Medical Billing Forum
Coding => Coding => : ravik July 07, 2009, 10:28:28 AM
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kindly suggest the correct ICD and CPT codes
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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
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**snicker** Sorry but I just had to
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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
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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.
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Linda is right, it sounds like the service is just not a covered benefit under the patient's plan.
Michele
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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
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midwife, you really seem to know your stuff!! never dealt with that part of billing,
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Ah shucks, ya made me blush. :-)