CMS Pub. 100-04, ch. 4, § 300.5

This benefit is payable for beneficiaries who have diabetes or renal disease. Contractors

are urged to perform data analysis of these services in your jurisdiction. If you determine

that a potential problem exists, you should verify the cause of the potential error by

conducting an error validation review as described in the Program Integrity Manual

(PIM), Chapter 3, Section 2A. Where errors are verified, initiate appropriate corrective

actions found in the PIM, Chapter 3, Sections 3 through 6. If no diagnosis is on the

claim, return the claim as unprocessable. If the claim does not contain a diagnosis of

diabetes or renal disease, then deny the claim under Section 1862(a)(1)(A) of the Act.

A. Special Requirements for A/B MACs (B)

• Registered dietitians and nutrition professionals can be part of a group practice in

which case the provider identification number of the registered dietitian or

nutrition professional that performed the service must be entered in on the claim

form.

• The specialty code for “dietitians/nutritionists” is 71.

B. Medicare Summary Notices (MSNs)

• Use the following MNT messages where appropriate. If you locate a more

appropriate message, then you should use it.

• If a claim for MNT is submitted with dates of service before January 1,

2002, use MSN 21.11 (This service was not covered by Medicare at the

time you received it). The Spanish version is ‘Este servicio no estaba

cubierto por Medicare cuando usted lo recibio.’

• If a claim for MNT is submitted by a provider that does not meet the

criteria use MSN 21.18 (This item or service is not covered when

performed or ordered by this provider). The Spanish version is ‘Este

servicio no esta cubierto cuando es ordenado o rendido por este

proveedor.’

C. A/B MAC (A) Special Billing Instructions

MNT Services can be billed to A/B MACs (A) when performed in an outpatient hospital

setting. The Hospital outpatient departments can bill for the MNT services through the

A/B MAC (A) if the nutritionists or registered dietitians reassign their benefits to the

hospital. If the hospitals do not get the reassignments the nutritionists and the registered

dietitians will have to bill the Medicare A/B MAC (B) under their own provider number

or the hospital will have to bill the Medicare A/B MAC (B).

NOTE: Nutritionists and registered dietitians must obtain a Medicare provider number

before they can reassign their benefits.

The only applicable bill types are 13X, 23X, 32X, and 85X.