Guide to Inpatient Nutrition Services

Outpatient nutrition services are provided by registered dietitians in the Nutrition Counseling Clinic and in designated adult and pediatric specialty clinics. Based upon the patient's needs, nutrition services are integrated with the overall goals of care and may include:

  • Nutrition assessment of dietary patterns and comparison with appropriate standards
  • Assessment of dietary patterns and comparison wiht appropriate standards
  • Estimation of nutritional needs; nutrition related goal setting 
  • Individualized nutrition education and counseling for general nutrition principles and for therapeutic diets
  • Participation in team rounds and meetings

Where are Nutrition Services Provided?

 

UCSF Nutrition Counseling Clinic (NCC)
The UCSF Nutrition Counseling Clinic is staffed by Registered Dietitians to provide individual nutrition counseling appointments for adults and adolescents. Patients are seen by appointment only and a physician’s referral is required. For more information or to make an appointment, call 415-353-2291. Patients may also contact the ACC Call Center for an appointment, 415-353-4174. If insurance preauthorization is needed, please wait for authorization before making an appointment. 

NCC Locations: 

Nutrition Counseling Clinic, Mount Zion Campus

1701 Divisadero Street, 5th Floor San Francisco, CA Located in General Medicine

 

Lakeshore Family Medicine Center

1569 Sloat Boulevard, San Francisco, CA

Insurance Coverage for Nutrition Counseling

Please note that health insurance plans may not include nutrition counseling as a covered service. Preauthorization is required to ensure that nutrition counseling will be covered by insurance. Patients should be aware there is a fee for nutrition counseling if it is not covered by their insurance policy.

Clinics with Scheduled Coverage by a Registered Dietitian
Many UCSF specialty clinics include a registered dietitian as a member of the health care team. These are clinics with a high proportion of patients likely to be at nutrition risk or clinics with patients who are treated with medical nutrition therapy. Patients who receive care in a UCSF specialty clinic listed below can usually be seen by the registered dietitian in the clinic and do not require a referral to the Nutrition Counseling Clinic. Clinics with a Registered Dietitian on site include: 

Adult Clinics Pediatric Clinics
ALS Clinic                  

Bariatric Surgery
Cystic Fibrosis Clinic
Diabetes Clinic
Diabetes Teaching Center

Heart Transplant

Hepatology Clinic

Inflammatory Bowel Disease Center
Intestinal Rehabilitation Program

Lung Transplant
Obstetrics-Diabetes and Pregnancy

Polycystic Ovarian Syndrome Clinic
Positive Health Practice

Pre-Renal Transplant
Weight Management Program

Mount Zion

Cancer Resource Center
Chronic Dialysis Unit

Radiation Oncology

Cardiology              Children’s Renal Center   

Diabetes Clinic (Madison Clinic)
Genetics-Metabolic Clinic
GI Clinic

LIFE Clinic

Immunology

Neurology (Ketogenic Diet)

Oncology
Cystic Fibrosis Clinic

Rheumatology
Spinal Defects Clinic
Teen Clinic

WATCH (obesity)

Other Nutrition Resources at UCSF

  • Weight Management Program. Call 415-353-2105 for information 
  • Diabetes Teaching Center. Call 415-353-2266 for information
  • Osher Center for Integrative Medicine CAll 415-353-7700 for information 

Off-Site Nutrition Services for Some Patients
Certain patients receive care at other sites where the services of a Registered Dietitian would be available. In general, these patients would not require a referral to the Nutrition Counseling Clinic. Examples of off site programs are: 

  • Women, Infants and Children’s Supplemental Food Program (WIC). Low-income pregnant or lactating women and children 5 years old or younger with a medical or nutrition risk may be referred to a WIC clinic for nutrition education and food vouchers. 
  • Chronic Dialysis. Patients with end stage renal disease who undergo dialysis treatment would receive nutrition care from the Registered Dietitian who is employed by the dialysis center used by the patient. 
  • Adult Day Health Centers. General nutrition screening and nutrition education are provided at Adult Day Health Centers. 
  • UCSF Home Care and other home care providers. The services of a Registered Dietitian are provided when medically indicated for patients who receive home care services. 
  • Skilled Nursing Facilities. Registered Dietitians at SNFs provide nutrition screening, nutritional assessment, on-going monitoring of nutritional status and medically prescribed diets. 

 

Which patients should be referred to Nutrition Counseling Clinic?

 

Common reasons for referrals and the general approach are shown in the table below. 

Condition Nutrition Therapy
Obesity/Overweight Individualized weight management plan; consider a referral to the UCSF Weight Management Program for modified fast/meal replacement program.
Diabetes Individualize meal plan; consider referral to UCSF Diabetes Teaching Center.
Lipid disorders Consultation about calorie intake, fat intake, exercise, weight management.
Gastrointestinal disorders Evaluation of diet quality, food intolerances, individualized guidelines for food selection and meal planning.
Congestive Heart Failure/Hypertension Evaluation of current diet, principles of low sodium diet, individualized plan for calorie level to achieve or maintain desired weight goal.
End stage liver disease Calculate and counsel on individualized protein, energy and nutrient intake.
End stage renal disease If on dialysis, advise patient to consult with the dietitian at the dialysis center.  If not on dialysis, calculate and counsel on protein, energy, nutrient and fluid intake to maintain body weight and lean body mass and manage uremic symptoms.
FTT: Unintentional weight loss of > 10% in 6 months Nutrition counseling focused on increasing calorie and nutrient intake.
Suspected inadequate diet due to poor appetite, dysphagia or other medical condition Nutrition counseling focused on increasing calorie and nutrient intake.
Need for tube feeding Initial assessment should be done in hospital or through home care. Monitoring and problem-solving available in NCC.
Need for parenteral nutrition Not provided in NCC. Refer patient to Gastroenterology.
Other conditions determined by the clinic provider Individualized nutrition care plan to achieve desired outcomes depending on patient’s needs and goals identified in provider referral.

 

What services or interventions are provided by the Registered Dietitian?

The Registered Dietitian provides nutrition assessment and counseling based on the patient’s individual needs. This includes evaluation of current intake and advice for improving the nutrient content of an individual’s diet, as well as medical nutrition therapy. Medical nutrition therapy involves assessment of the nutritional status of patients with a condition, illness, or injury that puts them at nutrition risk. This includes review and analysis of medical and diet history, laboratory values, and anthropometric measurements. Based on the assessment, a nutrition care plan is developed to manage the condition or treat the illness or injury. The plan generally includes the following: (1) Diet modification and counseling leading to the development of a personal diet plan to achieve nutritional goals and desired health outcomes; and (2) Specialized nutrition therapy including recommendations for supplementation with medical foods or nutrient supplements for those unable to obtain adequate nutrients through food intake only.

How do you refer a patient to Nutrition Counseling Clinic?

A written physician's referral is required. UCSF physicians should make a referral through Apex. No referral is needed if the patient will be seen by the registered dietitian in a UCSF specialty clinic. 

Physicians from outside UCSF must make a written referral on the required NCC Referral Form. Insurance pre-authorization is required prior to scheduling the appointment. If the visit is not pre-authorized, the patient will be responsible for the fee. 

Once insurance pre-authorization has been obtained, the patient may schedule an appointment through the Call Center at 415-353-4174 or directly with the Nutrition Counseling Clinic at 415-353-2291.

 

Does insurance cover appointments in the Nutrition Counseling Clinic?

Nutrition counseling is often not covered as an insurance benefit. Patients should be informed that they may be required to self-pay if their insurance does not authorize nutrition counseling.

If a patient is a UCSF patient with coverage for Hills Physicians, no pre-authorization is required. If the patient has other insurance, please obtain pre-authorization or ask the patient to request authorization from the insurance company for Medical Nutrition Therapy (CPT code 97802). Authorization should be confirmed in writing before an appointment is scheduled in the Nutrition Counseling Clinic.