Effective January 1, 2013, injection administration of medroxyprogesterone acetate (Depo-Provera) should be reported using HCPCS code J1050 (Injection, medroxyprogesterone acetate, 1 mg).
V25.9Z30. 9 converts to ICD-9-CM: V25. 9 - Unspecified contraceptive management.
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).
Long term (current) use of hormonal contraceptives Z79. 3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z79. 3 became effective on October 1, 2021.
J1050 Injection, medroxyprogesterone acetate, 1 mg is used to bill for the Depo- Provera drug administered.
The contraceptive injection (Depo-Provera, Sayana Press or Noristerat) releases the hormone progestogen into your bloodstream to prevent pregnancy. Depo-Provera is most commonly given in the UK and lasts for 13 weeks. Occasionally, Noristerat may be given, which lasts for 8 weeks.
96372 CPT code is used for the administration of any diagnostic, therapeutic, or prophylactic substance (a drug, a fluid, etc.) by a physician or assistant.
CPT® code 96372: Injection of drug/substance under skin or into muscle | American Medical Association.
Encounter for initial prescription of contraceptive pills Z30. 011 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z30. 011 became effective on October 1, 2021.
Encounter for contraceptive management2022 ICD-10-CM Diagnosis Code Z30: Encounter for contraceptive management.
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.
ICD-10 Code for Long term (current) use of hormonal contraceptives- Z79. 3- Codify by AAPC.
Meloxicam Injection, for Intravenous Use (Anjeso™) HCPCS Code J3490: Billing Guidelines.
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.
Preventative medicine counselingCPT 99401: Preventative medicine counseling and/or risk factor reduction intervention(s) provided to an individual, up to 15 minutes may be used to counsel commercial members regarding the benefits of receiving the COVID-19 vaccine.
CPT defines this code as an “office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician.” It further states that the presenting problems are usually minimal, and typically five minutes are spent performing or supervising these services.
Behavior Change Interventions: 99401-99412 for patients who already have a behavior often considered an illness, such as substance use disorder. Preventive Medicine: 99381-99387; 99391-99397 for adults, children and infants Codes based on age of patient and whether new/established.
New Jersey law requires health plans sold in the state to cover a set of mandated health benefits, among these are prescription female contraceptives. Including, but not limited to, birth control pills, implanted devices, and diaphragms, at no cost to the patient.
V25.01 is a legacy non-billable code used to specify a medical diagnosis of general counseling on prescription of oral contraceptives. This code was replaced on September 30, 2015 by its ICD-10 equivalent.
The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
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.