Internal Medicine Coding Alert
READER QUESTION ~ Use Preventive Counseling Codes When Necessary
Question: Our internist spent 30 minutes with an established patient discussing and prescribing birth-control pills during a preventive medicine counseling session. He went over the differences between the pill and the patch and other birth-control devices as well. Which ICD-9 codes should we report for the preventive visit?
Kentucky Subscriber
Answer: You should report 99402 (Preventive medicine counseling and/or risk factor reduction intervention[s] provided to an individual [separate procedure]; approximately 30 minutes) and link it to V25.01 (Encounter for contraceptive management; prescription of oral contraceptives).
Remember: Because 99401-99404 are time-based codes, your physician must document the amount of face-to-face time spent counseling, and the content of the counseling is crucial. Notes for the counseling visit should include references to pamphlets or other materials the physician reviewed with the patient.
Best bet: You'll stand a better chance of convincing payers to reimburse for counseling if you're able to provide particulars on the content of the discussion and reasons the internist prescribed a certain contraceptive.
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