Endocrinology Coding Alert
You Be the Coder: Select Code Carefully for Dietician's Services
Question: If a patient sees the endocrinologist for a level-three office visit, and then also sees one of our dieticians for a 60-minute visit on the same day, how should we bill for the dietician's services? Could we attach a prolonged service code to the endocrinologist's 99213 (Office or other outpatient visit for the E/M of an established patient) to account for the dietician's service?
Texas Subscriber
Answer: You cannot report prolonged services (99354) to account for the dietician's service because the same physician must perform both 99213 and the prolonged service in order to link the two codes together on the same claim. In this case, you must report two separate services rendered by two separate providers.
If you are an American Diabetes Association-certified diabetes self-management education program, you may be able to use diabetes self-management training (DSMT) codes to report the dietician's services for Medicare patients. CMS pays on two DSMT codes: G0108 (Diabetes outpatient self-management training services, individual, per 30 minutes) and G0109 (Diabetes self-management training services, group session [2 or more], per 30 minutes).
Non-Medicare patients: If you are a certified education program, the patient has commercial carrier coverage, and the dietician renders DSMT in a group setting, you should report 99078 (Physician educational services rendered to patients in a group setting [e.g., prenatal, obesity, or diabetic instruction]). Some carriers will also cover 99078 for diabetes education if you are a non-certified program.
Another option: If the dietician counsels the patient on nutrition issues other than diabetes education and training, or if the dietician provides DSMT and you are a non-certified program, you may also be able to report medical nutrition therapy codes for the dietician's service:
97802 - Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
97803 - ... re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
97804 - ... group (2 or more individual[s]), each 30 minutes.
- Published on 2004-09-23
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