Preventive Medicine: Medical Nutrition Therapy and Cardiovascular Disease (CVD)/Obesity Prevention

May 9th, 2018 - Find-A-Code™
Categories:   CPT® Coding   HCPCS Coding   Diagnosis Coding   Modifiers   Preventive Medicine Service  
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Medical Nutrition Therapy and Cardiovascular Disease (CVD)/Obesity Prevention

Procedure Codes
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
G0446: Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes


G0447: Face-to-face behavioral counseling for obesity, 15 minutes
G0473: Face-to-face behavioral counseling for obesity, group (2–10), 30 minutes
97802: Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
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

ICD-10-CM
G0446, G0270-G0271, 97802-97804: No specific diagnoses, contact prayer for guidance.
G0447, G0473: Z68.30-Z68.39, Z68.41-Z68.45

Frequency
G0446: Once annually for CVD risk reduction
G0270-G0271, 97802-97804: 3 hours total in the first year, 2 hours total for subsequent years
G0447, G0473: In the first year:

  • Once a week for the first month
  • Once every other week months 2-6
  • Once every month (where qualified) months 7-12
    • At the 6-month visit, a reassessment of obesity and a determination of the amount of weight loss must be performed.
    • To be eligible for additional face-to-face visits occurring once a month for an additional 6 months, beneficiaries must have lost at least 3kg.
    • For beneficiaries who do not achieve a weight loss of at least 3 kg during the first 6 months, a reassessment of their readiness to change and BMI is appropriate after an additional 6-month period.

Additional Information
G0270-G0271, 97802-97804

  • With Medicare, the following three criteria have to be met:
    • Must receive a referral from their treating physician; and
    • Diagnosed with diabetes, renal disease, or have received a kidney transplant in the last 3 years; and
    • Services are provided by a registered dietitian or nutrition professional
  • Coverage criteria can vary, check with your payer

97802-97804

  • Requires the use of modifier 33 when USPSTF requirements are met

G0446-G0447, G0473

  • Beneficiary must be competent and alert at the time counseling is provided; and be performed by qualified primary provider in a primary care setting.

G0447, G0473

  • Only covered for obesity

Find-A-Code™ - Preventive Services - The information in this document does not guarantee payment or that included codes meet applicable qualifications as preventive services for all insurances and insurance plans, please consult your payer.


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