elective termination W/Mifepristone

[desireewhite185@yahoo.com]

Hello,
We are just starting to offer in office service of elective termination via Mifepristone and Miso. I see Codes S0190 and S0191, and I imagine the diagnosis Z33.2 will have to be on these. We will bill this as E/M visit so my question is, if the patient doesn't want parents to know about this, can we put Z31.69 Encounter for other general counseling and advice on procreation. I imagine they will discuss birth control going forward..so that or the Z30.0 Encounter for general counseling and advice on contraception.
Does anyone know if the EOB would show the meds given and diagnosis for the pills? I haven't dealt with this at all.
Then, if self pay/don't want insurance billed has any office set up a set rate for these?
Thanks, Desiree

 

[nielynco]

Hello,
We are just starting to offer in office service of elective termination via Mifepristone and Miso. I see Codes S0190 and S0191, and I imagine the diagnosis Z33.2 will have to be on these. We will bill this as E/M visit so my question is, if the patient doesn't want parents to know about this, can we put Z31.69 Encounter for other general counseling and advice on procreation. I imagine they will discuss birth control going forward..so that or the Z30.0 Encounter for general counseling and advice on contraception.
Does anyone know if the EOB would show the meds given and diagnosis for the pills? I haven't dealt with this at all.
Then, if self pay/don't want insurance billed has any office set up a set rate for these?
Thanks, Desiree

First you have to know your State regulations about health care to minors if this is the case. If she is of the age of consent and is paying for the procedure herself you can simply bill the procedure. If she is a minor, you MUST check your state regulations first. You bill for the services provided whether to insurance or to the patient based on your usual charges. The S codes are used by the BCBS program and as such do not have any relative values assigned to them, but should be priced based on your cost in providing the drugs if you bill these codes and provide the drugs. If the drugs are administered you are doing an abortion procedure, not general counseling. Despite her not wanting her parents to know, you must bill correctly for what was done and why. Your only option is to be able to classify this visit as confidential, but if it goes to the family insurance, the insurance company will know the details and the family will get an EOB with the codes.