Medical Billing Forum

Coding => Coding => Topic started by: ravik on July 07, 2009, 07:28:28 AM

Title: Preconception Counseling
Post by: ravik on July 07, 2009, 07:28:28 AM
 kindly suggest the correct ICD and CPT codes
Title: Re: Preconception Counseling
Post by: Michele on July 07, 2009, 08:49:38 PM
I think the ICD9 you are looking for is V26.4 - Procreative Management, General Counseling and Advice.  As for the CPT code, it depends on who is performing the service.  If it is a mental health provider then you would use one of the counseling codes 90801-90847.  If it is a medical provider you might want the consultation codes 99241-99275.

Michele
Title: Re: Preconception Counseling
Post by: Pay_My_Claims on July 07, 2009, 08:52:02 PM
**snicker** Sorry but I just had to
Title: Re: Preconception Counseling
Post by: ravik on July 08, 2009, 07:31:06 AM
Michelle

  We coded 26.4 with 99204, claim returned saying they don't cover routine exams and it is patient responsibility, service has been provided by a OB/GYN Physician at her office.

Thanks
Ravi
Title: Re: Preconception Counseling
Post by: PMRNC on July 08, 2009, 08:55:29 AM
That could very well be as some plans do not cover preventative screenings/visits. If the claim was denied but was coded correctly the patient would be responsible for payment.
Title: Re: Preconception Counseling
Post by: Michele on July 09, 2009, 07:06:55 AM
Linda is right, it sounds like the service is just not a covered benefit under the patient's plan.

Michele
Title: Re: Preconception Counseling
Post by: midwifebiller on July 13, 2009, 10:25:01 AM
We bill for preconception counseling fairly regularly. V25.4 is incorrect. 1) it needs a fourth digit and 2) this code is for contraception surveillance (checking an IUD, giving another Depo shot or re-issuing a rx for the Pill, etc.) and is not a good code to use for preconception counseling.  We use V25.09 (Family Planning Advice).

We have also found that only a very robust insurance plan will cover preconception counseling--most of the time the member will need to pay out of pocket.

~Kelli
Midwife Billing & Business, LLC
Title: Re: Preconception Counseling
Post by: Pay_My_Claims on July 13, 2009, 11:36:56 AM
midwife, you really seem to know your stuff!! never dealt with that part of billing,
Title: Re: Preconception Counseling
Post by: midwifebiller on July 17, 2009, 03:05:47 AM
Ah shucks, ya made me blush.  :-)