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.
ICD-10 code Z32. 01 for Encounter for pregnancy test, result positive is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
ICD-10 code O02. 81 for Inappropriate change in quantitative human chorionic gonadotropin (hCG) in early pregnancy is a medical classification as listed by WHO under the range - Pregnancy, childbirth and the puerperium .
J1050 Injection, medroxyprogesterone acetate, 1 mg is used to bill for the Depo- Provera drug administered.
2022 ICD-10-CM Diagnosis Code Z30: Encounter for contraceptive management.
Pregnancy Test: CPT Code 81025 for human chorionic gonadotropin (hCG) urine testing performed in the office should be reported on a claim any time the test is performed.
CPT® Code 84702 in section: Gonadotropin, chorionic (hCG)
Effective January 1, 2013, injection administration of medroxyprogesterone acetate (Depo-Provera) should be reported using HCPCS code J1050 (Injection, medroxyprogesterone acetate, 1 mg).
ICD-10 code Z32. 02 for Encounter for pregnancy test, result negative is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
ICD-10 code T80 for Complications following infusion, transfusion and therapeutic injection is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes .
Z30.9Z30. 9 - Encounter for contraceptive management, unspecified | ICD-10-CM.
Diagnosis CodesDiagnosis CodeDescriptionZ30.019Encounter for initial prescription of contraceptives, unspecifiedZ30.02Counseling and instruction in natural family planning to avoid pregnancyZ30.09Encounter for other general counseling and advice on contraceptionZ30.2Encounter for sterilization21 more rows
6 Irregular menstruation, unspecified.
Z30. 9 - Encounter for contraceptive management, unspecified. ICD-10-CM.
The reimbursement rate for J1050 is $0.20 per unit (1mg). Since the code description is based on 1mg, providers should bill the applicable units based on the 1mg. Examples: A medroxyprogesterone acetate injection was given for 150 mg for contraceptive use.
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.
If there was no pre-defined high-risk diagnosis, then the termination of pregnancy date should be used as the end date/delivery date.This low risk pregnancy may be billed with a package code if four or more visits were completed before the termination.If less than four visits were provided an E/M code can be billed for each visit.
If RhoGamand 17P are administered during a routine prenatal visit, then the agency may bill the therapeutic injection code (96372) and the HCPCS code for RhoGam[RhoGam(J2790-full dose or J2788 -partial dose) or 17P CPT code for Makena (Q9986) –Brand new guidance as of 07/2017 or CPT code for Compound (Generic) Q9985 –Brand new guidance as of 07/2017
Unlike the CPT codes for IUD procedures, there is a unique CPT code 11983 that is used to describe the removal and reinsertion of the contraceptive implant. Include the ICD-10 code Z30.46 (encounter for surveillance of implantable subdermal contraceptive) which supports the routine checking, removal, or reinsertion of the implant.
There is NOT one singular code that describes an IUD removal and reinsertion. It is essential that you code and bill BOTH the CPT code 58301 for the IUD removal and 58300 for the IUD reinsertion with a modifier 51 on the second procedure in order to be paid appropriately for the services. Some payers require modifier 59, instead of 51, so ensure your billers track these requirements and use the correct modifier. Use the unique ICD-10 diagnosis code Z30.433 (encounter for IUD reinsertion) to support both CPT codes.
Do NOT code BOTH a 99211 and a 96372 on the same visit for a Depo-Provera injection. The services will typically not pay even with a modifier 25 attached.
An additional ICD-10-CM code that identifies the contraceptive method in which the complication arose is required. The ICD-10-CM codes for complications must be billed with Z30.2.
Antibiotic regimens are the same as for treatment of uncomplicated PID, as listed in the “Treatment and Dispensing Guidelines for Clinicians” in the Benefits Grid section in this manual. Also refer to the Pharmacy Formulary and Clinic Formulary sections in this manual.
The Pregnancy ICD 10 code belong to the Chapter 15 – Pregnancy, Childbirth, and the Puerperium of the ICD-10-CM and these codes take sequencing priority over all the other chapter codes.
Ectopic pregnancy (Code range- O00.00 – O00.91) – This is a potentially life-threatening condition in which the fertilize egg is implanted outside the uterus, usually in one of the fallopian tubes or occasionally in the abdomen or ovaries.
Galactorrhea. Other obstetric conditions, not elsewhere classified (Code range O94-O9A) Sequelae (Late effects) of complication of pregnancy, childbirth, and the puerperium (O94)- Includes conditions or late effects that may occur any time after the puerperium.
Morbidly adherent placenta (Placenta accrete, Placenta increta, Placenta percreta) Placental infarction. Placenta previa (Code range O44.00- O44.53)- Condition in which the placenta is implanted in the lower parts of the uterus.
HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome – (Code range O14.20- O14.25) – A very rare condition seen in pregnant patients mostly with pre-eclampsia usually before the 37 th week of pregnancy.
Missed abortion (O02.1)- The retention of a non-viable fetus along with the placenta and embryonic tissues inside the uterus without the body recognizing the loss of pregnancy and therefore failing to naturally expel the non-viable contents like in spontaneous abortion.
Hydatidiform mole (Code range- O01.0 – O01.9) – Also known as molar pregnancy is an abnormal fertilized egg or a non-cancerous tumor of the placental tissue which mimics a normal pregnancy initially but later leads to vaginal bleeding along with severe nausea and vomiting.