Coding and Coverage Committee Report

Fall 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. The Committee supports Association work to position RD members as the most valued source for food and nutrition services.

Member Educational Outreach and Awareness

  • Increase members’ understanding and use of codes by presenting "Cracking the Code" presentation at targeted affiliate association state meetings (Spring 2009). The coding presentation will be posted on ADA’s Web site for 24/7 member access.
  • Provided leadership development for affiliate and DPG leaders by posting a web-based presentation on Committee structure/function and member coding and coverage-related resources on ADA’s Web site (accessible via the link below).
  • Provided technical review and approval of ADA’s Diabetes White Paper — Defining the Delivery of Nutrition Services in Medicare MNT versus Medicare DSMT Programs. Prepared for ADA members and external diabetes stakeholders, the paper describes the current regulatory and practice framework that supports nutrition care under Medicare Part B for people with diabetes.
  • Funded the Evidence-Based MNT Effectiveness Workgroup to determine the cost-effectiveness of inpatient and outpatient MNT services provided by an RD, and the effectiveness of RD-provided MNT services compared with other healthcare professionals who provide nutrition services and education. Data will be incorporated into the MNT Works Kit and other member resources.
  • Sponsored two FNCE 2008 sessions: "Billing and Coding 101: Tips for Successful Billing," Sunday October 26 from 1:30 to 3:00 p.m., and the RD Coding Network and reimbursement rep session for members interested in shaping coverage and payer policies, Sunday October 26 from 5:00 to 6:00 p.m.
  • Two committee members have presented a session on coding, Medicare policies and marketing nutrition services to attendees at the Renal DPG Pre-FNCE workshop "Train for the Chronic Kidney Disease Medical Nutrition Therapy Triathlon".
  • Preparing Journal article on RD coding practices based on data from ADA’s 2008 Coding Survey.
  • Promote use of ADA’s MNT Works Kits and ADA Third Party Payer brochure to members involved in expanding local coverage efforts with payers and other healthcare decision makers. Coordinate efforts to update MNT coverage chart posted on ADA’s Web site (accessible via the links below).

External Group Outreach [Commercial Payers and Centers for Medicare & Medicaid Services (CMS)]

  • Participate in phase two of the CDR-funded third party payer outreach initiated to increase payer awareness of RD-provided nutrition services and to influence MNT coverage. This fall, ADA will initiate a phone survey among a geographically representative group of HMO and PPO payers.  
  • Along with the Legislative and Public Policy Committee, monitor and provide regulatory comments to the Centers for Medicare & Medicaid Services (CMS) regarding Medicare Physician Fee Schedule rules and MNT code values established by CMS. Contributed to ADA comments submitted to CMS regarding the 2009 Proposed Medicare Fee Schedule Rule. Adjustments to the Medicare MNT code values, based on ADA and AMA recommendations, are anticipated in the 2009 Medicare fee schedule (released in early November).
  • Participating in an ADA physician outreach workgroup to increase physician awareness of and referrals for RD-provided services. Strategies and best practices for effective member interaction and collaboration with physicians will be determined by this workgroup.

American Medical Association (AMA) Coding Activities

  • Participated in three AMA code meetings to represent RDs’ interests in AMA’s coding deliberations. Monitoring and providing feedback to AMA regarding the administration of the multi-specialty AMA Practice Information survey. Promote RD participation in the ADA/AMA Practice Information Survey. The survey collects RD expenses required to run a practice. Data will be shared with the CMS to influence payment policies.
  • Oversee the selection process for ADA’s representative to the AMA Current Procedural Terminology (CPT) Health Care Professional Advisory Committee (HCPAC).

Committee Contact Information
The Committee has completed four conference calls and is represented on ADA’s Evidence-Based Practice and Legislative and Public Policy Committees. More detailed coding and coverage information is available on the MNT section of the ADA Web site, accessible via the link below or at www.eatright.org/advocacy/mnt. For additional information, please contact Pam Michael, Nutrition Services Coverage Team at 800/877-1600, ext. 4747 or PMichael@eatright.org.

2008-2009 Coding and Coverage Committee:
Charlotte Thiessen MS RD LMNT, Chair
Keith Ayoob EdD RD FADA
Linda Arpino MA RD CDN Mary Ann Hodorowicz, MBA, LN
Susanne Luchetti, MS, RD, LDN
Diane Machiniski, MS, RD
Jane White PhD RD FADA LDN
Pam Michael, MBA, RD, Tori Bender, MSJ, and Hellen Coleman — ADA staff

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