PDF coding for the contraceptive implant and IUDs is available.
Correct coding can result in more appropriate compensation.The following information can be helpful in helping practices receive appropriate payment.You can see the online version of the Quick Coding Guide for updates.
The diagnostic coding will vary, but usually will be selected from the Encounter forContraceptive Management code series.These are the codes.
The contraceptive method that was previously prescribed should be monitored.
October 1, 2015, is when the ICD-10 codes will go into effect.They may not be reported before the effective date.
The cost of the supply is not included in the procedure codes.The supply should be reported separately using a code.
Most IUD services will have a diagnosis code from the V25 series or the Z30 series.
The cost of the supply is not included in the procedure codes.Use a HCPCS code to report the supply.
The J7297 Levonorgestrel-releasing contraceptive system has a 3 year duration.
Beginning on January 1, 2015, the J7298 Levonorgestrel-releasing contraceptive system will be used.
Continue to use the J7302 Levonorgestrel-releasing contraceptive system on December 31, 2015.
Evaluation and Management codes, a procedure code, and a HCPCS code may be reported under certain circumstances.Each billing code must be supported by documentation.
It is not appropriate to report both an E/M services code and the procedure code if there is discussion of contraceptive options during the same encounter.
The documentation must indicate a significant, separately identifiable E/M service if it is reported with a procedure.The documentation must show the components of history, physical examination, and medical decision making.More than 50% of the visit must be spent counseling the patient in order to report an evaluation and management visit.Documentation should include the following when time is a factor in the selection of the level of service.
There are times listed in the outpatient E/M services codes.For example, if an established patient is seen for 25 minutes, including 15 minutes spent counseling, report code 99214.The level of history, physical examination, and medical decision making do not matter in selecting this code.Some payers don't recognize time spent counseling.Third-party payers should be consulted before this coding practice is implemented.
An E/M service that is significant on the same day as a procedure or other service is added to the code.This shows that there was an E/M service and a procedure.