Capture Diabetes Counseling Services With This Action Plan
Published on Mon Apr 24, 2006
Medicare will cover MNT and DSMT--but you must meet these requirements With the number of diabetes cases consistently on the rise, you can't afford to miss out on reimbursement for nutritional and educational services that your staff dieticians provide.
On any given day, nearly half the patients at Montefiore Medical Center in the Bronx -are there for some trouble precipitated by- diabetes, according to a recent report in The New York Times titled -Diabetes and Its Awful Toll Quietly Emerge as a Crisis.- And nutrition and diabetes education is the key to preventing further disease-related complications.
-Nutritional and diabetes education alone lowered our patients- A1c by almost 1 percent without changing medication regimens,- says Reinhard Wolfgang Beel, CEC, business manager at Cumberland Valley Endocrinology Center LLC in Carlisle, Pa.
When your practice takes part in these prevention efforts by offering nutritionist- or dietician-run diabetes sessions, you can ensure your physician receives Medicare payment if you take these steps: Step 1: Choose Between CPT and HCPCS Codes When an individual nutritionist consults with a patient in a non-certified physician setting, you-ll most likely report diabetic sessions with 97802-97803. -But if your practice has an American Diabetes Association-approved program, you may also use G0108-G0109,- says Maureen Latanick, PhD, RD, CDE, a nutritionist with Millhon Medical Clinic in Columbus, Ohio.
Here's how: For non-certified programs, select the nutrition session code based on the patient's status and the individuals involved. -Use 97802 (Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes) for initial medical nutrition therapy (MNT) involving a single Medicare diabetic patient,- Latanick says.
Report a follow-up patient session with 97803 (... re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes), she says. For group sessions, assign 97804 (... group [2 or more individuals], each 30 minutes).
Example: After a physician diagnoses a patient with diabetes and orders MNT, the practice's nutritionist meets with the patient for a 45-minute initial assessment and intervention. The patient later returns for a two-hour group session that involves re-assessment and intervention.
You should report the initial session with three units of 97802 and the group follow-up session with four units of 97804. One unit of the individual code represents 15 minutes, and a group unit consists of 30 minutes.
To code ADA-certified diabetes self-management training (DSMT) sessions, determine how many patients attended the service. Code individual sessions with G0108 (Diabetes outpatient self-management training services, individual, per 30 minutes). When two or more patients attend the session, assign G0109 (Diabetes self-management training services, group session [2 or more], per 30 minutes).
Step 2: Report Under the Nutritionist's Number Prompt payment of MNT sessions depends on avoiding one common filing mistake: reporting these sessions as incident-to. Because [...]
