The Coding which RND's use to provide Medical Nutrition Therapy to diabetes and renal patients was supported by the National Academy of Nutrition and Dietetics in order to provide RDN'S with reimbursement for seeing Medicare patient for which we previously received no reimbursement! Naturally, our outpatients became are a good number of diabetic patients. The goal of this was not to just provide payment for diabetes self-management services only. This was never meant to provide payment or to cover all diabetes services, yet people try to high jack these to cover their costs in different situations. The financial support for and lobbying for reimbursement took a long time too! While many of us cross-train where there is a need for services, for example, I as an RDN who is board-certified in critical care and in diabetes so I am able to teach all aspects of DMSE. The designation of CDE does not mean you have a degree in or license to provide Medical Nutrition therapy and in most states, the only person who is licensed to provide Medical Nutrition Therapy is the RDN. CDE nurses are valuable team members, and they understand the role of nutrition therapy, but in terms of providing the same level of skill in the provision of Medical Nutrition Therapy their training can be somewhat short. Medical Nutrition Therapy is not quite as easy using MyPlate as I see when I am teaching nurse providers. Nurses have one semester of nutrition. Most of us RDN's have Masters Degrees in the field. The documentation and billing should reflect the type of technical care provided. What is needed is legislation by nurses to request coded to do what they do best too. That way patients have the opportunity to get more time with both specialties. Time with the RN and Time with the RDN. Keep plugging away at it RNs don't need to sell Medical Nutrition Therapy short. By high jacking these little reimbursement codes you are selling our patients short. Keep asking for reimbursement for the skills you offer so we all can meet the standards of care for our patients.
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Dana Thompson MSC, CDE
Advantage Nutrition and Diabetes Prevent
Glendale AZ
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Original Message:
Sent: 04-09-2020 13:31
From: Catherine Rolih
Subject: Can RN CDCES provide DSMT via telehealth?
We need the ADA to vigorously advocate CMS (and other payors) for change in that policy - particularly since communication of medication/insulin changes is outside scope of practice for RDs in most states.
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Catherine Rolih MD
Novant Health
WINSTON SALEM NC
Original Message:
Sent: 04-06-2020 17:09
From: Angela Frey
Subject: Can RN CDCES provide DSMT via telehealth?
All the information I have accessed has indicated RNs and Pharmacists are unable to bill for DSMT via telehealth. Is there any recent updates with COIVID-19 indicating RNs can provide DSMT via telehealth?
Thank you for your input,
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Angela Frey BSN, RN, CDCES
Wauseon OH
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