Wiki monthly pregnancy test due to acne treatment

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valleycoder

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we have a few patients who are on acne medications that can cause birth defects so our providers are requiring they return to our office monthly for a pregnancy test. the patients dont see a provider but they do see the nurse. i'm trying to see how others are billing for this situation - are you billing a nurse visit or do you just bill for the test?
 
since it is a scheduled test for which there is a code you do not code a 99211. you use the V72.4x for the dx code ans the appropriate test code.
 
Your code sets seem to be incomplete.
V 58.69 is code for long term drug usage and 706.1 is for dermatological condition.
don't you think that we have to report that there was a preg test ordered which is the main encounter every month before continuation of treatment for acne.
As Mitchelle said the specific code for pergnancy test is the main Vcode.
V 58.69 is not primary listed, either.
Moreover your CPT code has to be supported by a pregnancy diagnosis code.
Thanks
 
The V58.69 is the secondary dx listed on this. The reason for the pregnancy test is due to the use of the medication, or "medication monitoring". We bill out our Accutane patients like such:

99214-25-- A major ROS is done as a result of the Accutane tx.
81025

Dx: 706.1, V58.69

This seems to be all encompassing and works for every major payor.

Thanks for your feedback.

Jen Verlinda, CPC
 
Pregnancy test with accutane cpt code 81025

Our provider insists on billing 81025 for pregnancy tests patients bring to office. I disagree. Provider understands test to be for the process of determining pregnancy by "visual color comparison method", even if with the patient's otc test. Please help. I have never heard of this. All in-office pregnancy tests i have seen are done with the office's supplies, not the patient's. The provider's rational is that of a patient bringing his own meds and our charging the admin. Fee. Again, i disagree. I think this is very different. Any thoughts?
 
I agree

We had the same thing happen. From a coding standpoint, CPT Codes are defined by the work/service/procedure performed by the Provider. If we did not hand the test to the patient, from our own purchased supplies, and review results, then we do not bill it out. As for the injections, he is correct. If a patient brings the medication but we "perform the service" of administering the injection, then we bill for those codes. But how we would even know when the patient took the test and if she was the one who did it. (not saying that in a bad way, but the documentation would not be accurate, that's all. No offense.)
 
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