# billing for a dietician



## Colliemom (Dec 16, 2011)

We are hiring a dietician, and we are wondering how we would bill for her services?  What codes would we will bill?  Would we use 99401 - 99404, or an established patient code? (99211 - 99215)  The dietician is also a PA, if that matters.

She would either be seeing the patients for an office visit, for a GI related issue, and then counseling them on diet OR the physician would perform the office visit and the PA/dietician would then provide the counseling on diet.

Thank you!


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## Colliemom (Dec 22, 2011)

Bump


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## herrera4 (Dec 22, 2011)

depending on ins i might look at 97802/97803 bill by each 15 min or we are told for bcbs use s9470 as one unit and we dont bill if pt sees dietician and doc on same day


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## eescalante (Dec 28, 2011)

Agree with the CPT codes suggested by herrera4.

Also, be aware that Medicare (and most commercial payers) only cover nutrition for End Stage Renal Disease and Diabetes diagnoses. Otherwise, all our nutrition patients are self - pay.


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## Colliemom (Apr 24, 2012)

Thank you!

So you do not feel that the 99401 - 99404 would be appropriate?  I read in the description that these codes are use for new or established patients for "preventative medicine counseling and risk factor reduction...and should address such issuses as family problems, *diet and exercise,* substance use, sexual practices, injury prevention,...etc."


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## Colliemom (Aug 1, 2013)

*New question on billing for dietician visits*

Has anything changed in how to bill a visit performed by a dietician for nutritional counseling?  

Also, 

So you do not feel that the 99401 - 99404 would be appropriate? I read in the description that these codes are use for new or established patients for "preventative medicine counseling and risk factor reduction...and should address such issuses as family problems, diet and exercise, substance use, sexual practices, injury prevention,...etc."


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## bethdeak (Aug 1, 2013)

When I worked in a Gi practice that employed a dietician we always billed with the 97802 and 97803 CPT codes in 15 minute increments.  Visits ranged between 30-60 minutes depending on the appointment (new/return).

ABN's are necessary for Medicare patients if your dietician is not seeing the patients for one of the four or so approved ranges of dx codes. (DM, ESRD, ect).  Some practices choose to make all their MNT self pay, then encourage the patients to submit directly to their  commercial carriers for consideration.

Our patients never saw the dietician on the same day, the rationale was that sometimes patients that they thought might need to see a dietician would end up being able to be counseled by the MD and not in fact need extensive MNT services.  Patients in the practice referred to the dietician were referred because it was above and beyond what counseling the physician could provide (complete review of diet/supplements/bowel habits ect).


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