Wiki OCP Initiation Visit

Create Wiki
E

eharloff

Networker
Messages
37
Location
Grand Rapids, MI
Best answers
0
I've been having issues getting claims paid when patients come in for OCP initiation because the Z30.41 gives me an error stating it cannot be a primary diagnosis but what other dx am I supposed to use if the patient has no other concerns? I should add we are primary family practice.

TIA!
 

2025 ICD-10-CM Diagnosis Code Z30.011
us.webp

Encounter for initial prescription of contraceptive pills​

 
eharloff said:
I've been having issues getting claims paid when patients come in for OCP initiation because the Z30.41 gives me an error stating it cannot be a primary diagnosis but what other dx am I supposed to use if the patient has no other concerns? I should add we are primary family practice.

TIA!
Click to expand...
Hi Eharloff,
Why is the female patient coming in ...just to get BC pills? I d use reason associated in which provider could document such as: Mensuration problems use N92.6 block, N88.8, N95. Post. Men. Bleeding, E28 Ovarian Dysfunction, or Dented Uterus Q91.81 or N94.89. I d selected dx N94.89 takes in all kinds of disorders with uterus , then Z30 dx. Or dx block R87.61 if had pap was abnormal but documented. But did the patient get pap same day as assigned BC pills?
Well hope this helps you somewhat.
Lady T
 
Last edited:
TThivierge said:
Hi Eharloff,
Why is the female patient coming in ...just to get BC pills? I d use reason associated in which provider could document such as: Mensuration problems use N92.6 block, N88.8, N95. Post. Men. Bleeding, E28 Ovarian Dysfunction, or Dented Uterus Q91.81 or N94.89. I d selected dx N94.89 takes in all kinds of disorders with uterus , then Z30 dx. Or dx block R87.61 if had pap was abnormal but documented. But did the patient get pap same day as assigned BC pills?
Well hope this helps you somewhat.
Lady T
Click to expand...
Patient doesn't have any issues - just is sexually active and started on OCPs. No pap was done as she's 17
 
What procedure code are you billing? Some payers will not pay for routine/preventive care unless you also bill a routine CPT code (so not an E&M code). Some payers expect there to be a documented condition/complaint in order to pay for an E&M visit.
Check payer policies, in this crazy healthcare environment, some companies don't pay for OCP, or it may be her age and they use the 'we don't cover that diagnosis code' excuse to make it look like we don't know how to code (don't get me started...... ) :)
 
You must log in or register to reply here.
Top