Marilyn Posted Mon 22nd of April, 2019 15:53:19 PM
I need to bill a Nutrition as Preventative. I have tried ?z71.3/97802" but the claim is still being denied. Member has coverage, but I am just being directed to ACA guidelines which I cannot seem to find the answer.
SuperCoder Answered Tue 23rd of April, 2019 03:50:23 AM
For Non Medicare payers, you should use the appropriate CPT code from the code range 99381-99397. These codes are specific to preventive medicine services. These are age specific codes. Use the appropriate CPT code from the provided code range as per the age documented in the records. For Medicare patients, G0348 would be the code for initial visit and G0349 for the subsequent visits.
Please find attached link for more information:
Marilyn Posted Wed 24th of April, 2019 11:40:24 AM
The issue with billing 99381-99397 isn't it that Nutritionist cannot use those procedure codes, but only PCP?
SuperCoder Answered Thu 25th of April, 2019 04:05:55 AM
I agree to what you are saying. Some payers consider nutritionist as a PCP in their specific plans whereas a lot of them do not consider nutritionist as PCP. This may vary as per payer and plans. Your billed diagnosis code Z71.3 is an unacceptable principal diagnosis code when billed as a standalone dx code. Per guidelines, this code cannot be billed as a primary diagnosis code. Please add another appropriate diagnosis code along with ICD 10 code Z71.3 as per your documentation.
Possible diagnosis code that can be billed along with Z71.3:
- Z71.82 – Exercise counseling
- Z71.89 – Other specified counseling
- Z72.4 – Inappropriate diet and eating habits
- Z72.89 – Other problems related to life style
Use the appropriate diagnosis code as per your documentation.