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Diabetes self-management training

Janice Posted Mon 20th of February, 2012 21:00:27 PM

Is it acceptable to bill diabetes self-management education provided by a medical assistant is an endocrinologist office as '98960' ?

SuperCoder Answered Tue 21st of February, 2012 10:22:58 AM

Hi Janice,

Firstly, you should not report 98960 for diabetes self-management education. Also I think, Medicare does not pay for 98960-98962, but does publish RVUs for these codes.
Secondly, if any registered dietician or other licensed nutrition professionals has provided for diabetes education, you may report one of MNT codes 97802-97804 as per CPT Assitant.
(See Other Codes for Nutrition Services)
For outpatient diabetes self-management training services, you could use HCPCS Level II code G0108-G0109 as per medical necessity.

Janice Posted Tue 21st of February, 2012 21:06:52 PM

Hi Birenda,
Thanks for the input. The training is not diet-related, would 98960 then be indicated for commercial payors?

SuperCoder Answered Wed 22nd of February, 2012 03:38:40 AM

For commercial payors, you could probably report for this.

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