MEDICAL NUTRITION THERAPY (MNT) CPT - G0270, 97802 & 97804

Medicare provides coverage of medical nutrition therapy (MNT) for beneficiaries diagnosed with diabetes or renal disease (except for those receiving dialysis). More than 13.7 million Americans, at least 60 years or older, are diagnosed with diabetes or chronic kidney disease.1 MNT provided by a registered dietitian or nutrition professional may result in improved diabetes and renal disease management and other health outcomes and may help delay disease progression.

Diabetes Mellitus

Diabetes (diabetes mellitus) is defined as a condition of abnormal glucose metabolism using the following criteria:

*A fasting blood glucose greater than or equal to 126 mg/dL on 2 different occasions.

*A 2-hour post-glucose challenge greater than or equal to 200 mg/dL on 2 different occasions.*A random glucose test over 200 mg/dL for a person with symptoms of uncontrolled diabetes.

Renal Disease

For the purpose of this benefit, renal disease means chronic renal insufficiency or the medical condition of a beneficiary who has been discharged from the hospital after a successful renal transplant within the last 36 months. Chronic renal insufficiency means a reduction in renal function not severe enough to require dialysis or transplantation [Glomerular Filtration Rate (GFR) 13-50 ml/min/1.73m2].

Medicare providers must use the following Healthcare Common Procedure Coding System/Current Procedural Terminology (HCPCS/CPT) codes listed below.

G0270
Medical nutrition therapy; reassessment and subsequent intervention(s)  following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), individual, face-to-face with the patient, each 15 minutes

G0271
Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes

97802
Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
(NOTE: This CPT code must only be used for the initial visit.)

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

Diagnosis Requirements

MNT services are available for beneficiaries with diabetes or renal disease. The treating physician must make a referral and indicate a diagnosis of diabetes or renal disease. For further guidance, contact your Medicare Contractor.


Reasons for Claim Denial

The following are examples of situations where Medicare may deny coverage of MNT services:

* The beneficiary is not qualified to receive this benefit.
* The individual provider of the MNT services did not meet the provider qualification requirements.

3 comments:

Anonymous said...

WOw! Nice topics, I am looking this type of topics, I want more. I know The best

chiropractic clinic helps people in Buford GA with back pain, neck pain, headaches.
chiropractor buford ga

Anonymous said...

My friend had a newly elevated cholesterol and blood pressure, her doctor sent her to an RD [Registered Dietitian]. The RD really helped her understand what she can do; meal planning, recipes, etc...

Anonymous said...

My friend had a newly elevated cholesterol and blood pressure, her doctor sent her to an RD [Registered Dietitian]. The RD really helped her understand what she can do; meal planning, recipes, etc...

Medical Billing Popular Articles