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4 Tips Advance Your Coding for Medical Nutrition Therapy

Ensure payment by informing patients up front if therapy is noncovered
You may not know how and when you can bill medical nutrition therapy (MNT) services if your endocrinology practice also offers diabetes self-management training (DSMT). Which codes you should report depends on your practice's credentials, the service your practice renders, and each payer's specific requirements.
Improve your MNT coding prowess with these four expert tips:
1. Choose between DSMTand MNTcodes. If your practice has an American Diabetes Association-certified diabetes self-management education program, you can choose G0108 (Diabetes outpatient self-management training services, individual, per 30 minutes) or G0109 (Diabetes self-management training services, group session [2 or more], per 30 minutes) in addition to MNTcodes:


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.

If your practice is ADA-certified, you can report MNT codes if you simply counsel the patient on nutrition. However, if you counsel a diabetic patient on other facets of diabetes management in addition to nutrition, DSMT codes more accurately describe the service you provide, says Cindy Lewis, office manager at Palm Beach Diabetes and Endocrine Specialists in West Palm Beach, Fla.
If your practice is not ADA-certified, you can use MNT codes to report all of your medical nutrition education services. "We use 97802-97804 for diabetic patients who get medical nutrition education, but also for patients with other endocrine disorders, such as obese patients," says Teresa Herminghuysen, office manager of Endocrine Care and Education Center in Biloxi, Miss.
Reporting both: Depending on the payer, a patient's policy may include coverage for both DSMT and MNT, says Ginger Such, RD, CDE, program director at Indiana University Diabetes Center in Indianapolis. For example, Medicare will pay for a diabetic patient to receive DSMT and MNT within the same treatment period if the physician deems it necessary and the patient meets certain requirements. The only catch: "A beneficiary may not receive MNT and DSMT on the same day," states the Centers for Medicare and Medicaid Services in an article titled "Additional Clarification for Medical Nutrition Therapy (MNT) Services."
2. Bill under the correct provider identification number (ID). You should first check with payers and state guidelines regarding who can provide nutrition counseling. Medicare only covers services "furnished by a registered dietician (RD) or nutrition professional meeting certain requirements," according to CMS. Some private payers, however, may allow registered nurses and nurse practitioners to provide MNT services.
Consider contracts: In addition [...]

- Published on 2004-06-21