Wiki FQHC - Depo Provera and E&M

[dhartnettsmith]

I am looking for clarification on billing for an Office Visit and Depo Provera injection on the same day.

I know that you can bill the OV, drug and injection for a New Patient when all elements of the E&M are met or even for an Existing Patient when they are being seen for Birth Control Counseling. However, I do not believe you can bill an OV for the follow-up injections (this drug is administered every 3 months). So after the New Patient and/or initial birth control Counseling visit, all additional visits would be billed with the drug and admin code only. Does anyone have information/documentation that states otherwise?

 

[tmartin11]

I am looking for clarification on billing for an Office Visit and Depo Provera injection on the same day.

I know that you can bill the OV, drug and injection for a New Patient when all elements of the E&M are met or even for an Existing Patient when they are being seen for Birth Control Counseling. However, I do not believe you can bill an OV for the follow-up injections (this drug is administered every 3 months). So after the New Patient and/or initial birth control Counseling visit, all additional visits would be billed with the drug and admin code only. Does anyone have information/documentation that states otherwise?

did you ever get any clarification on this? I am currently in the same boat and it is causing such an uproar because the providers are upset they have to see the patients and cant charge the visit.

 

[dhartnettsmith]

did you ever get any clarification on this? I am currently in the same boat and it is causing such an uproar because the providers are upset they have to see the patients and cant charge the visit.

I did. If the patient is only being seen for the injection, you would not be able to bill for the OV. You would bill for the medication and admin codes only.