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Important information about the Culinary Health Center
Latest COVID-19 information for
Participants Providers Employers

Culinary Healthier U office visit billing guidelines

Provider must submit initial and any subsequent claims with a patientʼs Body Mass Index (BMI) as the primary diagnosis. Provider must ensure that patientʼs BMI is coded to the highest level of specificity (Z68.20 – Z68.54). Any claim submitted without patientʼs BMI as the primary diagnosis will be denied.

Provider is allowed two (2) additional office visits if patientʼs BMI is less or equal to 29 and any of the diagnoses listed below are submitted on the claim:

E40 – E46 Malnutrition
E63.0 – E63.9 Nutritional deficiencies
E00 – E07.9 Thyroid disorders
E70 – E88.9 Other metabolic disorders
F50 – F50.9 Eating disorders
O24.4 Gestational diabetes mellitus
R62.7 Underweight, failure to thrive
R73.0 – R73.09 Abnormal glucose

Provider is allowed up to twenty five (25) additional office visits if a patientʼs BMI is less or equal to 29 and any of the diagnoses listed below are submitted on the claim:

E10 – E10.9 Diabetes mellitus – Type 1
E11 – E11.9 Diabetes mellitus – Type 2
E66 – E66.9 Overweight
E75 – E75.6 Hyperlipidosis
E78 – E78.6 Hyperlipidemia
I10 – I15.9 Hypertension
I20 – I25.9 Ischemic heart disease
I26 – I28.9 Pulmonary heart disease
I30 – I51.9 Other forms of heart disease
N18 – N18.9 Chronic kidney disease

Provider is allowed up to twenty five (25) additional office visits if patientʼs BMI is 30+ regardless of additional diagnoses billed.