| |
| Section: |
Visits |
| Number: |
V-44 |
| Topic: |
Medical Nutrition Therapy (MNT) |
| Effective Date: |
July 17, 2006 |
| Issued Date: |
July 17, 2006 |
General Policy
Medical Nutrition Therapy (MNT) consists of an initial visit for an assessment; follow-up visits for intervention, and reassessment as necessary during the 12 month period beginning with the initial assessment (episode of care) to assure compliance with the dietary plan. Indications and Limitations of Coverage Medical nutrition therapy services (diagnostic, therapeutic, and counseling) when provided by a registered dietician or nutrition professional for medical necessary reasons will be reimbursed according to the applicable network rules.
Payment for Dietitian and Nutritionist Services
Payment for a registered dietitian or nutrition professional services are made at the lesser of the actual charge or 85 percent of the physician fee schedule. - NOTE:
- This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical records.
Procedure Codes
| 97802 | 97803 | 97804 | G0270 | G0271 | |
Coding Guidelines
Code 97802 is to be used only once a year, for initial assessment of a new patient. All subsequent individual visits (including reassessments and interventions) are to be reported under code 97803, G0270. All subsequent group visits are to be reported under code 97804, G0271.
References
CMS On-Line Manual Pub. 100-4, Chapter 4, Section 300.4
Attachments
Procedure Code Attachments
Diagnosis Codes
Glossary
 |
This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical records.
Medical policies are designed to supplement the terms of a member's contract. The member's contract defines the benefits available; therefore, medical policies should not be construed as overriding specific contract language. In the event of conflict, the contract shall govern.
Medical policies do not constitute medical advice, nor the practice of medicine. Rather, such policies are intended only to establish general guidelines for coverage and reimbursement under Medicare Advantage plans. Application of a medical policy to determine coverage in an individual instance is not intended and shall not be construed to supercede the professional judgment of a treating provider. In all situations, the treating provider must use his/her professional judgment to provide care he/she believes to be in the best interest of the patient, and the provider and patient remain responsible for all treatment decisions.
Medicare Advantage retains the right to review and update its medical policy guidelines at its sole discretion. These guidelines are the proprietary information of Medicare Advantage. Any sale, copying or dissemination of the medical policies is prohibited; however, limited copying of medical policies is permitted for individual use.
|
