National survey of RDNs reveals consistently low levels of CPT coding knowledge

Findings from the Academy of Nutrition and Dietetics’ (Academy) national coding survey of Registered Dietician Nutritionists (RDN) show that 7.8% respondents don’t know what CPT codes are or are not aware of using them.

The Academy periodically surveys RDNs who provide medical nutrition therapy in ambulatory care settings to learn about the factors that influence their ability to deliver and be compensated for preventive and therapeutic nutrition services.

Results from the latest iteration of this survey demonstrate that RDNs’ knowledge of billing and coding is low for RDNs in non-supervisory roles. Researchers found that:

• Nearly 8% of respondents reported not knowing what CPT codes are or are not aware of their department using them.
  • Most of these respondents stated that someone else (e.g.., the billing department) bills patient claims or that they do not bill insurance plans. 
  • This finding is consistent with previous iterations of the survey: In 2008, 9% of respondents reported not knowing what CPT codes were or were not aware of using them; in 2013, 3.3%.
• Between 2013 and 2018, there was a 12% increase in the proportion of respondents who reported using CPT codes for medical nutrition therapy (MNT).
  • Researchers note that this increase may be driven by implementation of the 2015 Affordable Care Act, which waived Medicare’s copay for this service and enhanced coverage for preventive services, thus increasing patient accessibility to MNT services.
• Despite significant changes to coverage policies, 46.6% of survey respondents indicated that they do not know of any recent changes in billing or coding that affect dietician nutritionists.

The findings have implications for RDN supervisors and management, who may benefit from providing education to staff on regulatory coding and billing changes. The Academy emphasizes that even in cases where another department or external service handles billing for service, RDNs need a working knowledge of coding and billing to ensure all potential revenue streams are being maximized.