Applying the recommended indicators for the diagnosis of preterm and neonatal malnutrition: Answers to frequently asked questions

Abstract

In 2018, a committee of expert preterm/neonatal registered dietitian nutritionists published recommended indicators for the diagnosis of malnutrition in preterm infants and neonates. This was in response to a need for indicators appropriate to the preterm/neonatal population, given the emphasis on diagnosing malnutrition in the pediatric and adult population. Since the publication, the authors have received numerous questions regarding the application and use of the indicators. This paper answers questions regarding the three categories of indicators and billing and reimbursement. The goal is to develop uniformity in the application of the malnutrition indicators for quality improvement and research efforts.

US neonatal intensive care unit registered dietitian nutritionists salary description and correlates: results of a survey

“…High individual patient acuity (e.g., patients diagnosed with severe malnutrition using the emerging NICU malnutrition diagnosis 18 ) impacts overall unit case mix, which could be used by third-party payers, increasing reimbursement to the NICU as a result of RDN assessment and management. 19 Although many NICU RDNs have sought additional certifications to demonstrate their expertise, the additional compensation from these achievements has been limited, even at facilities where staff report earning incentive pay for certifications. It is possible that these incentives were one-time spot bonuses, limiting their contribution to overall wages.…”

“…This could include evidence that demonstrates their impact on health outcomes. High individual patient acuity (e.g., patients diagnosed with severe malnutrition using the emerging NICU malnutrition diagnosis 18 ) impacts overall unit case mix, which could be used by third‐party payers, increasing reimbursement to the NICU as a result of RDN assessment and management 19 …”