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Basic Coding Guidelines for MNT

basic-coding-guidelines-for-mnt

Medical nutrition therapy (MNT) is a key component of diabetes education and management. MNT is defined as a ‘nutrition-based treatment provided by a registered dietitian nutritionist.’ It includes ‘a nutrition diagnosis as well as therapeutic and counseling services to help manage diabetes.’ MNT Is an intensive, focused, and comprehensive nutrition therapy service which involves in-depth […]

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Reimbursement Tips and Documentation Requirements for DSMT

Reimbursement Tips and Documentation Requirements for DSMT

The Centers for Medicare & Medicaid Services (CMS) provides reimbursement for Medicare beneficiaries for diabetes self-management training (DSMT), under certain conditions. Becoming familiar with the Medicare DSMT reimbursement guidelines can help increase a DSMES service’s financial sustainability. Reimbursement guidelines change often, the Centers for Medicare & Medicaid Services resources listed below to ensure access to […]

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Official Guidelines for Diabetes Mellitus – 2021 Update

Official Guidelines for Diabetes Mellitus – 2019 Update

The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments within the U.S. Federal Government’s Department of Health and Human Services (DHHS) provide the following guidelines for coding and reporting using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). These guidelines should be used as […]

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Medicare Coverage for DSMT Benefit

Medicare Coverage for DSMT Benefit

The Centers for Medicare & Medicaid Services (CMS) provides reimbursement for Medicare beneficiaries for diabetes self-management training (DSMT), under certain conditions. Becoming familiar with the Medicare DSMT reimbursement guidelines can help increase a DSMES service’s financial sustainability. Medicare Part B (medical insurance for outpatient care, preventive services, Ambulance Billing Services, and durable medical equipment) covers […]

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Coding Diabetes Mellitus in ICD-10-CM

Coding Diabetes Mellitus in ICD-10-CM

Results of a recent coding and clinical documentation pilot study indicate that the ICD-10-CM coding classification changes made for diabetes mellitus have significantly improved coding for this disease. The results of the study noted that although a few ICD-10-CM “unspecified” diabetes codes were assigned, the majority of the diabetes codes sufficiently captured the diagnoses as […]

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Using Correct Combinations – Modifier 59

Using Correct Combinations – Modifier 59

One of the most frequent errors can result from using the wrong modifiers. In addition to the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. In this article, we will be discussing wrong […]

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Using Correct Combinations – Modifier 24 and 25

Using Correct Combinations – Modifier 24 and 25

One of the most frequent errors can result from the submission of invalid modifier combinations. In addition to the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. The most commonly used wrong modifier […]

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Provisional Prior Authorization from Medicaid- Three State Approach

Provisional Prior Authorization from Medicaid- Three State Approach

Beneficiaries who are dually eligible for Medicare and Medicaid often experience difficulties accessing durable medical equipment (DME), such as wheelchairs, in a timely manner. Whether Medicare or Medicaid covers a specific item may be unclear. Medicaid usually is the “payer of last resort,” which means that DME suppliers generally must obtain a Medicare denial before […]

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Using Correct Combinations – Modifier 50

Using Correct Combinations – Modifier 50

One of the most frequent errors can result from the submission of invalid modifier combinations. In addition to​ the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. In this article, we will be […]

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