Find information and resources about the most recent release of the CMS Physician Fee Schedule. Read More
Submitting claims to Medicare and private insurance companies is the final process before receiving reimbursement for the nutrition services you provided. This section is intended to increase understanding of nutrition service procedural and diagnostic codes that are integral to the claims submission process in the fee-for-service model of reimbursement. This section includes the Billing Resource for RDNs, Medicare-specific information and resources such as "how-to's" for participating in the Physician Quality Reporting System (PQRS), forms and other useful resources to assist with the billing process.
Diagnosis codes, such as the new ICD-10-CM, are officially called the International Classification of Diseases, 10th Revision, Clinical Modification. These codes describe an individual's disease or medical condition. Physicians determine the patient's diagnosis and chart this in the medical record, while trained billers assign the diagnosis code numbers to the physician-documented diagnosis for use on hospital forms such as a superbill, the CMS 1500, and the UB-04.
CPT codes, or the Current Procedural Terminology codes, are procedure codes that describe the service rendered by the healthcare professional. The MNT codes 97802, 97803, and 97804 are CPT codes that RDNs use on claims to report nutrition services provided by the RDN.
Because codes change over time and across insurance programs, the Academy will keep members up-to-date with the current codes related to nutrition professionals.
Professional billers submit claims to Medicare and private insurance companies on behalf of their clients. Read More
The PQRS is a quality reporting program that uses negative payment adjustments to promote reporting of quality information by eligible professionals. Read More
Find answers to frequently asked questions about Medicare claims processing. Read More
The Academy's Coding and Coverage Committee has organized a workgroup that is establishing characteristics and sentinel markers for malnutrition diagnosis codes. Read More