Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > OB/GYN
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 03-26-2009, 07:07 AM
mm0105 mm0105 is offline
Contributor
 
Join Date: Apr 2007
Location: Danville, PA
Posts: 12
mm0105 is on a distinguished road
Default Dx code for depo provera shot

Hello. I just recently came across a problem when billing depo provera injections. I know that the code changed from 90772 to 96372, however the problem that i am encountering is the diagnosis code. Previously i was using v25.49 but now it is saying that v25.49 is an unacceptable primary dx. What should i be using? Thanks in advance for any help given!
Reply With Quote
  #2  
Old 03-26-2009, 07:40 AM
Lisa Bledsoe Lisa Bledsoe is offline
True Blue
 
Join Date: Apr 2007
Location: Greeley, Colorado
Posts: 2,043
Lisa Bledsoe is on a distinguished road
Question

Who is telling you that V25.49 is not an acceptable primary diagnosis? It most certainly is!
__________________
Lisa Bledsoe, CPC, CPMA
Reply With Quote
  #3  
Old 03-26-2009, 07:50 AM
mm0105 mm0105 is offline
Contributor
 
Join Date: Apr 2007
Location: Danville, PA
Posts: 12
mm0105 is on a distinguished road
Default

Medicaid is not accepting it (that's the only one I've had a problem with so far!) and I checked it on EncoderPro and they also say it is not an acceptable principal dx.
Reply With Quote
  #4  
Old 03-26-2009, 07:53 AM
dmaec's Avatar
dmaec dmaec is offline
True Blue
 
Join Date: Apr 2007
Location: Duluth, Minnesota
Posts: 1,134
dmaec is on a distinguished road
Default

that's odd the encoder would say that... the Vcode table in the ICD-9 books shows that V25.XX codes can be 1st or additional dx's. Page 19, 2009 ICD-9-CM .. print it and show it to them!

we haven't had an issue with payment (but I'm going to double check with the patiente account reps today just to be sure)!
__________________
Donna, CPC, CPC-H
Reply With Quote
  #5  
Old 03-26-2009, 08:21 AM
Lisa Bledsoe Lisa Bledsoe is offline
True Blue
 
Join Date: Apr 2007
Location: Greeley, Colorado
Posts: 2,043
Lisa Bledsoe is on a distinguished road
Default

Although encoder pro is a great product, it is not always accurate. Stick to the ICD-9 manual. I am also going to check with our Medicaid rep to see what she knows about this issue.
__________________
Lisa Bledsoe, CPC, CPMA
Reply With Quote
  #6  
Old 03-26-2009, 09:09 AM
mm0105 mm0105 is offline
Contributor
 
Join Date: Apr 2007
Location: Danville, PA
Posts: 12
mm0105 is on a distinguished road
Default

Ok - THANK YOU!!
Reply With Quote
  #7  
Old 03-26-2009, 09:56 AM
Lisa Bledsoe Lisa Bledsoe is offline
True Blue
 
Join Date: Apr 2007
Location: Greeley, Colorado
Posts: 2,043
Lisa Bledsoe is on a distinguished road
Default

I'm in Colorado. According to the rep that handles Medicaid in our office, Medicaid does not deny for V25.49, but does deny at times due to "other rules" (she did not elaborate). But the dx is not an issue for us. Good luck!
__________________
Lisa Bledsoe, CPC, CPMA
Reply With Quote
  #8  
Old 03-26-2009, 10:03 AM
RebeccaWoodward* RebeccaWoodward* is offline
True Blue
 
Join Date: Apr 2007
Location: North Carolina
Posts: 3,129
RebeccaWoodward* will become famous soon enough
Default

Our Medicaid carrier requires the family planning code V25.0- v25.09
Reply With Quote
  #9  
Old 03-26-2009, 11:42 AM
LOVE2CODE LOVE2CODE is offline
Expert
 
Join Date: Apr 2007
Location: Alexandria, VA
Posts: 323
LOVE2CODE is on a distinguished road
Smile

Quote:
Originally Posted by mm0105 View Post
Hello. I just recently came across a problem when billing depo provera injections. I know that the code changed from 90772 to 96372, however the problem that i am encountering is the diagnosis code. Previously i was using v25.49 but now it is saying that v25.49 is an unacceptable primary dx. What should i be using? Thanks in advance for any help given!
We use V25.09 and have no problem w/reimbursement.
__________________

Yolanda T. Haskins CPC, CMCO
Alexandria VA Local Chapter
Past President 2012 ~ 2013
Past Member Development Officer 2010 ~ 2011
Reply With Quote
  #10  
Old 03-26-2009, 02:18 PM
jillmtom jillmtom is offline
Guru
 
Join Date: Apr 2007
Location: Mesa, AZ
Posts: 103
jillmtom is on a distinguished road
Smile

Hello:

Keep in mind that if you use J1055 Injection, medroxyprogesterone acetate for contraceptive use, 150 mg; the V-code for contraceptive use is correct, however;

the J1051 Injection, medroxyprogesterone acetate, 50 mg; (also depo provera but a lower dose) is not for contraceptive use. It's used as a treatment instead of contraceptive management.
__________________
Jill Tom, CPC, CPC-H, CPC-I, PCS
East Valley Kachina Coders
East Valley Mesa, AZ AAPC Local Chapter
President 2011
President-Elect 2010
New Member Development Officer 2009
jillmtom@yahoo.com
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 12:22 PM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC