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Code for nutritionist

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Cherylwilli:
I have a nutritionist who isn't familiar with CPT codes and billing insurance companies.  The nutritionist has a patient who was referred from an OB.  The patient is pregnant and obese.  The OB wants patient, who is in her first trimester to keep her weight gain to 15 pounds.  Since my other providers are in mental health, I'm not sure if I should code this for something other than obesity (278.00).  Can someone advise me?  Thanks.

Cheryl

PMRNC:
You will want to check your state scope of licensing for coverage, but normally for Medical Nutritional Therapy (MNT) you would use CPT codes 97802  97803  97804.
I had a small LRD at one time but she was very small and mostly cash because many of the carriers did not cover it back then. In some states it's a mandated benefit for certain diagnosis. I can't advise you on the diagnosis since I don't have the patient's chart. you have to assign the diagnosis that corresponds to the documentation in the patient's chart. IMO you should leave that up to the provider, there could be other conditions documented.
For those carriers that are covering it, it's a very small amount of visits and a very minimal payment. With Medicare they only cover MNT for renal disease and diabetes.

Cherylwilli:
Oops my mistake, I said CPT code but meant DX.  The nutrionist has no idea and doesn't know anything about any codes to bill insurances.  I agree payment is minimal.  Thanks.

PMRNC:
The provider knows how to diagnose correct? In that case then she really needs to get a coder. She had better know how to diagnose, from there the diagnosis is documented and from there it's translated from the chart documentation to an ICD-9 code. This is one thing you cannot take lightly and no one here can really tell you what diagnosis to put down because although that is a valid dx code for obesity we don't have the chart to determine if any other diagnosis was documented nor should we/could we guess.
If you are not an experienced coder I highly suggest letting the provider know that this is out of your scope of services.

Pay_My_Claims:
Not to mention the obesity codes that denote it  complicate pregnancy

649.10-649.13 Which is probably somewhere she needs to look. She has 2 conditions, pregnancy and obesity. Being overweight myself, I know that it complicates pregnancy, because by nature you gain additional weight from that, but the more weight you gain, the more issues you have. Also being severly overweight has an adverse affect on the pregnancy. Just as Linda stated we don't know what code to have you use because we don't have access to the chart. The physician needs to either take a class geared towards her specialty, or hire a coder/biller. Because of the low reimbursements I personally wouldn't hire 2 people, but get someone who could do both. 

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