What will be the allotted MNT benefit if a beneficiary has both diabetes and renal disease?
According to CMS, beneficiaries with both diabetes and renal disease (not on dialysis or within 36 months post transplant) can receive hours of MNT beyond what the NCD guidelines stipulate. According to the Program Memorandum AB-02-059 (1) “Additional hours of MNT services may be covered beyond the number of hours typically covered under an episode of care when the treating physician determines there is a change in diet necessary. Appropriate medical review for this provision should only be done on a postpayment basis. Outliers may be judged against nationally accepted dietary or nutritional protocols.” The “progress notes” found in the American Dietetic Association’s protocols can help RDs document beneficiaries’ changes in behavioral MNT goals, and can be used to indicate the need for additional MNT visits.
