# E/M and 97802



## LLovett

I am seeing providers code both an E/M (could be problem or well) and 97802. There are no CCI edits in place but the documentation is not supporting time for the nutritional therapy and, especially with the well care, I don't think there is enough to support billing this service in addition to the E/M. 

These are going primarily to commercial payers, no Medicare. 

Just looking for others thoughts or supporting information. 

Thanks

Laura, CPC, CPMA, CEMC


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## jbcpc

Medicaid will allow four (4) visits per calendar year. Services must be provided by a licensed registered dietitian (LRD) or nutrition professional meeting certain requirements.

do these physicians meet the above as it is for dietitians not pcp's etc


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## LLovett

These are just physician, no special additional training. They are getting paid for these visits though. Which of course is their argument...


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## MarcusM

CPT 97802–97804. "These codes should be reported only for services provided by nutritionists. If a physician provides medical nutrition therapy, the E/M or preventive services codes should be used. Private payers may also accept HCPCS codes S9452, S9465 or S9470 for a session of nutrition therapy provided by a nutritionist."

http://www.aafp.org/fpm/2006/1000/p29.html


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## LLovett

Thank you Marcus, this is very helpful.


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## dkbill

*Can you bill them together*

Does anyone know if you can bill 97802 or 97803 with S9470?  
I have billed them together, Some ins companies pay for both codes and some do not.  What is the rule, or is it up to the ins co.


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## CodingKing

dkbill said:


> Does anyone know if you can bill 97802 or 97803 with S9470?
> I have billed them together, Some ins companies pay for both codes and some do not.  What is the rule, or is it up to the ins co.



Unless the payer specifically requests S codes use CPT codes instead. As far as I can tell billing the CPT & the S code is double billing


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