Ob-Gyn Coding Alert

Question: Our providers have our patients come back to our ob-gyn office after three months of putting them on birth control to make sure everything is fine. Most patients are on birth control for contraception. What procedure and dx code should I use?

Tennessee Subscriber

Answer: If your provider is still doing preventive counseling, use 99401-99404 (Preventive medicine counseling ...). Otherwise, you can only report the problem E/M codes (99211-99215, Office or other outpatient visit for the evaluation and management of an established patient ...) for these follow-up visits. CPT^®does not offer many good codes for lesser preventive care visits.

Best advice: You need to ask you payers if they do in fact cover the follow-up visits and if so, how they want you to bill them since they may deny your claim when you use the Z codes (Z30.011, Encounter for initial prescription of contraceptive pills and Z30.41, Encounter for surveillance of contraceptive pills) appropriately.