billing instructions for Depo-SubQ Provera 104 dispensed to client for HCPCS Code S9430, pharmacy compounding and dispensing services HCA is covering Depo-SubQ Provera 104 dispensed to the client effective January 1, 2021 Contraceptives coverage table Added coverage information and billing instructions for Depo-SubQ Provera 104 dispensed to
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Cpt Code For Depo Provera Injection Coupons, Promo Codes 07-2021. Cpt Code Injection Depo Provera Overview. Currently valid CPT/HCPC code or modifier usage CareSource seeks to apply fair and reasonable coding edits. Questions regarding coding and billing guidance should be submitted to the insurer in whose jurisdiction a claim would be filed.
J1050 Injection, medroxyprogesterone acetate, 1 mg is used to bill for the Depo- Provera drug administered.
Effective January 1, 2013, injection administration of medroxyprogesterone acetate (Depo-Provera) should be reported using HCPCS code J1050 (Injection, medroxyprogesterone acetate, 1 mg).
Z30.9Z30. 9 - Encounter for contraceptive management, unspecified | ICD-10-CM.
Encounter for surveillance of injectable contraceptiveICD-10 code Z30. 42 for Encounter for surveillance of injectable contraceptive is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Procedure code J1050 will require the use of a modifier in order for Medicaid to identify when the injection is for contraceptive use versus non-contraceptive use. Reimbursement Amount: The reimbursement rate for J1050 is $0.20 per unit (1mg).
CPT® code 96372: Injection of drug/substance under skin or into muscle | American Medical Association.
Codes 99401-99404 are reported when the entire encounter is for preventive medicine counseling (contraceptive and/or STI). The diagnosis code is Z30. 09 (encounter for other general contraception counseling).
Instructions under Z01. 411 and Z01. 419 (routine gynecological exam with or without abnormal findings) indicate that the codes include a cervical Pap screening and instruct us to add additional codes for HPV screening and/or a vaginal Pap test.
ICD-10-CM Code for Encounter for initial prescription of contraceptive pills Z30. 011.
In these cases, the provider should NOT bill J1050 on the claim since they were not supplying the medication. However, CPT 96372 with the appropriate diagnosis and modifiers may be billed for the administration services.
Your health care provider might recommend Depo-Provera if: You don't want to take a birth control pill every day. You want or need to avoid using estrogen. You have health problems such as anemia, seizures, sickle cell disease, endometriosis or uterine fibroids.
In terms of effect of Depo-Provera on ovarian function, the mean time for the return of follicular function increased with increasing doses of Depo-Provera and varied from 41.2 (25 mg), 59.6 (50 mg), 77 (100 mg), and 110 days (150 mg); these differences were significant.
When billing for injectable drugs use a HCPCS code to represent the drug. For example, Depo-Provera (150 mg, for contraceptive use) would be billed using the following codes. J1055: Injection; medroxprogesterone acetate, 150 mg.
Answer: The CPT codes to report for the procedures is 20611 (Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting). Don't forget to report CPT code J1030 for the 40mg of Depo-Medrol.
The new code is J1050, medroxyprogesterone acetate, 1 mg. To use it, you must indicate the dosage as a quantity. For example, if you injected 150 mg, you would use code J1050 x 150 on the claim. The diagnosis code will indicate the reason for the injection?that is, medical treatment or contraception.
In these cases, the provider should NOT bill J1050 on the claim since they were not supplying the medication. However, CPT 96372 with the appropriate diagnosis and modifiers may be billed for the administration services.