2- Senior Seminar Obesity Case Study for MNT Coding and Billing

Senior Seminar Obesity Case Study for MNT Coding and Billing Mark is a 16 y.o Caucasian male who lives with his grandparents. He does not play sports and rarely gets much exercise at school. Mark states he would like to start playing baseball for his high school, but gets discouraged when he is unable to keep up with others. He feels insecure about his weight and feels like he doesn’t fit in. He often skips breakfast, or eats something from the convenience store. He eats school lunch every day. His grandmother prepares a dinner meal at home every night. Mark and his grandparents sit at the dining room table, with the television off, for dinner. Anthropometric Data and Lab Values: Wt: 260# Ht: 74.75 in BMI: B/P: 140/72 mm/Hg Glucose: 125 mg/dL Fasting Insulin: 12 mg/dL A1C: 6.7% Total Cholesterol: 180 mg/dL LDL: 121 mg/dL HDL: 30 mg/dL Triglycerides: 225 mg/dL Diet History: When he eats breakfast, Mark often has a pop tart and on his way to the bus he often purchases a 16 oz bottle of Mountain Dew at the local convenience store. He usually chooses the pizza line with fries and a chocolate milk from the school cafeteria for lunch. He doesn’t consume fruit besides apples and pears. Afterschool snacks include sandwiches (like bologna and cheese or PB&J) and potato chips. He usually has a few cookies after this snack, and another Mountain Dew. For dinner his grandmother normally prepares hamburgers with a regular (white) bun, mac and cheese, and baked beans. He likes spaghetti with meatballs. He doesn’t like most meats except ground beef and fried chicken. With dinner he drinks either a can of Mountain Dew or some lemonade. He eats a bedtime snack, which includes powdered donuts or a bowl of Captain Crunch with 2% milk. Mark’s grandmother is concerned about his weight and risk of diabetes. Mark is concerned about playing sports. You will meet with this patient for one hour for the initial visit. Work in groups to complete the following information related to his visit. 1. What are his nutrition priorities? 2. What is Mark’s BMI? Plot this on the CDC growth chart for BMI for Age. Are there any concerning labs? 3. What CPT code would we use to bill for this patient? 4. How many units do we bill for this visit? 5. Complete a nutritional assessment by completing an ADIME note for Mark. You can use the template provided, or create your own chart. The note must be legible and clearly follow the ADIME format. Use the example provided for guidance. Additionally: How would you determine the following information? • Does this patient have a co-pay? • Has this patient met his deductible for the year? • What ICD 10 Diagnosis code would we use to bill for this patient?