How To Use CPT Code 97803

CPT 97803 focuses on medical nutrition therapy, specifically reassessment and intervention for individual patients during face-to-face sessions, with each 15-minute interval billed separately. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 97803.

1. What is CPT 97803?

CPT 97803 is a medical billing code used for medical nutrition therapy services, specifically for reassessment and intervention during individual, face-to-face sessions with patients. This code is billed for each 15-minute interval spent with the patient, focusing on reassessing their dietary needs and providing specific diet therapy to treat medical conditions and related symptoms.

2. 97803 CPT code description

The official description of CPT code 97803 is: “Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes.”

3. Procedure

The 97803 procedure involves the following steps:

1. The provider, typically a qualified nutrition professional, reassesses the patient’s medical condition and dietary needs.
2. The provider performs a nutrition screen and reviews the patient’s specific dietary plan.
3. The provider reevaluates the diet to improve the patient’s health and quality of life.
4. The provider spends 15 minutes with the patient, discussing long-term eating habits and health.
5. Each 15-minute interval of reassessment and intervention is billed separately using CPT 97803.

4. Qualifying circumstances

Patients eligible to receive CPT code 97803 services are those who require medical nutrition therapy due to a medical condition or related symptoms. These patients may have chronic diseases, such as diabetes or heart disease, or conditions that require specific dietary interventions, such as food allergies or gastrointestinal disorders. The provider must be a qualified nutrition professional, such as a registered dietitian or nutritionist, to deliver these services.

5. When to use CPT code 97803

It is appropriate to bill the 97803 CPT code when the provider reassesses a patient’s dietary needs and provides specific diet therapy during individual, face-to-face sessions. This code is used for subsequent visits after the initial assessment, with each 15-minute interval billed separately. For initial assessments, use CPT 97802. For group sessions of two or more patients, use CPT 97804.

6. Documentation requirements

To support a claim for CPT 97803, the following information must be documented:

• Patient’s medical condition and dietary needs
• Nutrition screen results
• Specific dietary plan and any modifications made during the reassessment
• Duration of the face-to-face session, broken down into 15-minute intervals
• Provider’s credentials as a qualified nutrition professional

7. Billing guidelines

When billing for CPT code 97803, keep in mind the following guidelines and tips:

• Bill for each 15-minute interval of face-to-face service during reassessment and intervention.
• Use CPT 97802 for initial assessments and CPT 97804 for group sessions.
• Ensure proper documentation of the patient’s medical condition, dietary needs, nutrition screen results, and specific dietary plan.
• Verify the provider’s credentials as a qualified nutrition professional.

8. Historical information

CPT 97803 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition.

9. Similar codes to CPT 97803

Five similar codes to CPT 97803 and how they differentiate are:

1. CPT 97802: Used for initial assessments of individual patients during face-to-face sessions, billed for each 15-minute interval.
2. CPT 97804: Used for group sessions of two or more patients, billed for each 30-minute interval.
3. CPT 99401: Used for preventive medicine counseling services, focusing on risk factor reduction and behavior change, billed for each 15-minute interval.
4. CPT 99402: Used for preventive medicine counseling services, focusing on risk factor reduction and behavior change, billed for each 30-minute interval.
5. CPT 99403: Used for preventive medicine counseling services, focusing on risk factor reduction and behavior change, billed for each 45-minute interval.

10. Examples

Here are 10 detailed examples of CPT code 97803 procedures:

1. A patient with diabetes requires reassessment of their dietary plan to better manage blood sugar levels.
2. A patient with heart disease needs a reevaluation of their diet to reduce sodium intake and improve heart health.
3. A patient with celiac disease requires a reassessment of their gluten-free diet to ensure proper nutrient intake.
4. A patient with a food allergy needs a reevaluation of their diet to avoid allergens and maintain a balanced diet.
5. A patient with irritable bowel syndrome requires reassessment of their dietary plan to manage symptoms and improve gut health.
6. A patient with kidney disease needs a reevaluation of their diet to reduce protein intake and protect kidney function.
7. A patient with obesity requires reassessment of their dietary plan to promote weight loss and improve overall health.
8. A patient with osteoporosis needs a reevaluation of their diet to increase calcium and vitamin D intake for bone health.
9. A patient with an eating disorder requires reassessment of their dietary plan to ensure proper nutrient intake and support recovery.
10. A patient with malnutrition needs a reevaluation of their diet to improve nutrient intake and promote weight gain.