Guide to Billing for Registered Dietitian Services
As a registered dietitian, providing quality nutrition services to clients is your top priority. However, ensuring proper reimbursement for your services is also crucial for the sustainability and ultimate success of your practice. Billing for registered dietitian services involves understanding the correct CPT codes, documentation requirements, common reimbursement challenges, and strategies to optimize billing practices. In this comprehensive guide, we will address frequently asked questions and shed light on how using an EHR with a built-in billing solution, like Healthie, can help your private practice thrive.
What CPT Codes Can Dietitians Bill?
When it comes to billing for dietitian services, understanding the appropriate Current Procedural Terminology (CPT) codes is essential. The CPT codes allow providers, including registered dietitians, to communicate the services they provided to payers for reimbursement.
For dietitians, the commonly used CPT codes include 97802 and 97803. These codes represent initial and follow-up assessment and intervention services for individual patients with individualized plans. The codes are as follows:
97802 - Medical Nutrition Therapy; Initial Assessment
This code covers the first visit with a client and includes a comprehensive assessment of their nutritional status, diet history, and health conditions. The registered dietitian develops a personalized plan based on this assessment.
97803 - Medical Nutrition Therapy; Re-assessment
This code covers follow-up visits where the dietitian reassesses the client's progress, makes necessary adjustments to the nutrition plan, and provides ongoing support and education.
H2: What Is the Difference Between 97802 and 97803?
The main difference between CPT codes 97802 and 97803 lies in their usage. As mentioned earlier, 97802 is used for the initial assessment, which is the first encounter between the dietitian and the client. During this session, the dietitian gathers detailed information about the client's medical history, lifestyle, dietary habits, and health goals.
On the other hand, 97803 is for re-assessment or follow-up sessions. After the initial assessment and the formulation of the personalized nutrition plan, the dietitian schedules follow-up visits to monitor the client's progress, address any challenges, and provide ongoing support. These follow-up sessions are essential to ensure the client's adherence to the plan and to make any necessary adjustments based on their response to the interventions.
So while a long-standing patient will have the first visit classified as CPT code 97802, there can be many subsequent visits which are then classified as CPT code 97803.
Can Dietitians Use ICD-10 Codes?
In addition to CPT codes, registered dietitians can also use ICD-10 codes to support their billing practices. The International Classification of Diseases, 10th Revision (ICD-10) codes provide a standardized system for documenting medical diagnoses. These codes offer additional information to insurers about the client's medical condition, which helps in justifying the need for medical nutrition therapy.
For example, if a registered dietitian is providing nutrition counseling for a client with diabetes, they would use the appropriate ICD-10 code for diabetes to demonstrate the medical necessity of their services. Properly linking CPT and ICD-10 codes ensures that the services rendered are clearly connected to the client's medical condition, increasing the likelihood of reimbursement.
How often can you bill 97802?
One common question that arises among dietitians is how often they can bill for the 97802 CPT code. Typically, this code can be billed once every calendar year per client for the initial assessment. It is important to note that the client must have a new or changed medical condition, or there should be a significant change in their treatment plan for the initial assessment to be billable again.
However, it's crucial to check individual payer policies and guidelines, as they may have specific rules regarding billing frequencies. Frequent assessments may be allowed in certain cases, such as when the client's medical condition significantly worsens, or there is a significant change in their nutritional needs.
Learn the basic of billing insurance for nutrition services in this Healthie webinar replay.
Streamline Your Billing With Healthie
Navigating the complexities of dietitian billing can be challenging, especially when dealing with different codes, documentation requirements, and payer policies. To streamline and simplify your billing processes, using a comprehensive solution like Healthie can be immensely helpful.
Healthie is an all-in-one EHR, practice management and engagement platform designed for nutrition professionals. It offers a suite of features to enhance efficiency and organization in your practice, including:
- Billing Integration: Healthie integrates with various billing software and clearinghouses, making it easier to submit claims, track payments, and manage reimbursement processes seamlessly.
- Automated CPT and ICD-10 Code Generation: Healthie generates the appropriate CPT and ICD-10 codes based on the services you provide and the client's medical condition, reducing the risk of billing errors and ensuring accurate claims submission.
- Electronic Superbills: With Healthie, you can create and send electronic superbills to clients, which include all the necessary billing and coding information for easy reimbursement from insurance companies.
- Insurance Verification and Eligibility Checks: The platform allows you to verify insurance coverage and eligibility for clients, ensuring you have the necessary information before providing services.
- Secure Payment Processing: Healthie facilitates secure online payment processing, enabling clients to pay for services conveniently while ensuring your practice's financial stability.
- HIPAA-Compliant Telehealth: Healthie's telehealth feature enables you to conduct virtual appointments with clients, expanding your reach and improving access to your services.
In addition to streamlining billing & operations, Healthie makes it easy for dieticians to enhance their product offering. With built-in features and third-party integrations, Healthie empowers dietitians to generate meal plans, sync smart tools such as scales and watches, and engage with clients both in-person and virtually, so that you can set your practice apart from the competition.
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