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Medicare covers screening and counseling for obesity

  1. #21
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    Northeast Kansas (NEKAAPC)
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    Medical Coding Books
    I cannot find anything on CMS that specifically addresses the ICD-9-CM codes to be used.

    I would suggest V65.3-dietary surveillance and counseling (which includes obesity) and V85.3_ or V85.4_ to report the BMI.

    Keep in mind there may be policies that will be specific to a Medicare intermediary so you will need to check with your local carrier.
    Brenda Edwards, CPC, CDEO, CPB, CPMA, CPC-I, CEMC, CRC
    AAPC Fellow
    AAPC ICD-10-CM/PCS Training Expert


    Kindness is contagious-PASS IT ON!

  2. #22
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    Overland Park, KS
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    Thanks. I spoke with one of the MAC carriers that I deal with and they could not provide me an answer. It appears that Medicare has not made an official determination on the ICD-9-CM codes for these services as of yet.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  3. #23
    Default
    What about CPT codes? Will these be billed as office visits?

    Thanks,
    Debbie

  4. #24
    Location
    Dover Seacoast New Hampshire
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    2,016
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    Quote Originally Posted by daharden View Post
    What about CPT codes? Will these be billed as office visits?

    Thanks,
    Debbie
    Since the other screening coverage (CVD, ETOH, etc) have been assigned G-codes, (see 2012 HCPCS and the links above to the LCDs) and the G0449 for obesity screening was apparently deleted, I can tell you that it will likely be a G-code, not an E&M code from CPT. We're waiting for the LCD to come out for the final answer on Obesity.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  5. Default Any updates
    Has anyone seen any updates re: the coding for the Obestiy screening yet?

  6. #26
    Default What codes insurance companies will accept
    Hello Everyone,

    Since Medicare has not officially come out with the codes for obesity screening and counseling, I am trying to find out what codes different insurance companies (Humana,Anthem etc.) are accepting for payment of screening and counseling for obesity but I am having the hardest time doing so. Can anyone give me any tips,help on where on these ins company websites I can find out such info? Or should I just call the ins company directly? Any help on this would be greatly appreciated. Thanks

  7. #27
    Location
    Dover Seacoast New Hampshire
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    I participated in a recent (12/28/2011) Ask the Contractor Conference sponsored by NHIC (contractor for ME, NH, VT, MA). I asked about the codes for Obesity Screening. Here's their answer.

    Q10.
    I am unable to locate information regarding obesity screening and coverage. There are no G-codes or diagnosis codes currently listed that would be appropriate to use.
    A10. On November 29, 2011, the Centers for Medicare & Medicaid Services (CMS) announced that Medicare is adding coverage for preventive services to reduce obesity. However, at this time CMS has not released the applicable codes to report this service. As soon as NHIC, Corp. receives that information from CMS, we will post to our website.
    Reference:
    http://www.medicarenhic.com/providers/articles/CMS%20Message%20201111-71.pdf
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  8. #28
    Location
    Overland Park, KS
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    Medicare has released the codes (HCPCS and ICD-9-CM) that are to be used for this service:

    http://www.cms.gov/MLNMattersArticle...ads/MM7641.pdf

    I would recommend consulting with your Medicare carriers for their guidance.
    Last edited by dballard2004; 02-16-2012 at 01:47 PM.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  9. #29
    Location
    Dover Seacoast New Hampshire
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    Dawson, the MLM article you are referencing is the guidance for the obesity counseling.

    We're still trying to identify the codes and guidance for the obesity screening.


    Just wanted to clarify, because they're two different services.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  10. #30
    Location
    Overland Park, KS
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    Pam,

    From what I gather, the screening is part of the obesity counseling. Per the MLM article, IBT for obesity includes an obesity screening.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

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