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CPT codes, descriptions and other data only are
copyright 2007 American Medical Association (or such other date of
publication of CPT). All Rights Reserved.
Applicable FARS/DFARS Clauses Apply. Current
Dental Terminology, (CDT) (including procedure codes, nomenclature,
descriptors and other data contained therein) is copyright by the American
Dental Association.© 2002, 2004 American Dental Association. All rights
reserved. Applicable FARS/DFARS apply.
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Billing Instructions for Medical Nutrition Therapy
Medical Nutrition Therapy services are covered as
of January 1, 2002, for patients with diabetes or renal disease.
The initial episode of MNT is for 3 hours the
first year and 2 hours each additional year, but additional hours may be
covered beyond the hours typically covered under an episode of care when
the treating physician determines there is a change of diagnosis or medical
condition within such episode of care that makes a change in diet
necessary.
MNT Service can be
billed to FIs when performed in an
outpatient hospital setting. The Hospital outpatient departments can bill
for MNT services through the local FI if the nutritionists or registered dietitians
reassigns their benefits to the hospital.
The only applicable bill types are 13X, 14X, 23X, 32X and 85X.
ICD-9-CM Codes That Support Medical Necessity
For patients with diabetes:
250.00-250.03 Diabetes mellitus without mention of complication
250.10-250.13 Diabetes with ketoacidosis
250.20-250.23 Diabetes with hyperosmolarity
250.30-250.33 Diabetes with other coma
250.40-250.43 Diabetes with renal manifestations
250.50-250.53 Diabetes with ophthalmic manifestations
250.60-250.63 Diabetes with neurological manifestations
250.70-250.73 Diabetes with peripheral circulatory disorders
250.80-250.83 Diabetes with other specified manifestations
250.90-250.93 Diabetes with unspecified complication
648.80-648.84 Other current conditions in the mother classifiable
elsewhere, but complicating pregnancy, childbirth, or the puerperium, abnormal glucose tolerance
For patients with renal disease:
403.00 Hypertensive Chronic Kidney disease, malignant, with chronic kidney
disease stage I through stage IV, or unspecified
403.01 Hypertensive Chronic Kidney disease, malignant, with chronic kidney
disease stage V or end stage disease
403.10 Hypertensive Chronic Kidney disease, benign, with chronic kidney
disease stage I through stage IV, or unspecified
403.11 Hypertensive Chronic Kidney disease, benign, with chronic kidney
disease stage V or end stage disease
403.90 Hypertensive Chronic Kidney disease, unspecified, with chronic
kidney disease stage I through stage IV, or unspecified
403.91 Hypertensive Chronic Kidney disease, unspecified, with chronic
kidney disease stage V or end stage disease
585.1 Chronic kidney disease, Stage I
585.2 Chronic Kidney disease, Stage II (mild)
585.3 Chronic Kidney disease, Stage III (moderate)
585.4 Chronic Kidney disease, Stage IV (severe)
585.5 Chronic Kidney disease, stage V
585.6 End stage renal disease
585.9 Chronic Kidney disease, unspecified
593.9 Unspecified disorder of kidney and ureter
For patients who had successful kidney transplant:
V42.0 Organ or tissue replaced by transplant, kidney
Claims submitted for any other conditions will be denied as not medically
necessary under Section 1862(a)(1)(A) of the SSA.
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