Primary Care Coding Alert
Include Supply Codes With Depo Provera Administration
Question: Our FP saw a patient for her third Depo Provera shot. What is the appropriate coding for this type of visit?
New Orleans Subscriber
Answer: Depo Provera stands for an aqueous injection of DMPA depo-medroxyprogesterone acetate, which is administered in the form of an intramuscular injection for contraceptive purposes to prevent conception.
When your FP administers an injection of Depo Provera, you’ll have to report the administration of the drug with the CPT® code 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular). You should also report the HCPCS code J1050 (Injection, medroxyprogesterone acetate, 1mg) to retrieve the cost of the injected drug. The units of service for J1050 should reflect the number of milligrams injected.
Don’t forget to report the diagnosis code V25.49 (Encounter for contraceptive management; Surveillance of previously prescribed contraceptive methods; other contraceptive method) to support the rendered service.
If the FP provided a significant, separately identifiable evaluation and management (E/M) service at the same encounter, you may also report the appropriate E/M code with modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service) appended to the E/M code.
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