Medical Coding and Billing: DIE4243

Why accept public and private insurance?

1. Opens up services to those who can not pay out of pocket
2. Many physicians will refer to a dietitian who takes insurance knowing that the patient will not need to pay out of pocket
3. Most dietitians see growth in their services when they accept insurance
4. Preventive services
Includes: "healthy diet counseling" and "obesity screening and counseling"

Private Insurance: Contracting

Process of becoming an in-network provider with insurance companies
- establishes policies/guidelines for filing claims

Private Insurance: Filing Claims (3)

1. Conducting an eligibility and benefits check
2. Filing claim
3. Getting paid

When filing a claim, what 2 forms are used by all payers?

UB04 and HCFA 1500

What information is required when filing a claim?

1. Charges
2. Coding
- CPT, Diagnosis Codes

E10.9

Type 1 diabetes mellitus without complications

E11.9

Type 2 diabetes mellitus without complications

Chronic Kidney Disease Diagnosis Code?

N18

Eating Disorder Diagnosis Code?

F50

Diagnosis codes are used to describe? (ICD-10)

Conditions

What code is only used once a year for the initial assessment of a patient?

97802, whereas 97803 would be the following visit

CPT Codes for Dietitians: nutritional counseling and dietitian appointment

S9470

On average, RDNs can expect approximately $____/hour nationwide, according to Healthy Bytes' data.

118

What are examples of alternatives to accepting private insurance?

1. Out of pocket pay
2. Packaged services
3. Health savings accounts
4. Flexible spending accounts
5. Super bills

Becoming a Medicare Provider as a RD:

1. Obtain NPI number
2. Apply to be individual Part B Medicare provider
3. RD receive own Medicare PTAN (provider transaction number)

Part A of Medicare covers

covers hospital inpatient services, care in a skilled nursing facility, home health visits and hospice care

Part B of Medicare covers

Preventative services, limited prescription medication

Part D of Medicare covers

prescription drugs

Basic coverage of MNT for the first year: __ hours (DM or CKD) under Medicare

3

Medicare coverage of MNT:

G0270: 15 min session
G0271: 30 min session

The nutritional care record is important because it provides?

Proof of care