UM Guidelines

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	Background Medical nutrition therapy (MNT) is a nutritional assessment, assignment of a specific diet, and counseling services to prevent or treat an illness or condition. While changes in dietary patterns of the individual may have an impact on health, other factors such as smoking, exercise, stress and heredity are also important. The prevailing concept in the medical community and the general population is that nutrition therapy, especially for chronic health problems, is an essential component of the prevention and management of the disease/condition. Medical nutrition therapy is simple and fairly inexpensive service that may have the benefit of improving health and well being and decreasing the need for pharmaceutical products for the individual. Medical nutrition therapy includes the following: Assessment of dietary intake Individualized diet counseling Encouragement of moderate physical activity Reinforcement of dietary principles during follow-up visits with evaluation of response to the diet Clinical Indications for Procedure Medical nutrition therapy for dietary counseling provided in an outpatient setting may be appropriate if ALL of the of the following are met: Provided by a state licensed or certified dietitian or nutrition professional or physician Conditions include 1 or more of the following: Diabetes with a lack of previous diabetes outpatient self-management training services Chronic renal insufficiency (glomerular filtration rate less than 20 mL/min) without maintenance dialysis Elevated serum fasting cholesterol, particularly with evidence of coronary heart disease or other cardiovascular disease Chronic diseases/conditions in which dietary adjustment has a therapeutic role such as phenylketonuria Counseling Services Services for medical nutrition therapy for dietary counseling are appropriate for 6 visits in a 12 month period. References BlueCross BlueShield of Tennessee network providers. July - September 2024. Centers for Medicare & Medicaid Services. CMS.gov. NCD for medical nutrition therapy (180.1). Retrieved August 2, 2024 from https://www.cms.gov. Centers for Medicare & medicaid Services (CMS). Decision memo for Medical Nutrition Therapy Benefit for Diabetes & ESRD (CAG-00097N). (2002, February). Retrieved September 6, 2016 from https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=53&ver=8&viewAMA=Y&bc=AAAAAAAAIAAA& National Guideline Clearinghouse. (2013). Clinical practice guidelines for healthy eating for the prevention and treatment of metabolic and endocrine diseases in adults: cosponsored by the American Association of Clinical Endocrinologist/the American College of Endocrinology and the Obesity Society. Retrieved September 6, 2016 from https://www.guideline.gov/search?q=Third+report+of+the+national+cholesterol+education+program+expert+panel+on+detection%2C+evaluation+and+treatment+of+high+blood+cholesterol. Tennessee Code: Title 63 Professions of the Healing Arts: Chapter 25 Dietetics and Nutrition: 63-25-101. Dietetics/Nutrition Practice Act. Retrieved September 6, 2016 from http://legislature.state.tn.us/sitemap.htm. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2020-2025 Dietary Guidelines for Americans. 9th Edition. (2020, December). Retrieved August 2, 2024 from https://www.dietaryguidelines.gov.