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Chapter 182-555 WAC

Last Update: 10/31/18


WAC Sections

HTMLPDF182-555-0400Provider requirements.
HTMLPDF182-555-0500Covered services.
HTMLPDF182-555-0600Documentation requirements.



The medical nutrition therapy program ensures that clients have access to medically necessary outpatient medical nutrition therapy and associated follow-ups.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-22-060, § 182-555-0100, filed 10/31/18, effective 1/1/19.]



The following definitions and those found in chapter 182-500 WAC apply to this chapter:
"Enteral nutrition" - See WAC 182-554-200.
"Medical nutrition therapy" - Means an interaction between the registered dietitian (RD) and the client or client's guardian for the purpose of evaluating and making recommendations regarding the client's nutritional status.
"Nutrition assessment" - Means the collection and documentation of information such as food or nutrition-related history; biochemical data, medical tests and procedures; anthropometric measurements, nutrition-focused physical findings and client history.
"Nutrition care process" - Means a systematic approach to providing high-quality nutrition care. Provides a framework for the registered dietitian to individualize care, taking into account the client's needs and values and evidence available to make decisions.
"Nutrition-related diagnosis" - Means a diagnosis within the scope of practice for an RD to diagnose and treat as defined by the Academy of Nutrition and Dietetics.
"Registered dietitian" - Means a dietitian who is registered with the Academy of Nutrition and Dietetics and who is certified by the Washington state department of health (DOH).
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-22-060, § 182-555-0200, filed 10/31/18, effective 1/1/19.]



The medicaid agency covers medical nutrition therapy for clients who are:
(1) Age twenty and younger; and
(2) Referred to a registered dietitian for medical nutrition therapy by a physician, physician assistant (PA), or an advanced registered nurse practitioner (ARNP).
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-22-060, § 182-555-0300, filed 10/31/18, effective 1/1/19.]


Provider requirements.

Medical nutrition therapy services must be delivered by a registered dietitian (RD) who:
(1) Has a current core provider agreement with the medicaid agency; and
(2) Has a national provider identifier (NPI).
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-22-060, § 182-555-0400, filed 10/31/18, effective 1/1/19.]


Covered services.

(1) The medicaid agency covers medically necessary medical nutrition therapy when related to a nutrition-related diagnosis for eligible clients, as described under WAC 182-555-0300.
(2) The agency covers medical nutrition therapy, nutrition assessment, and counseling for conditions that are within the scope of practice for a registered dietitian (RD) to evaluate and treat.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-22-060, § 182-555-0500, filed 10/31/18, effective 1/1/19.]


Documentation requirements.

In addition to the health care record requirements found in WAC 182-502-0020, the medical nutrition therapy provider must maintain the following documentation in the client's file:
(1) Referral from the provider, as described under WAC 182-555-0300;
(2) The medical nutrition therapy provider assessment following the nutrition care process:
(a) Nutrition assessment;
(b) Nutrition diagnosis, including the problem, etiology, signs, and symptoms (PES) statement;
(c) Nutrition intervention;
(d) Nutrition monitoring and evaluation.
(3) Any correspondence with the referring provider;
(4) Information on associated medical conditions; and
(5) Information concerning the medical need.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-22-060, § 182-555-0600, filed 10/31/18, effective 1/1/19.]