Culinary Healthier U office visit billing guidelines
Provider must submit initial and any subsequent claims with a patientʼs Body Mass Index (BMI) as the primary diagnosis. Provider must ensure that patientʼs BMI is coded to the highest level of specificity (Z68.20 – Z68.54). Any claim submitted without patientʼs BMI as the primary diagnosis will be denied.
Provider is allowed two (2) additional office visits if patientʼs BMI is less or equal to 29 and any of the diagnoses listed below are submitted on the claim:
| E40 – E46 | Malnutrition |
|---|---|
| E63.0 – E63.9 | Nutritional deficiencies |
| E00 – E07.9 | Thyroid disorders |
| E70 – E88.9 | Other metabolic disorders |
| F50 – F50.9 | Eating disorders |
| O24.4 | Gestational diabetes mellitus |
| R62.7 | Underweight, failure to thrive |
| R73.0 – R73.09 | Abnormal glucose |
Provider is allowed up to twenty five (25) additional office visits if a patientʼs BMI is less or equal to 29 and any of the diagnoses listed below are submitted on the claim:
| E10 – E10.9 | Diabetes mellitus – Type 1 |
|---|---|
| E11 – E11.9 | Diabetes mellitus – Type 2 |
| E66 – E66.9 | Overweight |
| E75 – E75.6 | Hyperlipidosis |
| E78 – E78.6 | Hyperlipidemia |
| I10 – I15.9 | Hypertension |
| I20 – I25.9 | Ischemic heart disease |
| I26 – I28.9 | Pulmonary heart disease |
| I30 – I51.9 | Other forms of heart disease |
| N18 – N18.9 | Chronic kidney disease |
Provider is allowed up to twenty five (25) additional office visits if patientʼs BMI is 30+ regardless of additional diagnoses billed.