Ob-Gyn Coding Alert

Answer: The difference between these two codes has to do with the payer, not the service. Code 90384 (Rho[D] immune globulin [RhIg], human, full-dose, for intramuscular use) is the CPT code for RhoGam and would be billed with injection code 90782 (therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular). If the injection occurs at the time of a billed evaluation and management (E/M) service, most payers will allow you to bill only the RhoGam, not the injection, which would be considered incidental to the E/M service. Code J2790 (injection, Rho[D] immune globulin, human, one dose package) is a HCPCS code recognized by Medicare and some private payers. Most payers will not accept 90782 in addition to J2790 unless no E/M service has been billed.

If the injection occurs during the pregnancy, the most likely diagnosis for use with either code is 656.13 (rhesus isoimmunization; antepartum condition or complication). If the patient is not pregnant, V07.2 (prophylactic immunotherapy) becomes the best diagnosis.

Answer for You Be the Coder provided by Melanie Witt, RN, CPC, MA, former program manager for the American College of Obstetricians and Gynecologists department of coding and nomenclature and an independent coding educator.