...... Healthy Weight Kids Coalition of Southern Kentucky is a coalition of health-related professionals and organizations with the goal of preventing and treating the serious  problem of overweight in children.

CODES FOR POSSIBLE REIMBURSEMENT FROM

HEALTH CARE INSURERS/GOVERNMENT PROGRAMS

Procedure Codes

SOURCE: HCPCS LEVEL II

            "Education codes"  include only for dental disease, asthma, birthing and lactation.

            but  NOTHING  under "weight, overweight or obesity"

SOURCE:  CPT EXPERT 2002

        *  Preventive medicine group counseling:

                                                                                    30 min.______ 99411

                                                                                    60 min.______ 99412

       *   Preventive medicine individual counseling:

                                                                                   15 min._______ 99401

                                                                                  30 min._______ 99402

                        (Can be coded separately from              45 min._______ 99403

                          comprehensive medical exam)              60 min._______ 99404

         * Administration and interpretation of RISK ASSESSMENT INSTRUMENT (e.g. health

            hazard appraisal)                                               ____________ 99420

         * Unlisted preventive medicine service                   ____________ 99429

         * Consultation, problem focused                             ____________ 99241

CASE MANAGEMENT SERVICES:

            99361   Medical conference by physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care.   99362 = approx. 60 minutes.

           99358  = prolonged services w/o face to face contact (review of records, tests,communicating with other professionals, family and patient.)   1 hour.

 ICD-9CM: What to use as a Diagnosis Code

First, try coding for other medical conditions, if present, that will have a higher chance of being re-imbursed.

Always code for any obesity-related conditions such as hypertension, diabetes, pre-diabetes, CNS dysfunction, hyper-insulinism, GERD, acanthosis nigricans, osteochondrosis, slipped femoral epiphysis, chronic fatigue, or family history of any above if hereditary.

Otherwise, here are some of the diagnosis codes for overweight:

(NO!)  Obesity and overweight                278.0  (includes nos, hyperalimentation, and metabolic)

(not likely to be re-imbursed)

Instead try:

(??)    Morbid Obesity                           278.01

(YES)  Abnormal weight gain                   783.1

(YES)  Excessive eating                           783.6

(YES) Obstructive Sleep Apnea               327.23

                        ************************

Preventive Medicine Codes:

            Dietary counseling and surveillance          V 65.3

            Counseling - treatment plan                      V 65.49  (includes health counseling, education)

            Counseling person other than patient        V 65.1  (for family diet planning)

            Screening                                              V 77.8

Please Let Us Know!

Let us know if you find out codes that work, or if any of these codes are not working. Just send a quick email to Dr Voakes at DrVoakes@bellsouth.net.