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Weight Loss Management by Specialist

Terry Posted Thu 09th of April, 2020 14:42:52 PM
I am wondering if a Specialist can be reimbursed for Weight Loss Management codes G0447, 97802-97804 and 99401-99404. I have seen remarks that sound like only Primary Care Physicians can bill for Weight Loss Management. We are a Gastroenterology office that uses Fibroscan and treats NASH and NAFLD . !. Can specialists bill with these codes? 2. What would the correct codes be for an initial weight management consult and "weigh ins" and follow up visits and counseling? 3. How often can they be billed?
SuperCoder Answered Fri 10th of April, 2020 11:49:54 AM

Hi Terry,

 

These services cannot be billed by specialist physicians. Weight loss management is performed by certified Nutritionist and Dietician and these codes can be billed by nutrition and dietician experts only.

 

Please find below link for more understanding:

 

https://www.cdc.gov/diabetes/dsmes-toolkit/reimbursement/medical-nutrition-therapy.html

 

https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00126165

 

Thanks!   

Terry Posted Fri 10th of April, 2020 13:09:54 PM
In the meantime I contacted BCBS and UHC and they said physicians and NPP such as NP's could bill these codes. I am speaking about in office Physician Managed weight loss clinics where the MD or NP sees the patients.
SuperCoder Answered Mon 13th of April, 2020 05:11:31 AM

Hi Terry,

 

Private payers have their own guidelines which may vary from payer to payer. You need to get in touch with your payer to identify the rules, regulations and guidelines related to weight loss management and bill accordingly.

 

Thanks!

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