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Writing Team
Cecilia Butler, MS, RD, CDE
CDR Sandra Lahi, RHIA, CPC
LT Diane Phillips, RD, LD, CDE
Sara Lee Thomas, MS, RD
CAPT Leeanna Travis, RD, MA, MS, CDE
CAPT Tammy L. Brown, MPH, RD, BC-ADM, CDE
Brenda Broussard, MPH, MBA, RD, BC-ADM, CDE
July 2006
Indian Health Service
Division of Diabetes Treatment and Prevention
Albuquerque, New Mexico
List of Photos
(87
kb
)
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List of Tables
(129
kb
)
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Foreword
(76
kb
)
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Acknowledgements
(85
kb
)
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Frequently Used Abbreviations
(87
kb
)
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Introduction
(106
kb
)
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Section One: Ready...Set...Medical Nutrition Therapy!
An Overview of Medical Nutrition Therapy Reimbursement
(138
kb
)
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The Medical Nutrition Therapy Medicare Benefit
(106
kb
)
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Qualifying Diagnoses for Reimbursement
(120
kb
)
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Section Two: Let’s Get Started...Go!
Seven Steps for Medical Nutrition Therapy Reimbursement
(143
kb
)
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Step 1: Become a Recognized Medicare Provider
(130
kb
)
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Step 2: Make Friends With Your Business Office
(122
kb
)
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Step 3: Obtain Treating Physician Referral and
Authorization for Patient Visit
(112
kb
)
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Step 4: Learn More About Procedural (CPT) Codes and
Diagnosis (ICD-9) Codes for Reimbursement
(132
kb
)
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Step 5: Document MNT Services
(172
kb
)
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Step 6: Track MNT Services and Reimbursement
(117
kb
)
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Step 7: Market Your MNT Services
(116
kb
)
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Section Three:
Resource Materials
(138
kb
)
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Flow Chart of Steps for MNT Reimbursement
(101
kb
)
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Appendix A: Top Ten Documentation Errors to Avoid in the IHS
(97
kb
)
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Appendix B: Indian Health Case Study
(16
kb
)
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Appendix C: Sample Forms
(100
kb
)
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CMS Form 1500 (“Health Insurance Claim Form”)
(208
kb
)
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IHS MNT Referral Form
(111
kb
)
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ADA and AADE Diabetes Services Order Form
(162
kb
)
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ADA Nutrition Progress Notes Form
(278
kb
)
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MNT Super Bill #1
(57
kb
)
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MNT Super Bill #2
(152
kb
)
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Third Party Reimbursement Tracking Form
(71
kb
)
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IHS PCC+ MNT Diabetes Template
(451
kb
)
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IHS PCC+ MNT Kidney Template
(458
kb
)
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PCC Ambulatory Encounter Record
(203
kb
)
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Appendix D: Nutrition Practice Guidelines and
MNT Evidence-Based Guides for Practice
(102
kb
)
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Appendix E: IHS Medicare Part A and B Coverage and
Billing Requirements for MNT and DSMT
(130
kb
)
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Appendix F: “Invest in Nutrition Services to
Reduce Health Disparities in AI/AN” Handout
(148
kb
)
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Appendix G: Additional Resources
(113
kb
)
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Glossary
(108
kb
)
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References
(90
kb
)
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Contributors
(85
kb
)
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This file last modified: Wednesday March 21, 2007 3:21 PM