Medical Billing Forum

General Category => General Questions => Topic started by: Cpatel on May 28, 2014, 07:46:06 AM

Title: Dietitian Billing
Post by: Cpatel on May 28, 2014, 07:46:06 AM
If Dietitian is working for a specialty group like Urologist, infectious Disease or Gastroenterologist, then can a Physician from same group refer a patient to Dietitian who is under same group NPI and Ptan? Will Dietitian be paid my Medicare and Commercials in this case for 97802/803?

Any response from experts is appreciated.
Title: Re: Dietitian Billing
Post by: Michele on May 28, 2014, 10:36:29 AM
Yes, I believe so.  They will be paid if it's a covered service under the plan.
Title: Re: Dietitian Billing
Post by: Cpatel on May 28, 2014, 02:06:14 PM
Thanks Michelle,

Also do Medicare cover Obesity and/or BMI dx with 9780X codes foe dietitian?

Appreciate.
Title: Re: Dietitian Billing
Post by: Sriram_Sub on May 29, 2014, 12:59:48 AM
I think yes. But code V65.3 (Dietary Surveillance and Counselling) would be more appropriate I guess. You may even try V85.4 (BMI 40 and over, Adult) depending on the age of the patient. Please post when you find a suitable code that is covered by Medicare so all of us could know what it is.
Title: Re: Dietitian Billing
Post by: Merry on May 29, 2014, 09:40:22 AM
Medicare only covers a limited set of diagnosis codes for a dietician. 
Title: Re: Dietitian Billing
Post by: Cpatel on May 29, 2014, 09:45:29 AM
Thanks for reply to all,

I will update once I start billing and receive response from Medicare.


Title: Re: Dietitian Billing
Post by: Merry on May 29, 2014, 01:52:14 PM
MNT_Reimb_Guide_Adden_508c.pdf
This is the latest info I could find on Medicare and dieticians.  Dated 2012. May be something more recent but I know, personally that the coverage is limited
Title: Re: Dietitian Billing
Post by: PMRNC on May 29, 2014, 02:15:41 PM
With the ACA, non grandfathered plans are also offering some services related to obesity. The plans required to cover it under the ACA have to spell out what is covered and under what circumstances.
Title: Re: Dietitian Billing
Post by: Merry on May 29, 2014, 02:36:31 PM
Agree Linda.. Well a little bit.  Under the ACA, obesity counselling is covered but only from a primary care provider;  not a registered dietician.  Question would be if a dietician is hired for this.. Could they bill as a dietician.  I say no.  Can they bill "incident to"..not sure.  Sad isn't it that the very people who are the best trained to do this cannot bill for this.  Of course if you have kidney disease or diabetes, that is a totally different story.  The rules for obesity counselling pertain to the primary care setting. 
Title: Re: Dietitian Billing
Post by: PMRNC on May 29, 2014, 03:04:41 PM
Quote
Under the ACA, obesity counselling is covered but only from a primary care provider;  not a registered dietician.  Question would be if a dietician is hired for this.. Could they bill as a dietician.  I say no.  Can they bill "incident to"..not sure.  Sad isn't it that the very people who are the best trained to do this cannot bill for this.  Of course if you have kidney disease or diabetes, that is a totally different story.  The rules for obesity counselling pertain to the primary care setting. 

If they are a part of the group practice yes..but again, going by licensure and scope of license. I don't think they can bill "incident to".
Title: Re: Dietitian Billing
Post by: Merry on May 29, 2014, 04:49:11 PM
Agree about not billing incident to.  Just thought maybe.  I don't know how a dietician would bill obesity counselling and get paid and certainly not fair to the patient who thinks it would be covered. Interesting subject as in this case scope of practice is not relevant.  And seriously, unless you have had a weight problem yourself, all you get is textbook material from primary care.  Rant over. 




Title: Re: Dietitian Billing
Post by: PMRNC on May 29, 2014, 05:27:51 PM
Quote
Agree about not billing incident to.  Just thought maybe.  I don't know how a dietician would bill obesity counselling and get paid and certainly not fair to the patient who thinks it would be covered. Interesting subject as in this case scope of practice is not relevant.  And seriously, unless you have had a weight problem yourself, all you get is textbook material from primary care.  Rant over. 

The dietician if used in primary care setting can be billed for under the primary care provider. My own health plan has allowed for this and it's specified. Hey I had my Jenny Craig paid for.. LOL (not the food, but membership and counseling).
Title: Re: Dietitian Billing
Post by: Merry on May 29, 2014, 06:29:36 PM
But this is Medicare Linda..different rules!!
Title: Re: Dietitian Billing
Post by: PMRNC on May 30, 2014, 02:53:15 PM
Yes, I know I was speaking of other health plans  Incidentally Medicare does pay a portion of Optifast which is liquid diet..  ::) Medicare covers all the Optifast counseling and labs.