Wiki J1050/96372 with E/M code?

ELBrock

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Hello! Can someone provide clarification on when it's appropriate to bill an office visit (99202-99215) with a Depo-Provera injection?
From my understanding, the injection, 96372, is already calculated to include some basic evaluation, such as vitals, appearance, etc.
Specifically, my situation is if a patient is late for her Depo-Provera injection (over 1 month late) and she sees the provider, who documents that she encouraged the patient to adhere to scheduled injections, would you consider that as qualifying for an additional E/M code? The provider also documented the last depo-injection, how the patient has been late multiple times in the past, and that she is experiencing spotting (which the provider documents as a normal symptom for this method of BC).
Thank you for your help!
 
Hi, if the provider meets with the patient and documents contraceptive counseling or other issues (different diagnosis besides Z30.42 surv. of injectable contraceptive), then you should be able to bill both the visit and injection. Just be sure to link the diagnosis codes to the correct line and add modifier 25 to the E/M visit.
 
Hello! Can someone provide clarification on when it's appropriate to bill an office visit (99202-99215) with a Depo-Provera injection?
From my understanding, the injection, 96372, is already calculated to include some basic evaluation, such as vitals, appearance, etc.
Specifically, my situation is if a patient is late for her Depo-Provera injection (over 1 month late) and she sees the provider, who documents that she encouraged the patient to adhere to scheduled injections, would you consider that as qualifying for an additional E/M code? The provider also documented the last depo-injection, how the patient has been late multiple times in the past, and that she is experiencing spotting (which the provider documents as a normal symptom for this method of BC).
Thank you for your help!
 
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