Wiki Diabetic Educator

Create Wiki
S

StacyGalloway

Networker
Messages
80
Location
Gardner, KS
Best answers
0
We have a new Diabetic Educator in our clinic and there has been several opinions on how to bill for this. I state G0108 (medicare) for individual training (30min) is what we need to use if it is just the patient coming in to see the DE only. If this code is not accepted by all insurance carriers, then can we use 99211 or 98960? Also is there a maximum number of visits they can have per year? Is it based on time? I have never billed for this and have read the AADE's Reimbursement Tips for Primary Care Practice, but would like some "real world" advice. Thank you!
 
Use G0108

We use G0108 for all insurances for diabetic education. Because this is a time-based code (30 minute) increments, the educator MUST document how much time was spent with the patient face-to-face.

It would never be appropriate to bill out a 99211 nurse visit for this service, as there is specific codes (CPT and HCPCS) for this service.
 
Sharon

New to my practice is diabetic education through a CDE. My question is does the CDE bill under her own NPI and how are the service billed for those carriers that do not enroll the educator.
 
Bumping this up. I have the same question about how to bill. The educator would be the servicing provider. Who would be the billing provider?
 
We have found that Medicare wants the physician who ordered the education listed as billing provider even though the DE does the work. We are still waiting on other insurances such as BCBS, Aetna.....to see what they prefer.

Stacy
 
At our facility, the "diabetes educator" is not even a CDE (RN), so I have been only using 99211 and having the medical director sign off on all her notes, and using his NPI for billing purposes
 
You must log in or register to reply here.
Top