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NCCI 9.2 Bundles Nutrition Therapy With Everything!

Published on Fri Aug 01, 2003

In the latest release of NCCI edits, the National Correct Coding Initiative bundles medical nutrition therapy (MNT) into several E/M CPT codes and even into some G codes. This widespread bundling of the MNT codes into established codes is likely to be the most important change for internists, given the amount of medical nutrition counseling they administer daily for many common patient conditions.
 

NCCI version 9.2, which went into effect July 1, bundles G0270 (Medical nutrition therapy, reassessment and subsequent intervention[s] following second referral in same year for change in diagnosis, medical condition or treatment regimen [including additional hours needed for renal disease], individual, face to face with the patient, each 15 minutes) and G0271 (Medical nutrition therapy, reassessment and subsequent intervention[s] following second referral in same year for change in diagnosis, medical condition or treatment regimen [including additional hours needed for renal disease], group [2 or more individuals], each 30 minutes) into many psychiatry, dialysis, rehabilitation, and E/M codes as well as the following G codes:
 
 

  •  G0108 Diabetes outpatient self-management training services, individual, per 30 minutes
     
  •  G0109 Diabetes self-management training services, group session (2 or more), per 30 minutes
     
  •  G0112 NETT pulmonary rehabilitation; nutritional guidance, initial
     
  •  G0113 NETT pulmonary rehabilitation; nutritional guidance, subsequent
     
  •  G0177 Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more).
     
    In all of the cases above (except G0177), G0270 and G0271 carry status indicator "0," meaning they cannot be unbundled from their comprehensive codes. MNT has status indicator "1" with G0177 and can be unbundled from the service to separately report services in cases where medical nutrition therapy does not play a role in the training services provided to a patient. In such a case, you would use modifier -59 (Distinct procedural service).
     
    In other changes, the codes below have been designated "mutually exclusive," which means you will not routinely bill these services together. These services are usually of the "either/or" variety: Your physician will perform one of them or the other, but almost never both in the same session. (See "NCCI 101: Navigate the Edits' Lingo" below for more information about mutually exclusive and bundled NCCI code designations.)
      
  •  93797 (Physician services for outpatient cardiac rehabilitation; without continuous ECG monitoring [per session]) is now considered mutually exclusive of 93015 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise ...), 93017 ( tracing only, without interpretation and report), 93018 ( interpretation and report only) and 93025 (Microvolt T-wave alternans for assessment of ventricular arrhythmias)
     
  •  93798 ( with continuous ECG monitoring [per session]) is mutually exclusive of 93017, 93018 and 93025.

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