The 5 mistakes behind most denied MNT claims
By Javier Alvarez · Updated · 2 min read
| Mistakes | 5, each with a one-line fix |
|---|---|
| Codes covered | 97802 (initial assessment) and 97803 (follow-up) |
| Format | This page and a free 1-page printable PDF |
The form above sends you the one-page PDF. Here are the five mistakes and the fix for each, so you can check a claim before it goes out.
1. Units that don't match the time
MNT codes are billed in 15-minute units, and units the note's time can't support get cut or denied. Fix: write start and stop times in every note and bill the units that time supports. The units calculator shows the thresholds.
2. Wrong place of service or modifier for telehealth
Payers disagree: some want POS 10 (patient at home), some POS 02, and many commercial plans want modifier 95. Fix: look up each payer's telehealth policy once and keep a one-line note per payer. The code sheet by payer lists what each one's public policy says.
3. A diagnosis that doesn't support MNT
Z71.3 on its own is often denied. For Medicare, MNT only covers diabetes, chronic kidney disease and the period after a kidney transplant. Fix: pair Z71.3 with the medical diagnosis and add the BMI (Z68.x) code as secondary when it applies. The BMI to Z68 finder helps with the last part.
4. Benefits not verified before visit one
Denial code CO-119 means the benefit limit was reached: the visits were used up. Fix: before the first visit, ask whether nutrition counseling is covered, how many visits a year, whether a referral is needed and what the copay is. The benefits checklist has the full list.
5. Initial and follow-up mixed up
97802 is the initial assessment and 97803 is every follow-up. Billing 97802 twice for the same patient is a common rejection. Fix: flag the first visit per patient and per payer, then switch to 97803.
When a claim is denied anyway
Paste the code into the denial checker to see what it means and who owes the amount. Duo Practice drafts the claim from the visit for you to review and checks these fields before it goes out. The chart is free; the claim service costs 3.9% of what insurers pay, with no monthly fee. See how the billing service works.