Coding and Coverage Committee Report Spring 2008

The ADA Coding and Coverage Committee provides oversight and strategic directives for the development, maintenance and communication of nutrition services codes, while empowering registered dietitians to expand coverage and receive competitive reimbursement for quality nutrition services. It supports Association work to position RD members as the most valued source for food and nutrition services.

Member Educational Outreach and Awareness

  • Initiated the online 2008 ADA Coding Survey among RD members and non-members to assess general business and coding practices; payer reimbursement trends for ambulatory care MNT services and RD interest in additional billing codes.
  • Presenting “Cracking the Code: Billing Potential Beyond Medical Nutrition Therapy” at twelve affiliate association’s annual meetings to increase members’ knowledge and understanding of coding and coverage.
  • Staffed the “MNT codes and Medicare Resources” booth at PPW 2008 and addressed members’ questions on reimbursement and advocacy resources for nutrition services.
  • Sponsoring the FNCE 2008 session: “Billing and Coding 101: Tips for Successful Billing,” on Sunday October 26 from 1:30 p.m. to 3:00 p.m., and the RD Coding Network session for members interested in shaping coverage and payer policies.
  • Committee members presented a poster session at FNCE 2007 to share information from the 2006 coding survey and MNT billing information.
  • More than 200 attendees participated in the Committee-sponsored FNCE 2007 session: “Optimize Your Claims — How a Billing Service Can Work For You.” The Committee also sponsored a FNCE networking session for RDs interested in influencing payer policies through participation in the ADA RD Coding Network.
  • The Committee’s coding survey article, “Registered Dietitians’ Coding Practices and Patterns of Code Use” was accepted by the Journal for release in Spring 2008.

Payer Outreach

  • Provided technical review of the CDR-funded third party payer brochure to increase payer awareness of RD-provided nutrition services and to influence MNT coverage.
  • Committee chair provided training to 240 RDs regarding the new brochure and advocacy strategies for contacting payers (n=1600) who received the brochure.
  • To assist members in expanding local coverage efforts with payers and other healthcare decision makers, 200 copies of the ADA MNT Works Kits have been distributed to members over the last six months.

Collaboration with other ADA Leader Groups/Committees

  • Coding and Coverage Committee members are participating on the ADA Measures Workgroup that is charged to strategically direct ADA’s development and implementation of nutrition measures and member education/training.
  • Sponsored the MNT Effectiveness Evidence-Analysis Workgroup to review research on cost-savings of RD-provided clinical nutrition services and the value/impact of RD nutrition services compared with services provided by other healthcare professionals.
  • Participated on the Evidence-Based Practice Referral Sub-Committee and helped draft the Journal article, “Referral Systems in Ambulatory Care — Providing Access to the Nutrition Care Process.”

American Medical Association (AMA) Coding Activities

  • As a means to increase code values for Medicare MNT services, the Committee has collaborated with American Association of Clinical Endocrinology, American Gastro-enterological Association, Obesity Society and Association of Parenteral and Enteral Nutrition to solicit physician participation in the AMA MNT code survey. Committee members served as an expert panel to review and revise practice expenses involved in providing MNT services. Committee members, along with physician representa-tives, will present MNT codes and practice expense data at the April AMA code meeting where recommendations will be determined and forwarded to CMS.
  • The Committee reviewed and provided feedback to the AMA Current Procedural Terminology (CPT) Panel on an independently submitted RD request to merge the MNT codes. Using data collected from the reimbursement representatives, and interaction with physician society panel members, the Committee submitted comments to AMA rejecting the code proposal on the basis that the change could possibly reduce payment for MNT services.
  • Represented ADA at the October and February AMA Physician Consortium for Performance Improvement to assess ADA involvement in the group’s development of quality measures.
  • Monitoring and providing feedback to AMA regarding the administration of the multi-specialty AMA Practice Information survey. Initiated communications to encourage private practice RDs to participate in the survey.
  • Keith Ayoob was re-nominated as ADA’s representative to the AMA CPT group.
  • Committee members attended five AMA CPT and RUC meetings representing RDs interests in AMA’s coding deliberations. Advocated for changes in AMA terminology to recognize non-physician professionals in AMA coding books, which may possibly lead to increased recognition of RD services by third party payers.

Additional coding and coverage information is posted on ADA’s Web page at: www.eatright.org/advocacy/mnt. Contact the Nutrition Services Coverage Team at 800/877-1600, ext. 4747 or PMichael@eatright.org.

Respectfully submitted by 2007-2008 Coding and Coverage Committee:
Keith Ayoob EdD RD FADA, Chair
Charlotte Thiessen MS RD LMNT, Chair-elect
Linda Arpino MA RD CDN
Mindy Benedict, MS RD CDE LDN
Susanne Luchetti, MS, RD, LDN
Jane White PhD RD FADA LDN
Pam Michael, MBA, RD and Tori Bender, MSJ, ADA staff

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