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Bariatric Billing

Angel Posted Thu 29th of August, 2019 15:52:37 PM
My provider(General Surgeon) see's patients on a regular monthly basis for weight management in preparation for Bariatric Surgery. Depending on the patient’s plan they may have to complete six to twelve months of supervised weight loss management to qualify for surgery, in addition to a one-time nutritional counseling and psychiatric evaluation. He is also the surgeon who performs the bariatric surgery. I have seen articles stating to bill these visits as G0447 for Medicare and 99401-99404 for commercial carriers. Are these codes for "dietary/nutritional" counseling only? Can these be reported by a General Surgeon? What is the correct way to bill for the supervised weight loss visits in preparation for Bariatric Surgery?
SuperCoder Answered Fri 30th of August, 2019 07:14:45 AM

Hi Angel,

 

Thanks for your question. Please find answer below:

 

Codes recognized by Medicare:

G0447 Face-to-face behavioral counseling for obesity, 15 minutes

G0473 Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes

G0447 and G0473 must be billed along with 1 of the ICD-10 codes for BMI 30.0 and over (Z68.30 - Z68.39, Z68.41 - Z68.45).

 

Codes recognized by commercial payers:

99401 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes

99402 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes

99403 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes

99404 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes

97802 Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes

97803 Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes

97804 Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes

 

Note: These codes can be reported by a general surgeon for "dietary/nutritional" counseling for face-to-face visit and can be reported when provider renders behavioral counseling for an obese patient who is overweight with a BMI greater than 30.

 

Dx Codes:

The above-mentioned CPT codes must be billed along with one of the following ICD-10 codes for BMI 30.0 or more:

1. Z68.30 Body mass index (BMI) 30.0-30.9, adult

2. Z68.39 Body mass index (BMI) 39.0-39.9, adult

3. Z68.41 Body mass index (BMI) 40.0-44.9, adult

4. Z68.45 Body mass index (BMI) 70 or greater, adult

 

Please feel free to write if you have any question.

 

Thanks

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