CPT Coding

Indirect calorimetry (the procedure performed by the ReeVue), is CPT coded and is covered by Medicare and most insurance providers.

CPT code	Description	Medicare National Fee Limit
94690	Oxygen uptake, expired gas analysis; Rest, indirect	$73.05

Diagnosis Codes

Weight Management

Medicare Nationally Covered Indications currently reads:

"Service performed in connection with the treatment of obesity are covered by Medicare when such services are an integral and necessary part of a course of treatment for diseases such as:  hypothyroidism, Cushing's disease, hypothalamic lesions, cardiovascular diseases, respiratory diseases, diabetes, and hypertensions."

The common codes associated with these disease states include:

  243  Hypothyroidism
  250  Diabetes Mellitus
  255.0  Cushing's Syndrome
*277.7  Dysmetabolic Syndrome X
  401.0-404.9  Hypertension
  414.0-414.07 Cardiovascular Disease
  780.50-780.59 Sleep Disturbances
  786.05  Shortness of Breath
  786.00-786.07  Dyspnea and Respiratory Abnormalities
  790.29  Abnormal Glucose (Pre-diabetes)
  V58.69  Long-term (current) use of other medications

These codes can be used in conjunction with a co-morbidity of obesity:

  259.9  Obesity of Endocrine origin
  278.0  Obesity, unspecified
  278.01  Morbid obesity, severe obesity

Nutritional Assessments

  263.0  Malnutrition of moderate degree
  263.1  Malnutrition of mild degree
  269.9  Nutrition, deficient of insufficient
  794.7  Hypermetabolism

Secondary to:

  277  Cystic Fibrosis
  307.1  Anorexia nervosa
  307.51  Bulemia
  579.9  Malabsorption
  783.6  Hyperalimentation
  949  Burns
  952  Spinal Cord Injury
  995.91  Sepsis
  998.83  Non-healing wound
  V65.3  Dietary surveillance and counseling

 

*The Adult Treatment Panel III requires 3 of the following items checked to make the diagnosis of Metabolic Syndrome, ICD 277.7:

1. Waist Men   >102 cm
2. Waist Women   >88 cm
3. HDL Men   <40 mg/dL
4. HDL Women   <50 mg/dL
5. Triglycerides   >150 mg/dL
6. Hypertension   >130/85
7. Impaired Fasting Glucose   >110 mg/dL

 This information is for educational purposes and is not a guarantee of reimbursement. Please contact your local carriers for information.