Name of Manual - Blue Cross and Blue Shield of Minnesota

Weight Management
Care (continued)
Coding Policies and Guidelines (Medical Services)
Nutritionists, Dietitians and other Providers
For many lines of business, Blue Cross pays Minnesota licensed
nutritionists, licensed dietitians, and registered dietitians directly
for services submitted with an eating disorder code 307.1, 307.50
and 307.51. The provider may submit using procedure/service
codes S9470, 97802, 97803, or 97804 based on the service
provided. No referral is necessary for the highest benefit level.
Some self-insured plans, however, may exclude coverage by a
dietitian, so benefits should be verified.
Licensed dietitians and licensed nutritionists can bill for
procedure/service codes S9470, 97802, 97803, G0447 and G0449
for diagnosis codes other than eating disorders. Services provided
by licensed dietitians and nutritionists must be submitted to Blue
Cross using the provider number or NPI of an eligible medical
clinic or hospital. The individual provider number or NPI of the
licensed dietitian or licensed nutritionist must also be submitted on
the claim.
Registered dietitians billing for services outside of behavioral
health diagnosis codes will have those claims denied unless the
services are submitted under the individual provider number of a
supervising physician. The –U7 modifier should also be submitted.
Health educators and exercise physiologists are not recognized as
eligible providers and their services will be rejected if received by
Blue Cross.
Weight Loss Programs
Blue Cross does not cover commercial weight loss programs (e.g.,
Nutra-systems, Jenny Craig, LA Weight Loss, Weight Watchers
etc.) with the exception of the PMAP contract.
Members of MinnesotaCare, BlueAdvantage, SecureBlue do have
limited weight loss programs benefits, including weight
management and nutrition classes.
Weight Loss Drugs
All fully insured groups cover weight loss drugs. Public Program
accounts do not cover weight loss drugs. Each self-insured account
chooses whether or not to cover weight loss drugs. Note that
patients covered by certain State Health Plan products have
specific authorization requirements for weight loss drugs.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (06/20/12)
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