Does BCBSKS Cover Medical Nutritional Therapy (MNT) and Diabetic Education?
The locally developed and marketed Blue Cross and Blue Shield of Kansas (BCBSKS) member contracts do not include a benefit for medical nutritional therapy. These contracts (often referred to as traditional BCBSKS contracts) typically include a benefit for diabetic education which may, and quite likely, includes nutritional guidance. Diabetic education services meeting the guidelines as outlined in the BCBSKS Institutional Provider Manual, Chapter 8; Benefits and Exclusions are billed to BCBSKS with HCPCS G0108 or G0109. The BCBSKS claims processing system looks for the presence of a diabetes diagnosis code in the primary diagnosis code field on the claim. If not in the primary field, benefits would not be allowed. Medical nutritional therapy CPT/HCPCS 97802, 97803, 97804, G0270 or G0271 (or any other assigned code) is not covered for members enrolled in traditional BCBSKS contracts. When provided by hospital staff, these services are billed using the UB-04 billing format. NOTE: Some ad
