How To Use CPT Code 97802

CPT 97802 focuses on medical nutrition therapy, specifically the initial assessment and intervention for individual patients, conducted face-to-face in 15-minute increments. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 97802.

1. What is CPT 97802?

CPT 97802 is a medical billing code used for the initial assessment and intervention of medical nutrition therapy. This code is specifically for individual, face-to-face sessions with the patient, with each session lasting 15 minutes. Medical nutrition therapy aims to treat medical conditions and related symptoms using specific diet therapy, which is designed to improve the patient’s health and quality of life.

2. 97802 CPT code description

The official description of CPT code 97802 is: “Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes.”

3. Procedure

The 97802 procedure involves the following steps:

1. Assessing the patient’s medical condition and nutritional needs.
2. Performing a nutrition screen to identify any dietary issues or concerns.
3. Developing a specific dietary plan tailored to the patient’s needs and medical condition.
4. Providing education and counseling to the patient regarding their dietary plan and long-term eating habits.
5. Monitoring the patient’s progress and adjusting the dietary plan as needed.

4. Qualifying circumstances

Patients eligible to receive CPT code 97802 services are those who have a medical condition or related symptoms that can be treated or managed through specific diet therapy. Examples of such conditions include diabetes, hypertension, obesity, and gastrointestinal disorders. The provider, typically a qualified nutrition professional, must determine that medical nutrition therapy is necessary for the patient’s treatment and management of their condition.

5. When to use CPT code 97802

It is appropriate to bill the 97802 CPT code when the provider is conducting the initial assessment and intervention for medical nutrition therapy with an individual patient. This code should be used for the first visit with the patient, during which the provider assesses the patient’s medical condition, performs a nutrition screen, and initiates a specific dietary plan. Each 15-minute increment of the session should be billed using CPT 97802.

6. Documentation requirements

To support a claim for CPT 97802, the following information should be documented:

• Patient’s medical condition and related symptoms that warrant medical nutrition therapy.
• Results of the nutrition screen, including any identified dietary issues or concerns.
• Specific dietary plan developed for the patient, including goals and recommendations.
• Education and counseling provided to the patient regarding their dietary plan and long-term eating habits.
• Duration of the session, in 15-minute increments.

7. Billing guidelines

When billing for CPT code 97802, it is important to follow the appropriate guidelines and rules. Each 15-minute increment of the initial assessment and intervention session should be billed separately using CPT 97802. For subsequent visits and reassessments, use CPT 97803. For group medical nutrition therapy sessions, use CPT 97804, which is billed for each 30-minute increment.

8. Historical information

CPT 97802 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 97802

Five similar codes to CPT 97802 include:

• CPT 97803: Used for reassessments and subsequent visits for medical nutrition therapy, billed for each 15-minute increment.
• CPT 97804: Used for group medical nutrition therapy sessions, billed for each 30-minute increment.
• CPT 99401: Used for preventive medicine counseling, individual, billed for each 15-minute increment.
• CPT 99402: Used for preventive medicine counseling, individual, billed for each 30-minute increment.
• CPT 99403: Used for preventive medicine counseling, individual, billed for each 45-minute increment.

10. Examples

Here are 10 detailed examples of CPT code 97802 procedures:

1. A patient with newly diagnosed diabetes receives an initial assessment and intervention for medical nutrition therapy to help manage their blood sugar levels.
2. A patient with hypertension is provided with an initial assessment and intervention for medical nutrition therapy to help lower their blood pressure through dietary changes.
3. An obese patient receives an initial assessment and intervention for medical nutrition therapy to develop a weight loss plan and improve their overall health.
4. A patient with celiac disease receives an initial assessment and intervention for medical nutrition therapy to create a gluten-free diet plan.
5. A patient with irritable bowel syndrome receives an initial assessment and intervention for medical nutrition therapy to develop a low-FODMAP diet plan.
6. A patient with kidney disease receives an initial assessment and intervention for medical nutrition therapy to create a renal-friendly diet plan.
7. A patient with a history of high cholesterol receives an initial assessment and intervention for medical nutrition therapy to develop a heart-healthy diet plan.
8. A patient with food allergies receives an initial assessment and intervention for medical nutrition therapy to create a safe and balanced diet plan.
9. A patient with a history of disordered eating receives an initial assessment and intervention for medical nutrition therapy to develop a healthy and sustainable eating plan.
10. A patient with osteoporosis receives an initial assessment and intervention for medical nutrition therapy to create a diet plan rich in calcium and vitamin D.