How To Use CPT Code 97804

CPT 97804 describes the use of medical nutrition therapy in a group setting, with two or more patients, for each 30-minute session. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 97804?

CPT 97804 can be used to describe the provision of medical nutrition therapy in a group setting, with two or more patients. This code represents each 30-minute session spent with the group, where a qualified nutrition professional assesses the medical condition of the patients, performs a nutrition screen, and initiates a specific dietary plan to improve their health and quality of life.

2. Official Description

The official description of CPT code 97804 is: ‘Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes.’

3. Procedure

1. A qualified nutrition professional assesses the medical condition of two or more patients.
2. A nutrition screen is performed to gather relevant information about the patients’ nutritional status.
3. A specific dietary plan is created and implemented to optimize the patients’ nutrition.
4. The nutrition professional spends 30 minutes with the group, providing education and advice on long-term eating habits and health.

4. Qualifying circumstances

CPT 97804 is appropriate for patients who require medical nutrition therapy in a group setting. The patients must be assessed by a qualified nutrition professional, and a specific dietary plan must be initiated to improve their health and quality of life. The code is used for each 30-minute session spent with a group of two or more patients.

5. When to use CPT code 97804

CPT code 97804 should be used when a qualified nutrition professional provides medical nutrition therapy in a group setting, with two or more patients. This code represents each 30-minute session spent with the group. If the session is face-to-face with an individual patient, CPT codes 97802 and 97803 should be used instead.

6. Documentation requirements

To support a claim for CPT 97804, the nutrition professional must document the following information:

• Medical condition of the patients and the need for medical nutrition therapy
• Specific dietary plan implemented for the group
• Date, start and end time of the 30-minute session
• Topics covered during the session, including education on long-term eating habits and health
• Progress made by the patients and any follow-up sessions scheduled
• Signature of the qualified nutrition professional providing the service

7. Billing guidelines

When billing for CPT 97804, ensure that the service is provided by a qualified nutrition professional and that the session is conducted in a group setting with two or more patients. This code should not be reported with CPT codes for evaluation and management services. It is important to use the appropriate CPT code based on the number of patients in the group (97802 for an individual patient, 97803 for reassessment and intervention).

8. Historical information

CPT 97804 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition.

9. Examples

1. A qualified nutrition professional providing a 30-minute group session on managing diabetes through dietary changes for a group of three patients.
2. A nutritionist conducting a 30-minute group session on healthy eating habits for a group of five individuals with obesity.
3. A registered dietitian leading a 30-minute group session on managing food allergies for a group of four patients.
4. A nutrition counselor providing a 30-minute group session on heart-healthy diets for a group of six individuals with cardiovascular disease.
5. A dietitian conducting a 30-minute group session on prenatal nutrition for a group of three pregnant women.
6. A nutrition educator leading a 30-minute group session on mindful eating for a group of seven individuals with eating disorders.
7. A registered dietitian providing a 30-minute group session on sports nutrition for a group of five athletes.
8. A nutritionist conducting a 30-minute group session on managing gastrointestinal disorders through diet for a group of four patients.
9. A dietitian leading a 30-minute group session on healthy aging and nutrition for a group of six older adults.
10. A nutrition counselor providing a 30-minute group session on vegetarian diets for a group of three individuals interested in plant-based eating.