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|ICD-10 DIAGNOSIS CODES – MEDICAL NUTRITION THERAPY |

| | |DIABETES | | |DIGESTIVE SYSTEM |

| |E10.6 |Diabetes, Type I, w/ specified complications | |K21.9 |GERD without Esophagitis |

| |E10.64 |Diabetes, Type I w/ hypoglycemia | |K29.7 |Gastritis, unspecified |

| |E10.65 |Diabetes, Type I w/ hyperglycemia | |K50.0 |Crohn’s Disease of Small Intestine |

| |E10.8 |Diabetes, Type I w/ unspecific complications | |K50.1 |Crohn’s Disease of Large Intestine |

| |E10.9 |Diabetes, Type I w/o complications | |K50.8 |Crohn’s Disease of Small and Large Intestine |

| |E11 |Diabetes, Type II | |K50.9 |Crohn’s Disease, Unspecified |

| |E11.64 |Diabetes, Type II w/ hypoglycemia | |K51 |Colitis, Ulcerative |

| |E11.65 |Diabetes, Type II w/ hyperglycemia | |K57.1 |Diverticulitis of SI w/o perforation or abscess |

| |E11.8 |Diabetes, Type II w/ unspecified complications | |K57.3 |Diverticulitis of LI w/o perforation or abscess |

| |E11.9 |Diabetes, Type II w/o complications | |K58 |Irritable Bowel Syndrome |

| | |KIDNEY DISEASE | |K59 |Constipation |

| |N18.2 |Chronic Kidney Disease, Stage 2 | |K90.0 |Celiac Disease |

| |N18.3 |Chronic Kidney Disease, Stage 3 | |K52.2 |Allergic and dietetic gastroenteritis & colitis |

| |N18.4 |Chronic Kidney Disease, Stage 4 | | |PREGNANCY |

| | |WEIGHT MANAGEMENT | |O21.1 |Hyperemesis gravidarum w/ metabolic disturbance |

| |Z68.30 |BMI 30.0 – 30.9, adult | |O24.01 |Diabetes, Type I, pregnancy (pre-existing) |

| |Z68.31 |BMI 31.0 – 31.9, adult | |O24.11 |Diabetes, Type II, pregnancy (pre-existing) |

| |Z68.32 |BMI 32.0 – 32.9, adult | |O24.410 |Diabetes, Gestational, diet controlled |

| |Z68.33 |BMI 33.0 – 33.9, adult | |O24.414 |Diabetes, Gestational, Insulin controlled |

| |Z68.34 |BMI 34.0 – 34.9, adult | |O26.00 |Weight gain, excessive, pregnancy, unspecified trimester |

| |Z68.35 |BMI 35.0 – 35.9, adult | |O26.10 |Weight gain, low, pregnancy, unspecified trimester |

| |Z68.36 |BMI 36.0 – 36.9, adult | |O99210 |Obesity complicating pregnancy, unspecified trimester |

| |Z68.37 |BMI 37.0 – 37.9, adult | | |CLINCAL & LAB FINDINGS |

| |E66.0 |Obesity, due to excess calories | |R73.02 |Impaired glucose tolerance test (oral) |

| |E66.01 |Obesity, morbid, due to excess calories | |R73.09 |Abnormal fasting GTT, other (pre diabetes) |

| |E66.9 |Obesity, unspecified | | |MALNUTRITION |

| |E66.3 |Overweight | |E44.1 |Malnutrition, protein/calorie, unspecified, mild |

| |R63.6 |Underweight | |E44.0 |Malnutrition, protein/calorie, unspecified, moderate |

| |R63.5 |Abnormal Weight Gain | |E43 |Malnutrition, protein calorie, unspecified, severe |

| |R63.4 |Abnormal Weight Loss | | | |

|ICD-10 DIAGNOSIS CODES – MEDICAL NUTRITION THERAPY |

| | |CIRCULATORY SYSTEM | | |DISEASES OF BLOOD |

| |I11.0 |Hypertensive heart disease with CHD | |D51.3 |Anemia, other dietary vitamin B12 deficiency |

| |I11.9 |Hypertensive heart disease without CHD | |D52.0 |Anemia, dietary folate deficiency |

| |I12 |Hypertensive chronic kidney disease | |D53.0 |Anemia, protein deficiency |

| | |ENDOCRINE & METABOLIC | |D53.9 |Anemia, nutrition, unspecified |

| |E78.1 |Hypertriglyceridemia, pure | | |MUSCOSKELETAL |

| |E78.5 |Hyperlipidemia, unspecified | |M81.8 |Osteoporosis, other, without current pathological fracture |

| |E88.81 |Metabolic syndrome | | |PEDIATRICS |

| |E03.9 |Hypothyroidism, unspecified | |Z68.52 |BMI, pediatric, 5th percentile to less than 85th percentile for |

| | | | | |age |

| |E28.2 |Polycystic Ovary Syndrome | |Z68.53 |BMI, pediatric, 85th percentile to less than 95th percentile for |

| | | | | |age |

| |E05.90 |Thyrotoxicosis, unspecified | |Z68.54 |BMI, pediatric, greater than or equal to 95th percentile for age |

| |E16.1 |Hypoglycemia, other | | |MISCELLANEOUS |

| |M1A.9 |Chronic gout, unspecified | | | |

| |M10.3 |Gout due to renal impairment | | | |

| |M10.9 |Gout, unspecified | | | |

| |E73.9 |Lactose Intolerance | | | |

| | |MENTAL & BEHAVIORAL | | | |

| |F50.01 |Anorexia nervosa, restricting type | | | |

| |F50.02 |Anorexia nervosa, binge eating/purging type | | | |

| |F50.2 |Bulimia nervosa | | | |

| |F50.8 |Eating Disorder, Other | | | |

| |F50.9 |Eating Disorder, Unspecified | | | |

|SERVICES and CPT CODE |

| |Fee | |Fee | | |

|□ 97802 -Initial Consultation and Assessment, |$ |□ 99372 – Telephone | | | |

|$ UNITS (15min/unit), | |Consultation | |Previous Balance| |

|□ 97803 -Follow-up/Reassessment Consultation, |$ | | | |$ |

|$ __UNITS (15 min/unit), | |□ Supplements (variable) | |Total Charges | |

|□ 97804 -Group, _____units (15 min/unit) | |□ Grocery Shopping _____units (15| |Amount Paid |$0 |

| | |min/unit) | | | |

|□ 83516 - LEAP MRT Testing 150 units | |□ Menu & recipe development | | | |

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