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The CPT® Code 97802 refers to Medical Nutrition Therapy (MNT) that involves an initial assessment and intervention conducted by a registered dietitian (RD) in a face-to-face setting with the patient. This service is billed in 15-minute increments, allowing for a structured approach to evaluating and addressing the nutritional needs of the individual. During this initial encounter, the RD performs a comprehensive assessment that includes gathering a detailed medical history, which encompasses both acute and chronic illnesses, as well as any other relevant health conditions. The RD also conducts a psychosocial assessment, taking into account various factors such as the patient's economic status, ethnic and cultural background, education level, occupation, and mental health status. Furthermore, the RD evaluates the patient's access to necessary foods for maintaining health and identifies any barriers that may hinder the ability to obtain or prepare food. A thorough review of the patient's current medications, including vitamins, minerals, and herbal supplements, is conducted to identify potential interactions with food, particularly those that may adversely affect nutrient absorption and excretion. The RD assesses the adequacy of vitamin and mineral supplementation to ensure that the patient is not consuming toxic levels. Additionally, a diet history is collected, which includes the frequency of meals and a typical 24-hour dietary recall. The RD may also evaluate food preparation methods to assess sodium and fat intake. The patient's appetite is rated, and any issues such as taste alterations, food allergies, religious dietary restrictions, and difficulties with chewing or swallowing are documented. A physical examination is performed to measure height, weight, body mass index (BMI), and arm or wrist circumference, while also noting any recent weight changes and evaluating the condition of hair, skin, and nails for signs of nutritional deficiencies. Based on this comprehensive assessment, the RD formulates a tailored nutrition therapy plan that addresses the specific needs of the patient, ensuring that the therapy is both effective and appropriate for their health status.
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The procedure associated with CPT® Code 97802 is indicated for individuals who require medical nutrition therapy due to various health conditions or nutritional needs. The following are specific indications for this service:
The procedure for CPT® Code 97802 involves several detailed steps that ensure a comprehensive assessment and intervention for the patient. Each step is crucial for developing an effective nutrition therapy plan.
After the initial assessment and intervention, the patient may be advised on follow-up appointments to monitor progress and make necessary adjustments to the nutrition therapy plan. The RD may provide educational materials and resources to support the patient in implementing dietary changes. Ongoing evaluation of the patient's adherence to the nutrition plan, as well as any changes in health status, will be essential for ensuring the effectiveness of the therapy. The RD may also recommend additional assessments or interventions as needed based on the patient's response to the initial therapy.
| Short Descr | MEDICAL NUTRITION INDIV IN | Medium Descr | MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI | Long Descr | Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P6D - Minor procedures - other (non-Medicare fee schedule) | MUE | 12 | CCS Clinical Classification | 237 - Ancillary Services |
| 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | AE | Registered dietician | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | CR | Catastrophe/disaster related | GT | Via interactive audio and video telecommunication systems | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | SW | Services provided by a certified diabetic educator | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | GW | Service not related to the hospice patient's terminal condition | HL | Intern | 33 | Preventive services: when the primary purpose of the service is the delivery of an evidence based service in accordance with a us preventive services task force a or b rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure. for separately reported services specifically identified as preventive, the modifier should not be used. | GX | Notice of liability issued, voluntary under payer policy | CS | Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | FQ | The service was furnished using audio-only communication technology | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q9 | One class b and two class c findings | GP | Services delivered under an outpatient physical therapy plan of care | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 32 | Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 96 | Habilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified health care professional may add modifier 96 to the service or procedure code to indicate that the service or procedure provided was a habilitative service. habilitative services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. habilitative services also help an individual keep, learn, or improve skills and functioning for daily living. | 99 | Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service. | AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | G0 | Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke | GF | Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital | GQ | Via asynchronous telecommunications system | KX | Requirements specified in the medical policy have been met | P1 | A normal healthy patient | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q3 | Live kidney donor surgery and related services | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | QW | Clia waived test | SA | Nurse practitioner rendering service in collaboration with a physician | U1 | Medicaid level of care 1, as defined by each state | U7 | Medicaid level of care 7, as defined by each state | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Added | First appearance in code book in 2001. |
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