patients. If someone wants to see a specialist, all they have to do is make an appointment, and they will automatically be seen, regardless of whether or not their visit is billable

  10. Default
    I work for a payer, a very large percentage of our contracts (both self funded and fully insured) allow 26 nutrition therapy visits per year, as a preventive service, (unlimited for age 22 and under.) Out of the 26, 10 can be used for conditions like ie hypertension, diabetes (in the event that someone doesn't have obesity.) Every payer will have their own rules. This is rather new, so watch your EOBs closely to ensure the adjudication is correct.

    Your question on the dietitian billing under a group. Yes, a physician can refer to a dietitian under the same TIN/NPI, their services would be billed separately with different CPT codes. Again, every payer likely has a different set of rules.
    Last edited by TheRoseLady; 05-28-2014 at 05:36 PM. Reason: Clarification about the 10 visits.

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