Wiki Birth control/info asap please

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HBULLOCK

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SALEM NH
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I work in a pediatric office and was wondering if someone could help me. We have girls that come in here for their ocp maintenance. Recently i recieved a denial from bc saying that the way we billed claim they would not pay. I billed a 99212 with a dx of v25.41. They said if she was having a blood pressure check we should be billing with that medical dx?? How do you bill these at gyn offices??? Thanks alot. :)
 
Since this is a pediatric office our policy is to ck the patient at 6 mth intervals to make sure everything is going ok and they ck the bp. You said you use the same codes we do though correct??
 
Yes, we use the same codes, although I work for a gov't facility and don't bill for reimbursement purposes. Would the code for screening htn work as primary?
 
I don't think it would be appropriate to use the screening BP dx as primary dx. The dx to be used should be the dx that was the reason for the visit. V25.41 would be appropriate for refill of oral birth control. Performing vitals is a routine procedure in most visits. In case of birth control it would be even more important to check the BP because the pills could have an effect on the patient's blood pressure. I guess, since the insurance is asking for it, I would use V81.1 screening for high blood pressure, but really that was not the purpose of the visits. I would send in the documentation with the appeal...
 
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